Allergy Debate Highlights Need for Reform

Allergy care in the UK is at a critical juncture, with rising demand highlighting long-standing gaps in services and expertise

CREDIT: This is an edited version of an article that originally appeared in Allergy UK

The UK has among the highest rates of allergy in Europe, with growing numbers of people living with food allergies, asthma, eczema and allergic rhinitis. Despite this rising prevalence, allergy has historically received limited strategic focus within NHS workforce planning and service design.

In many areas, there are no dedicated allergy clinics, and patients rely on general practice or overstretched secondary care services. Access to specialist allergy nurses and dieticians varies significantly between Integrated Care Boards (ICBs), leading to what campaigners describe as a postcode lottery in care. Last year, access to allergy services was debated in the House of Lords, placing the challenges facing patients firmly on the national stage. Allergy UK’s calls for allergy specialist nurses and dieticians in every ICB, alongside the creation of a National Allergy Register, were raised directly with ministers during the session.

What Was Discussed?

Need for Specialist Workforce: There was clear recognition that allergy specialist nurses and dieticians are essential in all ICBs to ensure consistent and expert care for patients with serious allergies. Workforce planning will be considered in upcoming government strategies.

Access to Needle-Free Adrenaline: The rollout of the new adrenaline nasal spray, EURneffy, was highlighted as an important innovation. Current access depends on local prescribing committees, but there is interest in NICE providing formal guidance to standardise availability.

Variation Across ICBs: Findings from Allergy UK’s Freedom of Information requests exposed significant differences in how allergy services are commissioned, reinforcing the need for national guidance to reduce disparities in care.

Single Patient Record as an Opportunity: Ministers acknowledged that the Single Patient Record could be used to embed a National Allergy Register, improving patient safety and service planning. This would help track severe allergies, support emergency care, and inform commissioning decisions.

Political Awareness and Support: The debate reflects growing recognition in Parliament of the gaps in allergy care. Peers from multiple parties voiced support for Allergy UK’s policy proposals, signalling potential momentum for future reforms.

Need for Long-Term Reform: While the discussion highlighted progress and the government’s openness to suggestions, it also made clear that structural issues—workforce shortages, inconsistent commissioning, and fragmented services—require sustained, long-term attention.

Moving Beyond Debate

The recent House of Lords debate did not resolve the challenges facing allergy care, but it signalled that the issue is gaining political attention. For patients and clinicians, the underlying concerns remain the same: inconsistent commissioning, workforce shortages and uneven access to specialist expertise. As allergy rates continue to rise, the question is not simply how to respond to individual service pressures, but how to design a coherent national approach. The parliamentary exchange has reflected that urgency, but translating discussion into sustained reform will require long-term investment, clearer commissioning guidance and a workforce plan that recognises allergy as a core area of need rather than a niche specialty.