Children with asthma could be at risk of unnecessary emergency hospital admissions due to a lack of testing, a charity has warned.

Asthma and Lung UK said that a first-line diagnostic test for asthma is children is not being routinely used in GP surgeries. It warned the NHS in England is “in the dark on childhood asthma” as a result.

The National Institute for Health and Care Excellence (NICE) recommends that children over the age of 5 with a “suggestive history of asthma” should be tested using the fractional exhaled nitric oxide (FeNO) test as a first-line diagnostic tool. The test measures the level of nitric oxide in the breath. A high level indicates that a person’s airways are inflamed, which could be a sign they have asthma.

But new data obtained by Asthma and Lung UK suggest that a significant proportion of health bodies are not commissioning FeNO for the diagnosis of children.

Using Freedom of Information requests, it asked regional health authorities whether FeNO is routinely commissioned in GP surgeries across each region. Of 42 local health bodies surveyed, 59% of those which responded (22 of 37) reported that they did not commission FeNO testing in primary care for children to the extent that the whole region is covered.

Only seven regional services were confident they had the capacity to manage both new diagnostic referrals and existing testing backlogs, the charity said.

Postcode Lottery in Diagnosis 

“A child’s access to timely and accurate asthma diagnosis should not depend on where they live,” said Dr Matt Swallow, clinical lead at Asthma and Lung UK. “The fact that some children must also contend with long waits or limited access to diagnostic testing simply because of their postcode is unacceptable.

“With the right diagnosis, treatment and support, asthma should be manageable and have a minimal effect on a child’s life. But without sufficient diagnostic capacity, many children risk being missed altogether, leaving them vulnerable to serious asthma attacks, avoidable emergency hospital visits and unnecessary distress for both them and their families.”

He added: “On the frontline in primary care, we do all we can to keep children with asthma safe and out of hospital; but without the tools to provide an accurate diagnosis, we are already on the backfoot.”

Sarah Sleet, chief executive of the charity, added: “Huge parts of the NHS in England are in the dark on childhood asthma as many areas either don’t commission enough testing to cover their patch, or don’t commission enough to meet demand.

“Without urgent action on children’s asthma care, the government’s own ambition to create the healthiest generation is at risk.”

NHS England has been approached for comment.