Let down by the system?

Neil Churchill - Chief Executive

Tagged: Peak flow, Smoking, Allergy, NHS, National Service Framework

In my last blog I complained about having to take time off work to get a flu jab. I also didn’t want to spend £15 that Boots were asking for the same service, when it would have been free on the NHS. In the end I bit the bullet, followed the advice of the Asthma UK Adviceline, took a morning off work and got my vaccination.

What I didn’t expect was the quality of the check-up I received. In the past I have been in and out of the nurse’s office in less than 20 seconds. This time, I got a proper check-up. Asthma control questions, blood pressure test, was I smoking? The works.

Unbelievably this was the first time since my asthma diagnosis many years ago that I was given a peak flow test (previous changes in medication have been made entirely on my answers to the doctor’s questions), all of which was prompted by a new computer system the GP practice has put in place. However, this made it all the more surprising that the nurse did not ask me any questions about allergy - especially as over the past year my asthma has been OK, but my allergies have sometimes played havoc.

It all made me think that the NHS is often great one-on-one; when you meet a doctor or a nurse the quality of care can be hard to fault. But at times you have to wonder if there is any 'system' behind it. I left assuming that GPs are incentivised to check my blood pressure but not my allergy, making it some way to go before the NHS can provide a genuinely patient-centred experience.

Which brings me back to work. Over the year ahead, Asthma UK wants to describe what we think a good asthma service should look like. We are having to do this because the Government has refused to do so (through what they call a National Service Framework). What do you think goes to make a good asthma service? Are there examples of good practice you can share? Or any bad examples to avoid? Let us know!

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ClaireOB

25 January 08
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Thanks for this information, will let you know what response I receive.

neil

24 January 08
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The government say that asthma is not a big enough problem, so can be left to local discretion. However, we know that children are 10 times more likely to have an emergency hospital admission for their asthma in some parts of the country than others. For adults there is a four-fold difference. And this is only one part of the problem: people tell us their treatment varies according to which GP they see too, and many people still tell us they don't get prompt access to a specialist when they need one. We believe this shows that primary care can be improved and needs to be, and a National Service Framework would really help. If you write to your MP, let us know what response you get!

ClaireOB

22 January 08
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"...If you want to help, you could contact your MP and ask them to raise the issue. We’d be more than happy to help you with this. Neil" I shall certainly do this (actually, have done before & MP was helpful). Was a specific reason given for the refusal to draw up a NSF for asthma?

neil

11 January 08
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A National Service Framework is a strategy for improving a particular service, usually for a health condition. The government did one for cancer and diabetes and is doing one now for COPD. You can find out about them on the DH website: www.dh.gov.uk. But they refuse to do so for asthma. And we have asked - in meetings with ministers and in letters to them. Despite the fact that there are 10 times as many hospital admissions in some areas than in others. We think this lets people down in those areas with the worst figures. But we are obviously not making enough noise. It's different if you live in Scotland, Wales and Northern Ireland, where they are taking asthma more seriously. If you want to help, you could contact your MP and ask them to raise the issue. We’d be more than happy to help you with this. Neil

Becks

10 January 08
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Quote: Over the year ahead, Asthma UK wants to describe what we think a good asthma service should look like. We are having to do this because the Government has refused to do so (through what they call a National Service Framework). I was hoping you could tell me how the Government has refused to do this and/or where can I find more information regarding this? Thanks!

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