Introduction

Asthma is a common lung condition that causes occasional breathing difficulties. It affects people of all ages and often starts in childhood, although it can also develop for the first time in adults. There's currently no cure, but there are simple treatments that can help keep the symptoms under control so it does not have a big impact on your life.

The main symptoms of asthma are:

• a whistling sound when breathing (wheezing)
• breathlessness
• a tight chest, which may feel like a band is tightening around it
• coughing

Asthma is caused by swelling (inflammation) of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow. It may happen randomly or after exposure to a trigger.

Common asthma triggers include:

• allergies (to house dust mites, animals or pollen, for example)
• smoke, pollution and cold air
• exercise
• infections like colds or flu

The symptoms can sometimes get temporarily worse. This is known as an asthma attack [1].

Worldwide, asthma affected an estimated 262 million people in 2019 and caused 455 000 deaths [2].

Data Overview

Prevalence

The below prevalence data is defined as the percentage of patients aged 6 yrs and older with asthma, excluding those who have been prescribed no asthma-related drugs in the previous twelve months, as recorded on practice disease registers from all registered patients aged 6 yrs and older. Oldham's latest asthma prevalence of 7.2% is higher than the national average of 6.5% and similar to the regional average of 7.1%. Rates have remained fairly stable across all areas since 2020/21. Oldham ranks 5th lowest across Greater Manchester and 6th highest across NHS England nearest neighbours. The Duru Practice has the lowest prevalence at 4.6%. Leesbrook Surgery has the highest prevalence at almost double this rate at 8.8%.

Figure 1: Asthma QOF prevalence (6+ years) trend
Source: NHS England

Figure 2: Asthma QOF prevalence (6+ years) across Greater Manchester
Source: NHS England

Figure 3: Asthma QOF prevalence (6+ years) by Oldham GP practice
Source: NHS England

Emergency Hospital Admissions

Understanding local trends of emergency admissions of children and young people with long term conditions, and benchmarking against geographical and statistical neighbours will support service review and redesign. The following measure represents the number of emergency hospital admissions due to asthma in patients under 19 years old per 100,000. Oldham's latest rate of 319 per 100,000 admissions is significantly higher than both the regional (170 per 100,000) and national (122 per 100,000) averages. In Oldham for 2022/23, this translates to there being 210 admissions. There have been improvements in rates compared to 2013/14, but the reduction in Oldham (-23%) is lower than the improvements seen across the North West (-42%) and England (-38%). Admission rates reduced during 2020/21 for all areas, likely due to Covid-19 restrictions.

Oldham has the second highest rate nationally, only exceeded by neighbouring Local Authority Tameside, who have a rate of 351 per 100,000. Trafford and Wigan are the only Greater Manchester authorities that fall below the national average.

Figure 4: Emergency hospital admissions for asthma (under 19 years) trend
Source: OHID, based on NHS England data

Figure 5: Emergency hospital admissions for asthma (under 19 years) across Greater Manchester
Source: OHID, based on NHS England data

Figure 6: Emergency hospital admissions for asthma (under 19 years) across NHS England nearest neighbours
Source: OHID, based on NHS England data

Figure 7: Emergency hospital admissions for asthma (under 19 years) by Oldham GP practice
Source: OHID, based on NHS England data

Although the rate of admissions for adults in Oldham is higher than regional and national averages, the rates are not as dramatically higher as with the children's data. Oldham's latest rate of 88 per 100,000 is slightly higher than the regional rate of 85 per 100,000 and significantly higher than the England rate of 72 per 100,000. For Oldham in 2022/23, this translates to 170 admissions. Similarly to the data for under 19s, the admissions in adults reduced significantly during 2020/21 for all areas and have been on an increasing trend since. The admission rate for adults has not returned to pre-pandemic levels. Oldham's latest rate is 5th highest across Greater Manchester. Please note that the children's admissions data is based on the resident population of Oldham, whilst the data for adults is based on the GP registered population.

Figure 8: Emergency hospital admissions for asthma (aged 19 years and over) trend
Source: OHID, based on NHS England data

Figure 9: Emergency hospital admissions for asthma (aged 19 years and over) across Greater Manchester
Source: OHID, based on NHS England data

Mortality

Every asthma death represents a failure of management of a reversible condition. Although advances in treatments, increased research and the development of evidence-based clinical guidelines have contributed to a reduction in deaths from asthma over the past 50 years, mortality rates within the UK are among the highest in Europe, and numbers have tended to increase over recent years although deaths are falling in younger people.

Asthma is a complex disease, and it is not just those with severe asthma who die. The National Review of Asthma Deaths (NRAD) was the first national investigation of asthma deaths in the UK and examined data from a cohort for whom asthma was the cause of death between February 2012 and January 2013. 1 A number of recommendations were made in order to reduce the number of asthma deaths, but there is little evidence of a systematic approach nationally to the implementation of these recommendations. There are still a significant number of deaths from asthma every year [3].

The data below represents Asthma deaths as an age-standardised rate of mortality with asthma recorded as the underlying cause of death in persons of all ages per 100,000 population. Oldham's latest rate of mortality of 2.2 per 100,000 is slightly lower than the national average of 2.4 per 100,000. Previously to this, Oldham's rate had been consistently higher than the national average since 2009/11. It should be noted that due to the small numbers involved in these calculations, any small difference in numbers will lead to a large fluctuation in rates. For the latest 3 year period, this equates to 13 deaths as a result of asthma. Oldham ranks 5th highest across Greater Manchester. Data was not available for Tameside.

Figure 10: Mortality rate from asthma, trend
Source: OHID, based on Office for National Statistics data

Figure 11: Mortality rate from asthma across Greater Manchester
Source: OHID, based on Office for National Statistics data 

Further Information & Resources

NHS Asthma Information
Information for patients from the NHS on asthma symptoms, treatment and care

Asthma + Lung UK
Asthma + Lung UK carry out research, campaigns and provide resources and guidance for a range of respiratory conditions, including Asthma.

WHO Asthma Fact Sheet
World Health Organisation fact sheet on Asthma. WHO is committed to improving the diagnosis, treatment and monitoring of asthma to reduce the global burden of NCDs and make progress towards universal health coverage.

References

[1] NHS Asthma page, https://www.nhs.uk/conditions/asthma/, accessed November 2024
[2] Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-22, accessed via WHO website, November 2024.
[3] OHID Data Profiles, https://fingertips.phe.org.uk/search/asthma#page/6/gid/8000009/pat/15/par/E92000001/ati/66/are/nE38000135/iid/93644/age/1/sex/4/cat/-1/ctp/-1/yrr/3/cid/4/tbm/1/page-options/car-do-0, accessed November 2024