Allergy sufferers face unequal access to care, report warns

New data highlights major gaps in access to specialist allergy services across the UK.

Findings suggest the availability of immunotherapy varies in different parts of the country.

It may also be less accessible to people living in deprived areas and those from ethnic minority backgrounds.

The report was produced by the British Society for Allergy and Clinical Immunology Registry for Immunotherapy (BRIT). It has been published in the journal Clinical & Experimental Allergy.

BRIT is a national project that records immunotherapy treatment. It is led by Dr Mich Lajeunesse, a Consultant in Paediatric Allergy and Immunology at University Hospital Southampton (UHS).

UHS has one of the largest allergy and immunology centres in the country. It is a World Allergy Organisation National Centre of Excellence.

Treating severe allergies

Immunotherapy involves being carefully exposed to an allergen over time. The body gradually becomes used to it and does not react so badly.

It is used for severe venom allergy to bee and wasp stings, peanut allergy and severe forms of hay fever and airborne allergies.

The treatment is less accessible in the UK than in many other European countries. Here, patients are typically only able to see specialists at hospital-based centres.

BRIT collects data on both adults and children. It records information on access to treatment, safety and real-world effectiveness.

The latest analysis looked at data from over 1,800 participants treated at 63 sites across the UK. Nearly half of them were children.

Geographical disparities

The results suggest people in Wales, Scotland and Northern Ireland are less likely to access specialist allergy centres than those in England.

The devolved nations have a combined population of 10.5 million, while the population of London is estimated at 7.5 million.

Despite this, only 3.5% of patients recorded in this analysis came from Wales, Scotland and Northern Ireland. 31.5% were from Greater London, with a further 65% from other parts of England.

The reasons for this include there being a higher number of allergists in England, with a particular concentration in the capital.

In Scotland, access is further limited by the peanut oral immunotherapy Palforzia not being approved for use.

Concerning inequalities

The study also uncovered disparities linked to socioeconomic status and ethnicity.

The most affluent participants were three times more likely to access immunotherapy care through the NHS compared to those from deprived backgrounds.

White participants in this study were 1.74 times more likely to receive a direct referral to an allergy specialist for immunotherapy from primary care. Referral pathways for people from other ethnic groups were often more complex, leading to delays and reduced access to treatment.

Dr Lajeunesse is supported by the NIHR Southampton Biomedical Research Centre. Last month, he also became an awardee in the UHS Research Leaders Programme.

He said: “This is the largest and most comprehensive report on the use of allergen immunotherapy in the UK.

“It highlights several concerning inequalities. These suggest access to specialist allergy treatment is far from equal.

“We need to better understand the barriers that exist and develop targeted interventions to address them.”