Ewan Pamela W, Durham Stephen R
Immunology Clinic, Addenbrooke's Hospital, Cambridge.
Clin Med (Lond). 2002 Mar-Apr;2(2):122-7. doi: 10.7861/clinmedicine.2-2-122.
Allergy is common and its prevalence has increased substantially in the last 2-3 decades. There has been a particular increase in severe allergic disease, including anaphylaxis and food, drug and latex rubber allergy. Provision of allergy services in the NHS is poor and there is a huge unmet need. Allergy is a full specialty, but there are few consultants and few trainees: only six centres in the UK offer a full-time specialist service. Most allergy services are provided by doctors--general practitioners and consultants in other specialties--with little or no training in allergy. Whilst specialists in other areas of medicine have a role in the management of allergy, it is no longer adequate to devolve most allergy care to them. The lack of special care leads to morbidity, mortality and substantial cost to the NHS, much of it avoidable. To ensure that adequate standards of care are satisfactory, allergy care must be led by allergy specialists. More consultant posts and training posts in allergy are urgently needed; this requires recognition by trust managers, regional commissioners and the Department of Health. As a first step, we propose the setting up of appropriately staffed regional allergy centres. This could be achieved with a central directive and (relatively minor) pump-priming of funding.
过敏现象很常见，在过去二三十年里其患病率大幅上升。严重过敏性疾病，包括过敏反应以及食物、药物和乳胶橡胶过敏，有了特别明显的增加。英国国民医疗服务体系（NHS）中过敏服务的提供情况不佳，存在巨大的未满足需求。过敏是一个完整的专科，但过敏专科顾问医生和实习医生很少：英国只有六个中心提供全职专科服务。大多数过敏服务由医生提供——全科医生以及其他专科的顾问医生——他们几乎没有接受过过敏方面的培训。虽然其他医学领域的专家在过敏管理中发挥着作用，但将大多数过敏护理工作下放给他们已不再足够。缺乏专门护理会导致发病率、死亡率以及给英国国民医疗服务体系带来巨大成本，其中许多是可以避免的。为确保护理标准令人满意，过敏护理必须由过敏专科医生主导。迫切需要更多的过敏专科顾问职位和培训职位；这需要信托管理人员、地区专员和卫生部的认可。作为第一步，我们提议设立人员配备适当的地区过敏中心。这可以通过一项中央指令以及（相对少量的）启动资金来实现。
