Memorandum by Dr Vibha Sharma (AL 28)
Food allergy in paediatrics is still, in most
District General Hospitals, a mainstream paediatric problem. Projected
figures lead one to anticipate an overall increase in the number
of sufferers of allergy. Presently, approximately one third of
the population have allergies and one in 70 people are said to
suffer from peanut allergy. I feel that there needs to be an appointment
of a Consultant Paediatrician with special interest in allergy
in each District General Hospital, who would link in with the
Regional Tertiary Centre with geographical based leadership.
This would facilitate provision of allergy services
nearer to the patients and obviate the need for sufferers to seek
help from independent alternative practitioners, who may not employ
evidence-based methods.
Tertiary Centres should have identified allergy
services, for the referral of complex food allergy patients and
to provide training and support for those working in the periphery,
both in the District General Hospital and in Primary Care. When
I took over an embryonic paediatric food allergy clinic, I found
this training and support difficult to access in my own region.
Resources need to be identified and ring fenced
to ensure the development and continuing provision of these services.
The alternative sector poses a major problem
in management of patients with allergy in the paediatric age group.
To quote an example, Vega testing, available in health food shops,
can often lead to advice on certain food restrictions. These are
non-evidence based. It is particularly a problem, in the paediatric
population, as exclusion of certain food types can predispose
them to nutritional deficiencies, which can affect growth significantly,
and hamper a child's potential.
Presently there are ear, nose and throat and
dermatology departments providing services for investigating various
allergies. It would be useful to consolidate all these resources
and provide a comprehensive service for investigation and management
of allergies.
May 2004
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