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Health: Asthma

I hope that I will come to that. We have also been developing a national strategy to improve the care and management of chronic obstructive pulmonary disease. We aim to publish this early next year. The strategy will include raising awareness of good lung health, accurate and early diagnosis, the proactive management of patients and the development of respiratory networks at both the national and the local levels. As we develop the strategy, we will be keen to highlight the areas in which lung health can be improved and specifically where improvement can be made to other respiratory conditions, particularly asthma. Officials are meeting the chief executive of Asthma UK shortly to discuss this further. The other key to the management of asthma is appropriate support for those in the community. This approach to the management of all long-term conditions was reaffirmed in High Quality Care for All, the recent review of the NHS carried out by my noble friend Lord Darzi. The review makes a commitment to ensure that practitioners have the necessary skills to provide effective care. For those professionals working in the field of asthma, this will build on the excellent programmes run for many years by the National Respiratory Training Centre. High Quality Care for All also sets out ambitious plans to offer personalised care plans to everyone with a long-term condition and to drive improvements in both primary and community-based services. These ambitions have been reflected in local plans developed in every strategic health authority in England. We think that the best way for service providers to achieve the proactive management of long-term conditions such as asthma is through personalised, tailored packages of care with more regular review. To support this, we have developed disease management information toolkits to inform decision-making at both the regional and the local levels. The use of the toolkits helps to build up intelligence across health and social care by providing key data and guidance for every primary care trust in England. The toolkits support decision-makers, commissioners and front-line providers in gaining a better understanding of those long-term conditions that are having the greatest impact on local health populations in terms of the use of emergency day beds and other healthcare resources. We know that self-care is absolutely vital, as several noble Lords said. Asthma was one of the first conditions to be included in the NHS Choices series of guides. The guides focus on advice about lifestyle, information about conditions and the treatments for them, and advice and support on living with a condition. In addition, we are making further investment in the Expert Patients programme to increase the capacity of course places available to offer patients from 12,000 to 100,000 a year by 2012. On the specific questions raised by noble Lords, the noble Viscount, Lord Simon, and the noble Baroness, Lady Tonge, both mentioned the importance of dealing with children with asthma. In September 2004, the National Service Framework for Children, Young People and Maternity Services publication included an exemplar patient journey on asthma, which I know Asthma UK has made a priority. I did some work with this organisation many years ago and indeed we were addressing the issue when I was talking to its representatives about how to get this into the hands of every teacher in the country. I am glad to see that progress has been made, because the patient journey on asthma in childhood exemplar forms part of the framework and its implementation is key. The noble Baroness, Lady Tonge, the noble Viscount, Lord Simon, and others mentioned a national framework. Following on from the NHS next-stage review, the Department of Health is developing the COPD clinical strategy with NICE. The COPD programme board is considering including a chapter on asthma in the clinical strategy. We will meet Asthma UK soon to talk about what can be done on asthma in the COPD strategy. My noble friend Lord Darzi’s report High Quality Care for All recommended the setting-up of a national quality board, the responsibilities of which would include deciding priorities for new work in the future on specific clinical conditions. We expect to consider the case for an asthma strategy over other candidates. The noble Lord, Lord Colwyn, and others raised the issue of health professionals being trained in the treatment of asthma. We will introduce modularised—a terrible word—accredited training packages and we will strengthen educational governance to ensure that all clinical staff have the opportunity to develop their skills throughout their careers. We regard asthma and chronic conditions as an important part of that. The noble Lord, Lord Colwyn, and the noble Earl, Lord Howe, both mentioned allergies and allergic disease. The research at Guy’s and St Thomas’s will focus on a prevention that includes allergic aspects. Diagnostic investigation to support that focus, including allergic aspects, is outlined in the 18-week breathlessness pathway, which includes specialist bronchial challenge tests and a pathway test for immune function. The north-west SHA is taking forward this work in looking at improving allergy services, as has been mentioned. The noble Lord, Lord Colwyn, asked how we record asthma admissions to make it easier to monitor them. We record asthma admissions and finished consultant episodes associated with asthma in the hospital episode statistics, which are provided at all levels. The noble Baroness, Lady Tonge, mentioned the training of nurses in the community. In addition to the proposals outlined in A High Quality Workforce for all health professionals, Modernising Nursing Careers focuses on developing fit-for-purpose education on long-term conditions. I shall deal with the other questions in writing, as I am conscious that my time is nearly up. Should we be worried about inoculating young babies with the DTP vaccine? We urge parents not to leave their children vulnerable to those serious illnesses because of an unproven claim that there is an extra risk. There is no substantive evidence, as far as the department is concerned, that the DTP inoculation puts babies at greater risk of asthma. I say to the noble Baroness, Lady Tonge, that an assessment will need to be designed by the Care Quality Commission as part of the development of the independent performance assessment of providers and the effectiveness of PCT commissioning. We are quite familiar with that, as I recall. I thank noble Lords for the many points that they have raised. There is no doubt that long-term conditions such as asthma present a massive challenge to health and social care, as well as to families and communities. I assure noble Lords that we will continue to support and encourage the NHS to ensure that people with asthma receive the care that they deserve. [The Sitting was suspended from 3.53 to 4 pm.]