Letter from the British Thoracic Society
Whereas the British Thoracic Society is strongly
supportive of the overall direction ofa strengthening of allergy
services (both clinical and research) within the UK we have little
if any specific numerical data of our own.
We recognise allergy to be an increasing workload
of primary care physicians, respiratory physicians, ENT specialists
and dermatologists as well as specialised tertiary allergy referral
centres. Respiratory physicians manage many patients with allergic
associated diseases (such as asthma, occupational asthma, rhinitis,
allergic alveolitis etc) and aspects of allergy are included in
the specialty training curricula.
1. We have formally supported the concept
proposed by the BSACI that there should be an Allergy clinic staffed
by Specialist Allergists or Immunologists within each teaching
hospital and that these should be equitably spread throughout
the UK.
2. From the available data we have seen
and on the BSACI website for the geographical location of the
present Allergy clinics the present capacity and potential shortcomings
of the tertiary Allergy/immunology services are unclear.
3. The exact number of patients with allergic
conditions for example hay fever, asthma, eczema and food allergy/intolerance
who are satisfactorily dealt within Primary care, Respiratory,
ENT, stroenterology and Dermatology clinics without the need for
referral to tertiary care is large, but the BTS has no figures
for such workload within any specialty.
4. However within our own specialty the
expenditure of asthma medications such as inhaled steroids are
amongst the largest single drug spends withinthe NHS.
5. Undoubtedly there is a small but very
important group of patients that our members would wish to refer
to specialist tertiary allergy services and who currently get
poor access by the limited number of such clinics and long waiting
times but again we do not have exact figures to support this.
6. We hope that your committee would explore
the current and future real and potential threats to the existing
allergy services throughout the UK. Examples would be retirement
of senior staff; a necessity for growth in training posts, capacity
for training general practitioners and consultants in organ based
specialties such as our own and of course research which regrettably
has a history of being under funded as far as respiratory medicine
is concerned.
7. It would also be helpful to develop an
ideal model for an allergy centre as far as specific staffing
and support ie Consultants, SpR's, Specialist Nursing, Secretarial
support and the costing thereof. One could then test the present
availability against the ideal model.
24 October 2006
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