Allergic conditions: policy context

There is no specific Scottish policy document related to services for allergic conditions. In 2000, the Scottish Medical and Scientific Advisory Committee (SMASAC) published a review entitled 'Immunology and Allergy Services in Scotland'. This made 23 recommendations relating to clinical and laboratory services, information availability, data collection, alternative treatments, education, training and research. Among other recommendations, the report called for an increase in the number of consultant immunology posts in Scotland. A further report on allergy services in Scotland, published in 2009, recommended the establishment of Regional Managed Clinical Networks (MCNs) and suggested that a working group be set up to identify ways in which current information deficiencies can be corrected.

Several other reports on allergy services may also be relevant to allergic conditions in Scotland. In 2003, the Royal College of Physicians published Allergy: the unmet need. (1 MB). This called for the development of regional allergy centres, including at least one regional centre for Scotland.

In 2004, the House of Commons Health Committee published a report entitled 'The Provision of Allergy Services'. This focused on allergy services in England and Wales. The report made a number of recommendations, including the appointment of a lead clinician for allergy in each Primary Care Trust, the provision of a specialist allergy centre (with a minimum of two adult and two paediatric allergy consultants) for each area with a population of 5-7 million people, and in the long term the development of a consultant-led allergy service in each teaching hospital. The UK Department of Health subsequently published a Response (191 KB) to this report.

Following these, in 2007, the House of Lords Science and Technology Committee published a report outlining their recommendations for the improvement of allergy service provision in the UK. This again called for at least one regional allergy centre led by a full-time allergy specialist, closer collaboration between clinicians in primary, secondary and tertiary care to promote dissemination of allergy knowledge throughout a region and better collection of allergy data.

An update on progress was published in 2010 by the Joint Royal College of Physicians and Royal College of Pathologists Working Party entitled 'Allergy services: Still not meeting the unmet need' (475KB). This concluded that there had been unsatisfactory progress regarding the implementation of many of the 2007 recommendations; it noted that only one pilot allergy centre had been established (North West England) and that there was still an absence of consistent and accurate NHS data on allergy services or workload and inadequate coding. The report re-emphasised the need for specialist leadership in allergy, enhanced networking of services and improved allergy data coding, collection and analysis throughout the NHS. There was a commitment for the group to reconvene after 2-3 years to review progress.

The National Institute for Health and Clinical Excellence (NICE) has published guidelines on food allergy in children and young people (CG116, 2011); anaphylaxis (CG134, 2011); drug allergy (CG183, 2014) and the treatment of venom anaphylaxis (TA246, 2012). A range of clinical guidelines is also published by the British Society for Allergy and Clinical Immunology (BSACI).