Prof. Adam Fox OBE of Allergy London and Chair of the National Allergy Strategy Group, contributed to the British Society for Allergy & Clinical Immunology’s latest issue on allergy care in the UK, alongside his National Allergy Strategy Group (NASG) colleagues Prof. Paul Turner and Prof. Hasan Arshad.
Some key points on this:
- AI, digitalisation, advanced cancer therapies, and pharmacological innovations are transforming healthcare, including allergy treatment.
- Allergy care is moving from a diagnostic focus to a therapeutic discipline, where treatments and immunotherapy can significantly improve patient lives.
- Despite progress, allergy management in the UK remains outdated, heavily reliant on symptom control rather than disease-modifying therapies.
- NHS financial strain and uncertainty over NHS England complicate the adoption of proactive allergy treatments.
- Many patients endure significant quality-of-life reductions, with limited access to long-term interventions like allergen immunotherapy (AIT).
- Allergic conditions are highly prevalent and among the most common chronic diseases in the UK – up to a third of adults have allergic rhinitis (with an estimated 10% under-treated), and ~800,000 already consume substantial NHS secondary care resources.
- Economic cost: The NHS spends around £1 billion annually managing allergic respiratory conditions, mainly on repeat appointments and symptomatic medication. Disease-modifying treatments could reduce this burden cost-effectively.
- Emerging treatments: Innovations like allergen immunotherapy, (recommended by NICE for certain forms of allergic rhinitis and for peanut allergy, although access to treatment remains severely limited) and biologics e.g., (omalizumab), offering disease-modifying potential and is supported by the US Food and Drug Administration (FDA) for food allergy.
- Many clinicians striving to introduce new treatments face significant barriers, including limited funding, space, and staffing, compounded by a lack of organisational support from Trusts and Integrated Care Boards (ICBs) and minimal backing from bodies like NICE to enforce guidance.
- Simultaneously, some clinicians remain in their comfort zones, adhering to established prescribing habits and hesitating to adopt new, evidence-backed approaches.
Urgent need for change:
Without proactive adoption of advanced treatments, allergy care risks lagging behind other specialties, worsening inequities and perpetuating a postcode lottery in patient outcomes.
Practical actions we as health professionals can take today include:
- Auditing referral patterns and identifying points of attrition
- Raising awareness and building prescribing confidence within teams
- Educating primary care colleagues on the full range of NICE-approved treatment options, including their long-term benefits and value, to ensure informed referral pathways and generate system-wide demand for better access.
- Working with commissioners to secure access to NICE-approved therapies
- Engaging patient representatives to support service redesign
