NHS: Patients with Allergies

Lord Scriven Excerpts

Thursday 12th December 2024 Grand Committee

[Lord Scriven (LD)]

My Lords, I thank the noble Baroness, Lady Ramsey of Wall Heath, for introducing this debate. I also thank the noble Lord, Lord Mendelsohn, and the noble Baroness, Lady Keeley, whom it is a pleasure to follow, for bringing this issue to life with personal stories that go beyond the statistics and bring home exactly what we are talking about today.

Allergy services in the UK are at a critical juncture. As my noble friend Lady Burt said, with more than 21 million people affected, allergies are no longer a niche issue. They represent a public health issue, from life-threatening anaphylaxis to chronic conditions such as allergic eczema. These conditions profoundly impact individuals, families and the NHS yet, despite this growing prevalence, the UK’s allergy care system remains inadequate. The Government must act to bridge these gaps and create a robust, equitable allergy care framework, with the Government and the NHS at the helm of these reforms.

Let us acknowledge the scale of the problem. Hospital admissions for allergic reactions have increased by 615% in the past 20 years. As other noble Lords have said, shockingly, there are only 40 specialist allergists; that is one for every 525,000 patients. For patients, this translates into a postcode lottery of care, with many waiting more than 18 months for appointments. Primary care also faces significant challenges, with most GPs lacking adequate allergy training. This leads to unnecessary referrals, misdiagnosis and poorly managed conditions. The strain is particularly acute for children and young adults. Food allergies, which can be fatal, are rising sharply in children, yet there is a severe lack of specialist support during the critical transition from paediatric to adult services, as other noble Lords have said. What priority will the Government put on these transition services?

The gaps in care are not just a human tragedy; they are an economic burden as well. Allergy care costs the NHS more than £1 billion annually in emergency admissions, prescription costs and referrals. Addressing this crisis requires systematic change, not piecemeal change, with the Government and NHS having to play pivotal roles. I ask the Minister: what will the NHS do urgently to expand the workforce? This includes increasing the number of specialist allergists and immunologists, as well as training GPs and nurses in allergy management.

A promising model was demonstrated in a pilot project by Allergy UK, where nurse-led clinics reduced waiting times from 18 months to just four to eight weeks. Some 95% of cases were managed successfully in primary care, saving not just lives but costs. What is the Government’s view on this pilot being rolled out nationally? Additionally, the Government should allocate targeted funding to recruit and train more allergy specialists.

Investing in allergen immunotherapy services is also critical. Although they are costly up front, these treatments prevent severe reactions and reduce long-term healthcare expenses. As many other noble Lords have said, we need to appoint a national allergies tsar or clinical director to lead a co-ordinated strategy. This role would oversee data collection, resource allocation and policy implementation—and, to put it bluntly, it would knock heads together to make sure that action happens. What is the Government’s view on appointing such a clinical director, and is there a timeframe for doing that?

Empowering primary care is vital to reduce pressure on specialist services. This can be achieved by embedding allergy-trained nurses and dieticians in every integrated care system, as other noble Lords have said. These professionals would manage routine cases, leaving specialists to handle the more complex ones. Where will the move from hospital care to community care fit in within the 10-year plan?

The absence of robust reporting systems for allergic reactions is another glaring gap. A mandatory near-miss reporting system for anaphylaxis, akin to the system in place in Australia, would allow us to identify emerging risks and act upstream. Will the Government look at such a mandatory near-miss reporting system?

Lastly, we must focus on prevention. Early allergen introduction and proactive eczema management in children have been proven to reduce lifelong allergy risks, yet these strategies remain underutilised. Will the Government prioritise funding for education campaigns and preventive measures? Improving allergy services is not just about saving lives; it is about improving the quality of life for millions of people. By investing in specialist care, empowering primary care and adopting preventive strategies, we can take important steps to transform allergy care.