What is asthma?
Asthma is a long-term condition in which the airways are inflamed and over-sensitive, narrowing in response to triggers such as viral infections, allergens, exercise, cold air and pollution. This causes episodes of wheeze, chest tightness, cough and breathlessness that vary over time — often worse at night or early morning. Asthma affects people of all ages; in the UK several million adults and children receive treatment, and it often coexists with hay fever and eczema.
Diagnosis has become more objective in recent years: alongside a suggestive history, guidelines recommend tests such as FeNO (a breath test measuring airway inflammation), spirometry with reversibility, and peak-flow monitoring. Confirming the diagnosis properly matters, because both under- and over-diagnosis are common.
Common symptoms
- Wheezing
- Breathlessness
- Chest tightness
- Coughing, often worse at night or early morning
- Symptoms triggered by exercise, allergens, cold air or infections
- Variable symptoms — good spells and bad spells
- Waking at night with cough or wheeze
How long will you wait?
Most asthma is managed in general practice, but routine referral to a respiratory clinic — for diagnostic uncertainty or poor control — typically waits several months, and access to severe-asthma services with biologic treatments involves further assessment stages.
Privately, you can typically see a respiratory consultant within 3–7 days, with spirometry, FeNO and allergy testing completed within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Preventer inhalers. Inhaled corticosteroids treat the underlying airway inflammation and are the foundation of asthma care.
- Reliever therapy. Fast-acting bronchodilators relieve symptoms; modern guidance favours combination inhalers so relief always comes with an anti-inflammatory dose.
- Add-on tablets. Leukotriene receptor antagonists such as montelukast help some patients, particularly with allergic triggers.
- Biologic injections. Targeted antibody treatments transform control in severe asthma driven by specific inflammation types.
- Personalised action plan. A written plan covering daily treatment, trigger avoidance and exactly what to do when symptoms worsen.
What does private treatment cost?
As a guide, a private respiratory consultation with spirometry and FeNO testing typically costs £400–£700, with follow-up reviews around £150–£250.
Does health insurance cover asthma?
Be aware that asthma is a chronic condition, so UK private medical insurance does not cover its ongoing management — inhalers, routine reviews and long-term prescriptions stay with your GP and the NHS. PMI can cover initial specialist diagnosis if symptoms arise after your policy starts, and acute complications are covered on many policies. Pre-existing asthma is usually excluded, though some insurers reconsider after a symptom-free period.
Frequently asked questions
Can adults develop asthma for the first time?
Yes. Although asthma often begins in childhood, adult-onset asthma is common — sometimes appearing after a viral infection, in association with occupational exposures, or around hormonal changes. New wheeze, chest tightness or night-time cough in adulthood deserves proper testing rather than assumption, both because asthma is treatable and because similar symptoms can come from other conditions, including reflux and heart problems.
Why should I use my preventer inhaler when I feel fine?
Because asthma's inflammation persists quietly between symptoms, and untreated inflammation leaves your airways primed to react. Regular preventer use keeps that inflammation suppressed, cutting both day-to-day symptoms and the risk of serious attacks. Relying on a blue reliever alone is now known to be risky — which is why modern guidelines favour combination inhalers that deliver an anti-inflammatory dose whenever you need relief.
What does poorly controlled asthma look like?
Warning signs include using a reliever inhaler three or more times a week, waking at night with symptoms, symptoms limiting exercise or work, and needing oral steroid courses. Any of these suggests your treatment needs stepping up or your inhaler technique needs checking — most poor control stems from technique or adherence issues rather than truly severe disease. An asthma review can usually restore good control.