Latest allergy study identifies new model for clinical care

Research by the University of Southampton has revealed how a new clinical care model can improve allergy treatment in the UK and reduce the burden on secondary care.

The University studied a clinic developed by London’s Whittington Hospital, which developed an innovative model to combat the demands of allergy treatment by providing more localised treatment.

One fifth of the world’s population, particularly children and young adults, is now affected by allergy, and the complexity and severity of their conditions is increasing. The UK has the highest incidence of allergy in Europe and patients currently wait a long time to be seen at a few specialist clinics. The cost of allergy care is estimated to be within the region of £1bn, much of which is thought to be avoidable.

The study was carried out by MSc Allergy student Dr Isobel El-Shanawany who, as part of her dissertation project, looked into the impact on hospital admissions of having GPs with a special interest in allergy caring for patients in a community setting.

Dr El-Shanawany, a GP with Special Interest (GPwSI) in allergy, set up a community paediatric allergy clinic with London's Whittington Hospital, running alongside existing hospital clinics to address local unmet needs, aiming to improve patient experience and decrease secondary care burden.

The aligns with the UK government implementing a new model of NHS care under their NHS Long Term Plan, which involves decentralising the delivery of healthcare with general practitioners delivering more care to patients closer to where they live. This study shows the value of an integrated model of allergy care and resonates with the current NHS policy plans, the vision of the NHS ten-year plan, new GP contract, and formation of primary care networks.

The numbers of allergy‐related hospital attendances and waiting times in 2013, 2014 and 2016 were assessed, while data regarding proportions of patients requiring GPwSI follow‐up or referral from the GPwSI community clinic to hospital was analysed as well as assessing patient satisfaction.

The study revealed that introducing the GPwSI community service significantly reduced the burden on secondary care, with fewer hospital attendances for allergy clinic patients.

In 2013, 65 per cent of allergy clinic patients attended other hospital services for allergy‐related complaints prior to their first allergy clinic appointment. This was reduced to 27.3% (community clinics) and 36.9% (hospital) in 2014 and maintained in 2016 (27.5% community clinics and 37.5% hospital). The findings also revealed that patient satisfaction in the hospital and community clinics was very high.

Dr El-Shanawany said: “This integrated model has made a great impact and starts to break down the barriers between primary and secondary care. We feel it could be an example used across the UK, as it ensures the right patients receive the right support.”

This study shows the value of an integrated model of allergy care and resonates with the current NHS policy plans, the vision of the NHS ten-year plan, new GP contract, and formation of primary care networks.

Moreover, this integrated, multidisciplinary service could provide a model to improve the unmet allergy need both in the UK and beyond. Findings from this clinical care model could also be applied to other chronic diseases in both adults and children, improving patient care beyond allergy.

Dr Judith Holloway, from the University of Southampton, said: “Isobel’s work is a landmark moment, improving care for patients with allergy. Her model reveals a way to reduce the burden on secondary care and satisfying patients’ needs by integrating primary and secondary care through GPs with a specialist role in allergy.

“The study is a leading example of how as a World Allergy Organisation Centre of Excellence, our students are able to become leaders and innovators in health care.”