Provision of Food Allergy Care in the United Kingdom and United States: Current Issues and Future Directions.

Abstract

Food allergy (FA) is a growing issue worldwide. The United Kingdom (UK) and United States (US) are high-income, industrialized countries with reported increases in FA prevalence over the past few decades. This review compares delivery of FA care in the UK and US and each country's response to the heightened demand and disparities for FA services. In the UK, allergy specialists are scarce and general practitioners (GPs) provide most allergy care. While the US has more allergists per capita than the UK, there is still a shortage of allergy services owing to the greater reliance on specialist care for FA in America and wide geographic variation in access to allergist services. At this time, generalists in these countries lack the specialty training and equipment to optimally diagnose and manage FA. Moving forward, the UK aims to enhance training for GPs so they may provide better quality frontline allergy care. In addition, the UK is implementing a new tier of semi-specialized GPs and increasing cross-center collaboration through clinical networks. The UK and US aim to increase the number of FA specialists, which is critical at a time of rapidly expanding management options for allergic and immunologic diseases requiring clinical expertise and shared decision-making to select appropriate therapies. While these countries aim to actively grow their supply of quality FA services, further efforts to build clinical networks, and perhaps, recruit international medical graduates and expand telehealth services, are necessary to reduce disparities in access to care. For the UK in particular, this will require additional support from the leadership of the centralized National Health Service, which remains challenging.