Up, Up and Away - the digital health podcast
On Up, Up and Away we speak to thought-leaders and opinion formers in the world of digital health, be that clinicians, patients, young people or other tech innovators. We find out what things are making a real difference.
Our talented team specialise in creating digitally enabled self-management programmes to the NHS for young people. We've spent the past eight years or so developing the Digital Health Passport - an evidence-based mobile app, which improves skills, knowledge and confidence to manage long-term conditions like asthma, epilepsy and sickle cell disease.
Up, Up and Away - the digital health podcast
Tackling Inequalities in Children’s Asthma — Learning from Brent Health Matters
In this episode of Up, Up and Away, Dom Burch speaks with Bethan Almeida, a senior nurse in Brent Health Matters, about childhood asthma, health inequalities, and what effective, community-led healthcare looks like in practice.
Bethan leads the children’s asthma workstream in one of the UK’s most diverse boroughs, where 149 languages are spoken and many families face barriers around health literacy, income, housing, and access to care. Her role bridges clinical care, public health, and system improvement, with a focus on preventing avoidable asthma harm.
Bethan explains how traditional healthcare pathways often disadvantage families who lack time, money, or confidence to navigate complex systems. Too many children reach specialist care far later than necessary, when much of the harm could have been prevented earlier in the community.
A key insight is that clinicians are not always the most trusted messengers. Families may say everything is fine in appointments, but share the reality with people they already trust — sports coaches, faith leaders, or community organisers. These individuals often have regular contact with families and the time to spot issues early and offer practical support.
Brent’s progress has been enabled by genuine NHS–council collaboration, using existing public health networks rather than building relationships from scratch. This has helped shift care from reactive to proactive — bringing services to families rather than waiting for crises.
One of the most powerful themes is what Bethan calls “compassionate discrimination”. Well-meaning professionals sometimes withhold full advice — for example about reducing dust mites or improving ventilation — because they assume families can’t afford to act on it. While compassionate, this lowers the bar of information and deepens inequality. Bethan argues that everyone deserves the same information, with extra support provided to help those who need it act on that advice.
The team also moved away from standard leaflets after communities said they were inaccessible. Instead, they co-designed simple, visual, multimedia resources that people actually use.
A standout innovation is the Asthma Community Coaches programme — trained local volunteers who support families, challenge myths, make referrals into clinical pathways, and feed real-world insight back into the system. To date, 58 volunteers have completed the programme.
As a result of this work, Brent now has local asthma diagnosis, high-risk clinics, and sustainable pathways that will continue beyond individual staff members.
The episode reinforces a simple but powerful message: people don’t need less information — they need better translation, better support, and genuine partnership.
