Brent has a higher rate of childhood asthma admissions than the London average, with particular concerns for children from Black ethnic groups and those living in the most deprived areas.
Data presented to Brent's Community and Wellbeing Scrutiny Committee revealed that Brent's childhood asthma admission rate is significantly higher than the national rate, and double the London average. The gap between Brent and the London average has widened over the past four years.
Dr Ruth Duplicy, Director of Public Health, highlighted that while there has been a 20% decrease in childhood asthma admissions and a 28% decrease in A&E attendances for asthma in Brent in the last year, the problem remains a significant concern. However, concerns were raised regarding the consistency of data presented on admission rates. Councillor Chadda pointed out discrepancies where different sections of the report stated varying percentage decreases in admissions, with explanations attributing these to different methods of defining an asthma-related admission. The most accurate figure, a 28% reduction, included conditions likely to be asthma but not definitively coded as such by hospitals. Councillor Clinton also questioned the high ED admissions figure compared to the total number of children with asthma in Brent, highlighting a need for clarity on data measurement periods.
Several risk factors contributing to childhood asthma were identified, including air pollution, damp and mould in housing, overcrowding, and lower vaccination rates. Brent has higher levels of overcrowding than the London average and is among the top three most overcrowded boroughs in the capital. Damp is also more prevalent in social housing.
Despite these challenges, significant progress has been made through a multi-agency approach. The Childhood Asthma Local Enhanced Service (LES) has seen a 56.5% increase in new asthma diagnoses.
The Brent Health Matters Children and Young People (BHM CYP) Asthma Programme is actively working to reduce inequalities through community outreach and the development of multilingual resources. This programme is specifically designed to reach children in the most deprived areas by delivering culturally appropriate asthma education and myth-busting at community events. Asthma community coaches, who are trusted community members, are also being trained. The programme has developed multilingual resources and a dedicated link worker assists families with unmet social needs identified during health checks. Healthy Child Clinics, a key part of the case-finding approach, specifically targeted one-third of all children in Brent's most deprived 20% of neighbourhoods. Furthermore, the #AskAboutAsthma campaign supports local priorities to reduce inequalities, improve diagnosis, and strengthen self-management by bringing together schools, primary care, community organisations, and healthcare providers. Specific outreach is being done in neighbourhoods to focus on particular demographic groups, utilising community champions from those demographics to raise awareness and encourage earlier treatment. There is also closer working with primary care to support engagement where families may not be engaging effectively.
The Asthma Nurse Specialist (ANS) service, though currently a 0.9 WTE post, has seen a 66% increase in referrals following pathway redesign and the removal of restrictive referral criteria. The service is also working to improve accessibility by accepting all A&E notifications and parent self-referrals, and by rescheduling clinic sessions to later in the day and after school hours to reduce educational disruption. CLCH NHS Trust is exploring alternative delivery models through the children's community nursing teams to provide year-round cover. As referrals increase, the plan is to present data to the ICB to discuss the needs and potential for extra funding. The service is part of a wider system-wide team of asthma specialists, including nurses within GP practices and another specialist nurse at Northwick Park Hospital.
Schools are also being engaged through the Asthma Friendly Schools Programme, with a significant number achieving accreditation or working towards it. There was also discussion about the need for more targeted work in schools, particularly in areas like Harlesden, and the potential for notifying schools during high air pollution alerts.
To further support early and accurate diagnosis, a FeNO machine has been purchased for community-based assessments. The BHM CYP Asthma Programme also aims to strengthen monitoring and medication adherence and enable asthma health checks at community events. The #AskAboutAsthma campaign supports local priorities to reduce inequalities, improve diagnosis, and strengthen self-management, bringing together schools, primary care, community organisations and healthcare providers.
For more detailed data on childhood asthma in Brent, refer to the Childhood Asthma Report Data Pack 2026.
The full public reports pack for the Community and Wellbeing Scrutiny Committee meeting can be found here.
The agenda frontsheet for the meeting is available here.
