Respiratory Disease (COPD and Asthma)

The World Health Organisation defines respiratory diseases as “diseases that affect the air passages, including the nasal passages, the bronchi and the lungs. They range from acute infections, such as pneumonia and bronchitis, to chronic conditions such as asthma and chronic obstructive pulmonary disease”.

Chronic Obstructive Pulmonary Disease (COPD) is the fifth biggest killer disease in the UK, killing approximately 25,000 people a year in England. Premature mortality from COPD in the UK is almost twice as high as the European average (EU-15).


Premature mortality for asthma in the UK is over 1.5 times higher than the European average (EU-15). Evidence shows asthma has become more common over the last 30 years possibly as a result of our changing lifestyles, homes with central heating and fitted carpets with little ventilation and diets with fewer fresh foods.


Knowsley CCG spends around £17 million in 2013/2014 on problems of the respiratory system, the majority of which is split between secondary care non-elective activity (£ 7.5 million) and primary care prescribing and pharmaceutical services (£4 million), the remainder (£5.5 million) being spent on elective inpatient and outpatient care. In terms of COPD and conditions relating to COPD the spend within secondary care on emergency admissions was approx. £4.2 million (56% of the £7.5m spent on secondary care non-elective activity).

In 2013/14 NHS Knowsley CCG spent £1.765 million treating and caring for people with asthma.


Across Knowsley there is a wide variation on mortality rates for respiratory diseases with the most deprived areas of the borough having double the mortality rates compared to the least deprived areas. Historically COPD detection rates have been lower in these more deprived areas.

For 2013/14 GP reported COPD prevalence ( the number of people who appear on GP registers with a diagnosis of COPD compared to the total GP practice population) in Knowsley is over double the England rate with approximately 3.5% of the registered population (5,558 people) compared with the England rate of 1.8%. Prevalence of asthma in Knowsley is, however, below national levels (5.4% in Knowsley compared to 5.9% nationally).


Knowsley had the 6th highest mortality rate due to respiratory disease in England out of 326 local authority areas between 2011 and 2013. Premature female mortality from respiratory disease was 46.0 deaths per 100,000 population in 2011-13, a decrease of 27% in the 10 years since 2001-03. For males, premature mortality was 72.2 deaths per 100,000 population, representing no real change since 2001-03.


In 2013 Knowsley had the 7th highest premature COPD mortality rate in England, out of 326 local authorities. Premature female mortality from COPD was 32.9 deaths per 100,000 females in 2011-13, a decrease of 11% since 2001-03. Premature male COPD mortality was slightly higher at 37.4 deaths per 100,000 males in the same period, however this represented a reduction of 15% over the previous 10 years.


The full JSNA report can be accessed here: JSNA Report Respiratory