National Survey of United Kingdom Paediatric Allergy Services

摘要

Abstract Background Comprehensive national assessments of paediatric allergy services are rarely undertaken, and have never been undertaken in the United Kingdom. A 2006 survey estimated national capacity at 30,000 adult or paediatric new allergy appointments per year and identified 58 hospital clinics offering a paediatric allergy service. Objective The UK Paediatric Allergy Services Survey was the first comprehensive assessment of UK paediatric allergy service provision. Methods All 450 UK hospitals responded to a survey. Paediatric allergy services are provided in 154 lead hospitals with 75 further linked hospitals. All 154 lead paediatric allergy services completed a detailed questionnaire between February 2019 and May 2020. Results The 154 paediatric allergy services self‐define as secondary (126/154, 82) or tertiary (28/154, 18) level services. The annual capacity is 85,600 new and 111,400 follow‐up appointments. Fifty‐eight percent (85/146) of services offer ≤10 new appointments per week (no data provided from 8 services—2 no response, 6 unknown) and 50 (70/139) of the services undertaking challenges undertake ≤2 food or drug challenges per week (no data from 3 challenge services). Intramuscular adrenaline is rarely used during challenges—median annual frequency 0 in secondary services and 2 in tertiary services. Allergen‐specific immunotherapy is offered in 39 (60/154) of services, with 71 (41/58) of these centres treating ≤10 patients per annum (no data from 2 immunotherapy services). The 12 largest services see 31 of all new paediatric allergy appointments, undertake 51 of new immunotherapy patient provision and 33 of food or drug challenges. Seventy percent (97/126) of secondary and all tertiary services are part of a regional paediatric allergy network. Only nine services offer immunotherapy for any food (3 for peanut), 10 drug desensitization and 18 insect venom immunotherapy. Conclusions There has been a fourfold increase in paediatric allergy clinics and an approximately sevenfold increase in new patient appointment numbers in the United Kingdom over the past 15?years. Most services are small, with significant regional variation in availability of specific services such as allergen immunotherapy. Our findings emphasize the need for national standards, local networks and simulation training to ensure consistent and safe service provision.