RESUMO
BACKGROUND: The NHS is not meeting the nation's allergy needs. There are insufficient allergy specialists, with variable care across the country. General practitioners (GPs) are lacking in allergy training. London's Whittington Hospital created a GP with Special Interest (GPwSI) community paediatric allergy clinic, running alongside pre-existing hospital clinics, to address local unmet needs, aiming to provide equity for patients, improve patient experience and decrease secondary care burden. OBJECTIVES: To establish whether improvements have occurred within the service by introducing a GPwSI-led community paediatric allergy clinic alongside providing GP education and referral pathways. This study asks: (a) Have allergy-related hospital attendances decreased with the provision of the community service? (b) Are patients seen in the appropriate clinic? (c) What proportion of patients require GPwSI follow-up? (d) Is there good patient satisfaction? (e) Have allergy clinic waiting times changed? METHODS: Numbers of allergy-related hospital attendances and waiting times in 2013, 2014 and 2016 were assessed. Data were analysed regarding proportions of patients requiring GPwSI follow-up or referral from the GPwSI community clinic to hospital. Patient satisfaction was assessed. RESULTS: Since introducing the GPwSI community service the burden on secondary care has decreased, with reduced hospital attendances for allergy clinic patients, although waiting times have increased. In 2013, 65% 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) and 36.9% (hospital) in 2014 and maintained in 2016 (27.5% community and 37.5% hospital), P < 0.01. Patient satisfaction in the hospital and community clinics is very high. CLINICAL RELEVANCE: This integrated, multidisciplinary Paediatric Allergy Service could provide a model to improve the unmet allergy need both in the UK and beyond. This GPwSI model could also be applied to other chronic diseases in both adults and children, improving care beyond allergy.
