El-Shanawany T M, Arnold H, Carne E, Misbah S A, Egner W, Wallington T B, Herriot R, Williams P E
Department of Medical Biochemistry and Immunology, University Hospital of Wales, Cardiff CF14 4XW, UK.
J Clin Pathol. 2005 Dec;58(12):1283-90. doi: 10.1136/jcp.2005.027623.
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.
To survey the allergy workload provided by clinical immunologists to inform service planning and resource allocation.
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.
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.
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.
英国国民医疗服务体系未能满足对过敏性疾病的诊断和治疗需求，这类疾病很常见且患病率不断上升。下议院特别委员会关于过敏服务的报告强调了不平等现象以及投资的迫切需求。
调查临床免疫学家提供的过敏诊疗工作量，为服务规划和资源分配提供依据。
通过超区域审计小组以问卷调查的方式，对临床免疫学家在2003年4月1日至2004年3月31日这12个月期间提供的过敏服务进行了调查。
接受调查的免疫中心为3200万人提供服务，几乎涵盖了专业过敏服务的全部项目。诊所容量、新转诊病例、预约时长和服务配置存在很大差异。服务主要由顾问医师提供，但与儿科医生和麻醉师联合开设诊所的情况在各地有所不同。已经开发出利用护士和临床助理的新型服务模式，值得进一步研究。
目前，顾问免疫学家和实习医生对专业过敏服务的发展和提供做出了重大贡献。从长远来看（与其他国家一样），顾问免疫学家可能仍将是英国三级过敏护理的主要提供者，并且在支持和发展及时为全国患者提供公平的专科过敏服务方面将发挥关键作用。加强过敏症专科医生与临床免疫学家之间的合作关系，将最有助于在短期内迅速发展过敏这一新专科，并确保患者能更好地获得服务。
