Respiratory health

This briefing describes what respiratory conditions are, factors that can affect respiratory health and government activity.

Health policy is devolved. This page provides information relevant to England. Parliamentary material and further reading relate to the United Kingdom.

What are respiratory conditions?

The respiratory system is essential for breathing and includes the nose, throat, larynx, windpipe, lungs and the diaphragm.

Conditions that can affect the respiratory system are wide ranging and can have varying levels of severity. They include:

• asthma, a common lung condition that causes occasional breathing difficulties
• chronic obstructive pulmonary disease, a group of lung conditions that cause breathing difficulties
• cystic fibrosis, an inherited condition that causes sticky mucus to build up in the lungs and digestive system
• lung cancers
• pulmonary fibrosis, a condition when the lungs become scarred and breathing becomes difficult
• respiratory infections, such as flu, covid, respiratory syncytial virus, pneumonia or tuberculosis
• sleep related breathing disorders, such as sleep apnoea when breathing stops and starts during sleep

There can be numerous symptoms of respiratory conditions, such as difficulty breathing or coughing, and they vary depending on the specific condition.

The government said in October 2024 that chronic respiratory diseases are the third biggest contributor to people’s years of life lost in England. It estimated the annual economic cost to the NHS of asthma and chronic obstructive pulmonary disease to be £3 billion and £1.9 billion, respectively. The government estimated lung conditions to directly cost the NHS in the UK £11 billion annually.

Factors that can affect respiratory health

Air quality

Reports from the Parliamentary Office of Science and Technology (POST) highlight strong evidence that certain individual pollutants and poor indoor and outdoor air quality can worsen some existing respiratory illnesses, such as asthma and chronic obstructive pulmonary disease.

Lord Darzi’s final report on the independent investigation into the NHS highlighted links between clean air improving respiratory health and urged the government to keep its climate ambitions. It said (p95):

Given the global health imperatives, the NHS must stick to its net zero ambitions. There is no trade-off between climate responsibilities and reducing waiting lists. Indeed, often health and climate are mutually reinforcing goals: cleaner air is good for the environment and good for respiratory health.

Cold weather

Many respiratory diseases and lung conditions can be caused or worsened by cold weather. Winter typically sees higher incidence of illnesses such as flu, noroviruses and pneumonia this can worsen pressures and capacity issues in the NHS. For example, NHS England reported that the number of people in hospital with flu at the end of December 2023 (an average of 648 patients per day in the week of the 21 December) was four times the figure at the end of November 2023 (160 in the week of 26 November).

A report published in September 2024 by the British Medical Association highlighted various measures to reduce the impact of respiratory illnesses on NHS pressures over winter 2024, including:

• making sure frontline staff have access to sufficient and appropriate respiratory protective equipment
• promoting responsible public health policies, such as vaccine uptake and public messaging and education of the risk of covid
• improved ventilation

Smoking

Smoking can worsen respiratory health. Data from NHS digital reports that in 2022/2023, 16% of all hospital admissions for respiratory diseases in people aged 35 and over were estimated to be attributed to smoking. The Library briefing on smoking statistics contains more statistics.

Occupational chemicals and particles

Certain jobs, such as those who work in manufacturing, baking and agriculture, put people at repeated long-term exposure to chemicals and particles that can cause lung problems. For example, the Health and Safety Executive, the national regulator for workplace health and safety, lists jobs with the highest rates of asthma caused or worsened by work environments to include bakers, vehicle spray painters and solderers.

Deprivation

Disadvantaged groups and areas of social deprivation can face higher risks of respiratory disease. Various reports have highlighted how more deprived communities have higher incidence of smoking rates, exposure to higher levels or air pollution, poor housing conditions and exposure to occupational chemicals and dust.

Government activity

The 2019 NHS Long Term Plan has various milestones related to respiratory health, including goals to make England a “smoke-free society”, reducing air pollution, extending health checks for lung cancer risks  and improving treatment and support for those with respiratory disease.

In May 2022, the government published guidance on respiratory disease prevention for healthcare professionals.

The Department of Health and Social Care published its Major conditions strategy: case for change and our strategic framework in August 2023, which covers six conditions (respiratory diseases, cancer, heart disease, musculoskeletal disorders, mental ill-health and dementia). A final major conditions strategy was not published before the general election was called in May 2024.

The new Labour government is currently working on a new 10-year health plan. When asked in October 2024 if respiratory health will be central to its plans, the government said:

The 10-Year Health Plan will consider the change needed to meet the three health mission goals: a fairer system where everyone lives well for longer; a National Health Service that is there when people need it; and fewer lives lost to the biggest killers. We will carefully be considering policies with input from the public, patients, health staff, and our stakeholders as we develop the plan.

On 5 November 2024, the government announced plans to use cutting-edge technology and data to create a real-time surveillance system to monitor the threat of future pandemics and respiratory infections in partnership with various organisations.

Further reading

NHS readiness for winter 2024/25, House of Commons Library, 28 October 2024

Respiratory syncytial virus and its impact on the NHS, House of Lords Library, 6 June 2022

Improving asthma outcomes in the UK, House of Commons Library, 3 December 2021

Support for people with chronic obstructive pulmonary disease, House of Commons Library, 15 November 2021