Select Committee on Health Written Evidence

Memorandum by Dr Andrew Clark (AL 49)

  I am a consultant paediatric allergist in Addenbrookes NHS Trust, Cambridge, a tertiary centre. I work with two colleagues who specialise in allergic diseases of adults.

  1.  The prevalence of allergy is rising and demand greatly exceeds the supply of specialised care to children with severe and complex allergy (asthma, food allergy, anaphylaxis, hay fever and eczema). Only six paediatric allergy consultants serve the childhood population of the UK (11.6 million in 2002). My post is the only one north of London, yet I receive no NHS funding and my position is supported by a limited tenure academic grant (to expire in 2007). Currently, many children with severe and complex allergy are cared for by general practitioners or general paediatricians whose training and expertise are variable and therefore quality of care for these children depends on where they live, with children in the north and West of the country being at a significant disadvantage. To illustrate the demand for specialised paediatric allergy services a recent survey showed that between February and May 2004, there were approximately 1,000 allergy consultations in our clinic. Nearly 360 consultations (36%) were for children, and two thirds of these were for peanut or nut allergy—a severe and complex allergy, requiring regular (usually annual) reappraisal. Resolution of nut allergy is unusual and this large group of children require annual review appointments for many years.

  2.  A core principal of The National Service Framework for Children is that professionals who care for children in hospital should be appropriately trained and experienced. Interpreted in the context of allergy this implies that children with complex and severe allergy referred to tertiary level clinics should be cared for by paediatric allergists. Currently this is not the case. Overall, we are referred over 500 new paediatric allergy patients per annum, of whom at least 300 will require annual follow up appointments and year-on-year; this adds a significant extra workload. As a consequence, even in our specialist centre, not every child can be reviewed by a paediatric allergist.

  3.  There is a need for improved under-and post-graduate training in allergy. The creation of more consultant posts in paediatric allergy together with recognition of specialist training will improve the care of children with severe allergy and facilitate the spread of expertise and knowledge from tertiary to primary care, improving provision of allergy services for all children.

May 2004

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