title: Survey of clinical allergy services provided by clinical immunologists in the UK.
abstract: BACKGROUND
  The UK National Health Service is failing to meet the need for diagnosis and treatment of allergic disorders, which are common and increasing in prevalence. The House of Commons select committee report on allergy services highlighted the inequalities and urgent need for investment.
  
  
  OBJECTIVE
  To survey the allergy workload provided by clinical immunologists to inform service planning and resource allocation.
  
  
  METHODS
  The allergy services performed by clinical immunologists during a 12 month period from 1 April 2003 to 31 March 2004 were surveyed by means of a questionnaire via supra-regional audit groups.
  
  
  RESULTS
  The immunology centres surveyed serve 32 million people and offer almost the complete repertoire of a specialised allergy service. There were large variations in clinic capacity, new referrals, appointment duration, and service configuration. Services were largely consultant delivered, but availability of joint clinics with paediatricians and anaesthetists was locally variable. Novel service delivery models utilising nurses and clinical assistants have been developed and merit further investigation.
  
  
  CONCLUSIONS
  Consultant immunologists and trainees currently make a major contribution to the development and provision of specialised allergy services. Consultant immunologists will probably remain key providers of tertiary level allergy care in the UK in the long term (in line with other countries) and will be pivotal in supporting and developing the provision of equitable national access to specialist allergy services in a timely manner. Rapid progress in developing the new specialty of allergy and securing better access to services for patients in the short term will be best served by strengthening the collaborative relationship between allergists and clinical immunologists.
authors.affiliation: Department of Medical Biochemistry and Immunology, University Hospital of Wales, Cardiff CF14 4XW, UK.
authors.forename: T M
authors.initials: TM
authors.lastname: El-Shanawany
authors.forename: H
authors.initials: H
authors.lastname: Arnold
authors.forename: E
authors.initials: E
authors.lastname: Carne
authors.forename: S A
authors.initials: SA
authors.lastname: Misbah
authors.forename: W
authors.initials: W
authors.lastname: Egner
authors.forename: T B
authors.initials: TB
authors.lastname: Wallington
authors.forename: R
authors.initials: R
authors.lastname: Herriot
authors.forename: P E
authors.initials: PE
authors.lastname: Williams
mesh_terms: D000328:Adult; D000486:Allergy and Immunology / Q000458:organization & administration*; D002648:Child; D003253:Consultants; D003695:Delivery of Health Care / Q000458:organization & administration*; D019538:Health Care Surveys; D006302:Health Services Research; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000628:therapy; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom; D000078329:Workforce; D016526:Workload / Q000706:statistics & numerical data