what is anaphylaxis
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Allergy services / patient care
The huge rise in the prevalence of allergies since the early 1990s took the NHS by surprise. Allergies have reached epidemic proportions, but NHS allergy services have not grown at a comparable rate. Since its formation in 1994, the Anaphylaxis Campaign has campaigned vigorously for better allergy services. In recent years it has done this as part of the National Allergy Strategy Group (NASG), an "umbrella" organisation of medical people and patient support groups.
The key events
1994: Campaign founders met Baroness Cumberledge, Parliamentary Under-Secretary of State for Health, to explain the need for an expansion in allergy services. Soon afterwards, the Chief Medical Officer issued clear guidelines to GPs, advising: "All patients suspected to suffer from peanut allergy should be referred to a specialist clinic".
1998: There had been little progress. The Campaign again visited the Department of Health, this time to make a case to Tessa Jowell, Minister of State for Public Health in the Labour Government.
1999: Allergy was designated a clinical speciality, with full approval given by Frank Dobson, the Health Minister in the Labour Government.
2002: The allergy community and patient groups, including the Anaphylaxis Campaign, compiled a report on allergy services for the Royal College of Physicians.
2003: The Royal College of Physicians (RCP) published its report showing the inadequacy of allergy service provision across the UK. http://bookshop.rcplondon.ac.uk/details.aspx?e=11
2004: The NASG launched the "Treat Allergy Seriously" campaign. Members of patient support organisations bombarded MPs with postcards describing how allergy patients were being let down. The same year, the House of Commons Health Committee heard evidence from allergy doctors and patient groups, including the Campaign. The committee's report confirmed the RCP findings.
2005: The Government's response to the Health Committee report was to set up a working group to review the allergy problem. As part of this group, the Anaphylaxis Campaign launched two surveys of its members. The first survey was conducted in 2005. All 7,695 members were sent a letter asking them to write about their experiences of living with severe allergy. Of the 7,695 who were mailed, 1,021 replied, making a 13 per cent return.
The second, more formal survey provided quantitative information to back up the findings in the first survey. This time the membership was asked to complete an on-line questionnaire and this brought responses from a total of 1,117 members (patients or the carers of patients). This amounted to 14 per cent of the membership.
Both surveys confirmed there is a serious unmet need. Poor quality of life was shown to be a huge issue. The findings were sent to the Department of Health.
2006: The Department of Health published its official report. Whilst accepting the unmet need, the solutions presented were half-hearted. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4137365
2007-8: The House of Lords Science and Technology Committee conducted an inquiry into allergy and made substantial recommendations including the creation of regional allergy centres across the country. http://www.publications.parliament.uk/pa/ld200607/ldselect/ldsctech/166/16602.htm
2008: The Department of Health appointed the North West Strategic Health Authority as the lead for a regional allergy centre. This is a pilot project with the aim of creating a “network” of allergy services in the North West region and eventually rolling it out across the country.
2009: The Royal College of Paediatrics and Child Health began a project to create care pathways for six areas childhood allergy. A care pathway is the series of stages under which a patient receives care under the NHS. This project was completed (see below).
2009: The National Institute for Health and Clinical Excellence (NICE) began a process of creating short, clinical guidelines for food allergy in children. This was completed (see below).
2009: The NASG met the Labour government’s Junior Under-Secretary of State for Health, Anne Keen, MP. There was agreement to work together to improve two areas crucial to improving allergy services: increased numbers of trainees in allergy and improved education for GPs.
2010: Following the general election, the NASG re-registered the All Party Parliamentary Group for Allergy and began a dialogue with the new health team.
2010: NASG met the Department of Health workforce team to put forward the need for an increase in the number of allergy trainees. This work is ongoing.
2011: NICE publish guidelines on diagnosing food allergy in children in primary care and community settings http://guidance.nice.org.uk/CG116
2011: NICE publish guidelines on anaphylaxis: involving assessment to confirm an anaphylactic episode and the decision to refer after emergency treatment for a suspected anaphylactic episode. http://www.nice.org.uk/guidance/CG134/PublicInfo
2011: The Royal College of Paediatrics and Child Health produced a series of care pathways for children with allergy. http://www.rcpch.ac.uk/child-health/research-projects/care-pathways-children-allergies/care-pathways-children-allergies
Reports into Allergy Services can be found here:
A review of services for allergy – Department of Health 2006
Report on Allergy - House of Commons Health Committee 2004
