• respiratory
• paediatric practice

As we enter a new decade, we must step up our efforts to improve outcomes for children with asthma in the UK. The levels of avoidable morbidity and mortality are unacceptable: among children in the UK with asthma, acute attacks cause 80 hospital admissions per day and 20 deaths per year.1 2 These outcomes are among the worst in high-income countries worldwide.3 Within the UK, health inequalities in childhood asthma are stark, with admission rates nearly 20 times higher in some areas than others. There is growing evidence that early-life insults to the developing lung increase the likelihood of airway damage through the life course, which is associated with premature death. It is welcome, given the current and future risks to children, that the NHS Long Term Plan refers to childhood asthma as an urgent national priority.4

Various factors must be addressed, in parallel. Socioeconomic factors, which in parts of the country are worsening, are now consistently implicated as drivers for both the development of asthma and subsequent poor control. Our models of healthcare are disjointed and disempowering: we need seamless, integrated, proactive models of care that stop children with uncontrolled asthma falling through the cracks and presenting at times of crisis. There is a complacency around paediatric asthma.5 This is completely at odds with the enthusiasm to improve outcomes in sepsis and child abuse, both of which were appropriately driven by avoidable deaths. The factor in our hands, as healthcare professionals looking after children and young people (CYP) with asthma, is the quality of the care we give. In this paper, we describe how the current national …