Appoint an Allergy Tsar as a champion for people living with allergies

The Government should appoint an Allergy Tsar to act as a champion for people with allergies to ensure they receive appropriate support and joined up health care to prevent avoidable deaths and ill health.

At least 2m people have a food allergy. Since 2012, there has been a 615% increase in hospital admissions for anaphylaxis, a potentially life-threatening allergic reaction. However, allergy remains a "Cinderella service" in the NHS. There has been little investment given to NHS allergy services. The care people with allergies receive is often patchy, and at worst has led to avoidable deaths. Without greater priority given to allergies, these problems will continue and more lives may be lost.

Most allergy services are commissioned locally through clinical commissioning groups (CCGs). However, to support patients with more complex conditions NHS England and Improvement (NHSE/I) directly commissions some specialised services.

Whilst there is currently no specific National Clinical Director or Speciality Adviser for routine allergy services, NHSE/I keeps the position under review and new National Clinical Directors or Specialty Advisers are appointed as necessary. Clinical advice and leadership on specialised immunology and allergy services are provided by the Clinical Reference Group (CRG). To support the implementation of coherent care pathways, the National Institute for Health and Care Excellence has published guidance on a range of allergy conditions including food allergy in under 19s, anaphylaxis and drug allergy.

Although allergies are very common, most allergic reactions are mild. Occasionally, however, a severe reaction or anaphylactic shock can occur. NHS Digital have confirmed that their data shows finished admission episodes where the primary diagnosis is anaphylaxis between 2011/2012 and 2020/2021 have increased from 3161 to 4359, an increase of 38%. This includes anaphylactic shock due to adverse food reaction, anaphylactic shock due to an unspecified reason, anaphylactic shock due to serum and anaphylactic shock due to adverse effect of correct drug or medicament properly administered. These admissions do not represent the number of patients as a person may have more than one admission within the period. Hospital episode statistics are recorded by financial year and episodes are only included in the data set once they are complete and all clinical information is provided.

The Government recognises the challenges faced by people with allergies and is taking a number of actions to further support them. This includes the introduction of Natasha’s law which will come into force on 1st October 2021. This will make it a legal requirement for all food retailers and operators to display full ingredient and allergen labelling information on every food item they sell pre-packed for direct sale, ensuring that people with allergies are protected appropriately and giving them confidence in the food they buy.

The Medicines and Healthcare products Regulatory Agency (MHRA) is also developing a communications campaign to convey key messages to improve the safe and effective use of adrenaline autoinjectors (AAIs) in the self-administration setting, including the need to carry two pens at all times. The campaign will aim to raise awareness and scientific understanding among patients, carers and healthcare professionals of the key messages associated with these products. Improved understanding of the rationale underlying the key messages is also likely to improve adherence, especially among healthcare professionals.

Furthermore, the National Institute for Health Research (NIHR), which is funded by the Department of Health and Social care, has awarded £2,371,773 for research into food allergy, over the last 5 years. It is currently funding two trials investigating food allergy using oral immunotherapy treatments, including one which compares two treatments for allergy to cow’s milk in babies and another which seeks to overcome severe allergic reactions to peanuts in adults. The NIHR welcomes funding applications into any aspect of human health, including food allergy.

In terms of relevant training for healthcare professionals, allergy and immunology training remains the responsibility of the Royal College of Physicians (RCP) through the Joint Royal Colleges of Physicians Training Board. A certificate completion of training in allergy and immunology is available to support specialist allergy care. The RCP also runs an accreditation scheme, ‘Improving Quality in Allergy Services’. In addition, the British Society for Allergy & Clinical Immunology also provide training for primary care staff across the country through workshops and educational meetings.

Department of Health and Social Care