Asthma + Lung UK Cymru are urging the new Welsh Government to take urgent action to improve basic asthma care to help reduce the number of children being hospitalised.
In February last year Asthma + Lung UK Cymru highlighted data from the National Respiratory Audit Programme (NRAP) Wales primary care audit report 2021-23, which revealed significant failings in children’s asthma care led to unnecessary hospitalisations.
With the publication of the new NRAP Wales primary care audit report 2023-25, the charity can reveal that little has changed, and targets are still being missed.
The number of emergency asthma admissions for children in 2024/25 was 957. While that is down from a three year high of 1110 in 2023/24, Asthma + Lung UK Cymru says this number is still far too many.
The charity points to the National Review of Asthma Deaths published in 2014, which stated that a major cause of asthma deaths was the lack of adequate basic care.
The NRAP Wales primary care clinical audit report gathers data from 371 GP practices covering the period 1 August 2023 to 31 July 2025. It finds:
- Less than one in four (24%) children received a personalised asthma action plan in the past 15 months. Little change from 2021-23.
- Less than half (47%) of children with asthma had a record of any objective measurement in the last 2 years, which is vital to confirm an asthma diagnosis and assess how well the child’s asthma is controlled . This has increased from 40% in 2021-23.
The charity points out that that asthma action plans are essential for ensuring the safety of children with asthma and should be provided during their annual asthma review. These plans help parents stay informed about any changes in their child’s condition and offer clear guidance on managing symptoms. They also serve as a vital resource for teachers and carers, ensuring everyone involved in the child’s care knows how to respond in an emergency.
Although hospitalisations are slightly down from the previous assessment, the charity has branded the lack of significant progress as “unacceptable.” They warn that poor basic care continues to lead to asthma attacks and hospitalisations, causing misery for children and parents across Wales, as well as unnecessary pressures on the NHS.
In Wales, there are over 40,000 children living with asthma.
Joseph Carter, Head of Asthma + Lung UK Cymru said:
“Although the new government’s ambition to end child poverty is welcome, they have made no commitment to ensuring that children living with chronic health conditions get the care they deserve.
“We’re therefore calling on the new Welsh Government to urgently review the findings of the latest NRAP report and implement necessary improvements in children’s asthma care.
“Nearly a thousand children every year end up in hospital due to an asthma attack or related emergency, showing that families are not being provided the knowledge they need to manage asthma effectively. Yet, with early diagnosis and clinical support, youngsters with asthma should be able to live normal lives.
“It has been two years since the findings of the last audit on asthma care for children in Wales were published, and even though there has been a slight improvement, fundamentally little has changed. This lack of real action is worrying and frankly unacceptable.
“Children’s asthma care needs to be at the top of the new Welsh Government’s health agenda, helping to save lives and reduce emergency hospital admissions.”
Asthma + Lung UK Cymru point to the positive impact on children and families who receive the asthma care they need.
Alice from Pembroke Dock, has a four-year-old son, Sam, who has been diagnosed with viral wheeze (children aren’t officially given a diagnosis of asthma until they are over 5). She said:
“Sam has had episodes of wheezing since he was a baby. As an infant he was admitted to hospital several times with respiratory illnesses, including COVID-19 and RSV, which was extremely worrying and he has used a reliever inhaler since he was around five or six months old.
“Because Sam’s wheeze occurs with a range of triggers, not just viral infections, and because he has responded so well to treatment with an inhaled corticosteroid (preventer inhaler), his healthcare team is managing him as having suspected asthma. However, I understand that diagnosing asthma in children under five can be difficult, and many children with preschool wheeze do not go on to develop asthma. As Sam gets older, he will have further assessment and, if needed, additional tests to help confirm the diagnosis.
“Sam has started school and is loving it. It is great that his school is very asthma aware and has a personalised asthma plan in place. The plan has been discussed fully with teaching staff, and a spare inhaler is kept at school at all times.
“In 2025, when Sam was three years old, he needed six courses of oral steroids because his wheezing episodes kept getting worse. Thankfully, his GP recognised that he needed a more structured approach and put him on a proper management plan, including a preventer inhaler twice a day. It took some time to find the right dose – he initially needed two puffs twice daily and now only uses one puff twice daily – but it has been a game changer. Since starting regular preventer treatment, Sam’s symptoms have been much better controlled, and he has not needed to return to hospital with breathing problems since January.
“Having a clear diagnosis pathway, regular reviews and an effective management plan have made a huge difference to Sam and our family, helping him stay well, enjoy school and take part in everyday activities like other children his age.”
