Is there a gap between the demand for and the availability of specialist services for paediatric allergy in the West Midlands?

Problem

Paediatric allergy in the UK is a growing problem. Recent publications have shown an increase in the number of children attending accident and emergency (A&E) units with anaphylaxis. There are also data suggesting that the prevalence of self-reported eczema and allergic rhinitis amongst children has increased in the UK. We set out to explore whether there has been [a] an increase in the prevalence of GP diagnosed common allergic conditions amongst children in the UK and the West Midlands (WM) and [b] differences in the provision of secondary care services for paediatric allergy in the region over the period 2000-2013

Approach

We explored data relating to all children between the ages 0-17 years registered within the Health Information Network (THIN) database during the period 2000-2013. Children with allergies and related conditions were identified using the appropriate Read codes. Trends in prevalence of these conditions for the UK as well as WM were estimated for the study period. The provision of specialist services in the WM was ascertained by requesting information from each of the 17 acute trusts within the region and the data were compared to those from a survey carried out in 2005/6.

Findings

Over 1 million children were registered in the database during the study period providing over 6 million person years for analysis. About 10% of these children were registered within the WM. The prevalence of allergic rhinitis, allergic conjunctivitis and food allergy amongst children in the UK has increased by 58% (95%CI: 56.2-60%), 64.6% (95%CI: 62.4-66.6%) and 52% (95%CI: 49-54.8%) respectively. Of the food allergies investigated, nut allergy prevalence increased by 72.6% (95%CI: 68.5- 76.15%) and that of egg allergy by 42.13%( 95%CI: 35.5- 48.1%). Data analysis for the West Midlands is ongoing.Our survey of the NHS Trusts providing paediatric allergy services in the West Midlands region has shown no appreciable increase in the provision of specialist services in the region

Consequences

There has been an increase in the number of children consulting GPs with allergies and related conditions between 2000-2013. There has been no appreciable improvement in the provision of paediatric allergy services in the WM during this period. This suggests that there is an increasing burden on GPs in the management of these children without adequate support from secondary care. Our findings suggest that there is a discrepancy between demand and supply for these services which needs to be urgently addressed.