Welcome to Breathe Equal

It is estimated that around 1 million people in the UK have ‘difficult’ asthma and around 200,000 people in the UK have ‘severe’ asthma.¹

People with severe asthma have persistent symptoms that don’t respond to conventional, high dose preventative treatment² and may experience frequent life-threatening asthma attacks and regular hospital admissions.³

The UK has one of the worst mortality rates for asthma in Europe.⁴ For those living with the most severe forms of asthma, underdiagnosis and delayed referral to specialists are contributing to these poor outcomes.⁵

Deprivation is associated with higher rates of mortality from asthma in England – in 2020 the most deprived groups had mortality rates that were more than triple those of the least deprived.⁶

Evidence also shows that asthma patients experience inequalities in outcomes on the basis of their gender,⁷ race,⁸ and socioeconomic status.⁹

Chronic Obstructive Pulmonary Disease (COPD) is a group of lung conditions that cause difficulty breathing due to obstruction or narrowing of the airways.

It is the fifth most common cause of death in the United Kingdom and causes a significant number of hospitalisations, accounting for 133,103 emergency hospital admissions in England in 2019/20¹⁰, making it the second leading cause of emergency admissions.¹¹

As with asthma, there is significant geographic variation in the prevalence of COPD – prevalence of COPD in the 10% most deprived areas of England is estimated to be double that of the most affluent 10%.¹²

To deliver meaningful change that bridges the gaps in equitable access, diagnosis and treatment; addresses the gender disparity of hospitalisation and mortality rates for women; and ensures ethnic minority groups are no longer more likely to be admitted to hospital for respiratory conditions; we recommend the following policy changes:

• A review of existing guidelines, pathways and policies to ensure factors associated with variation in respiratory treatment and outcomes are addressed proactively (including, where appropriate, co-creation with affected groups) 
• The NHS must commit to exploring all available therapies in instances of treatment failure and to end the prescribing of maintenance oral corticosteroids (OCS) as a default treatment.
• A coordinated, national approach to joining up respiratory data from across the health system, with all tiers of NHS provision required to input into a new platform.

Read more about these policy asks in the ‘Our Respiratory Mission’ section below.