Out in the cold: lung disease, the hidden driver of NHS winter pressure

Our report, Out in the cold, lays bare the steep rise in lung disease admissions to hospitals in recent years.

Out in the cold cover page

The report warns that a failure to address a predictable and obvious seasonal variation in respiratory admissions is at the heart of our A&E winter crisis. It's potentially causing patients needless harm.

Read the full report (PDF, 1.6MB)

Our analysis reveals that this annual fluctuation has consistently repeated over the last 7 years. Yet many hospitals have failed to adapt their services to cope with the surge in respiratory admissions.

Key findings

  • In 2016/17, respiratory admissions peaked in December at 32,492 – far above the average of 10,652 for the 20 most commons disease areas.
  • There are 80% more lung disease admissions in the winter months of December, January and February then there are in the warmer spring months of March, April and May.
  • Only 10 in 104 hospital trusts who responded to our requests for information on their 2017/18 winter plans said they were going to give more beds to people admitted for lung conditions.
  • The vast majority of respiratory admissions are in infants and children aged 1 to 4 (17%), and people aged 65 and above (54%).
  • Over the last 7 years lung disease admissions to hospital have risen at over three times the rate of all other conditions (36.6% vs 11.1%).

Key recommendations

  • Improve our prevention strategy, to reduce general respiratory infections and help people who have an existing lung condition to better manage it themselves. This includes ensuring people get the flu jab and take part in pulmonary rehabilitation.
  • Strengthen community care and support outside of hospital, so patients are confident that they do not need to go to emergency departments to get the care they need.
  • Acknowledge the growing number of unavoidable respiratory admissions in winter, and adapt our hospital services to address this seasonality.
  • Ensure that people leaving hospital are given consistent and reliable assessment, treatment and follow up in the community to reduce the risk that they’ll need to be readmitted to hospital.
  • In the long term, we need a more strategic approach to improving the care and outcomes for the millions of people who have been diagnosed with a lung condition in England. We have established a Taskforce for Lung Health to produce a new 5-year strategy.

Read the full report (PDF, 1.6MB)