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provision of allergy Services : Sixth report of session 2003-04, Vol. 2: Oral and written Evidence
With allergies affecting about 30% of the adult population, and 40% of children, the need for a skilled primary care service is essential. The Committee, though, found serious problems in provision of such services. To combat this, the Committee recommends; setting up a network of primary care allergy providers; improved incentives for GPs to treat allergies; a system for better training in understanding and dealing with allergies; developing a framework that introduces allergies into the GPs Special Interest programme, so giving their treatment higher priority. Besides the deficiencies highlighted in the primary care services, the Committee also recommends improvements to secondary and tertiary care, and that at least one specialist allergy centre should be located in each of the former NHS regions, serving populations of between 5-7 million, and with a minimum of four allergy consultants. The Committee thinks that in the longer term, allergies should be the focus of a full specialist consultant workforce, with every major teaching hospital having a consultant-led service

Allergy

Great Britain: Parliament: House of Lords: Science and Technology Committee

Published: 2007-09-26

Total Pages: 156


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Allergy in the United Kingdom has now reached epidemic proportions. In the UK the incidence of common allergic diseases has trebled in the last twenty years to become one of the highest in the world. Treatment of allergies is a significant cost to the National Health Service. Allergies can have a detrimental impact upon the education of children at school or the performance of adults at work. There is a severe shortage of allergy specialists in the United Kingdom. Problems with data collection mean that statistics are imprecise, and a significant proportion of general practitioners are unable to diagnose and manage allergic disorders, and have nowhere to refer patients with complex allergies. The report recommends that allergy centres led by a full-time allergist should be developed, where various specialists come together to diagnose and manage patients with complex allergic disorders. These allergy centres should be a source of education and training for doctors, nurses and other healthcare workers at every grade. They should also advance research, enabling effective treatments to be developed, and should provide the clinical database required for epidemiological studies. Clinicians within the allergy centre should work together with local schools, employers, charities and others to educate the general public, and particularly patients and their families, on allergy matters. Other recommendations include: maintaining clinical surveillance systems to monitor allergic disease; calling for further research into the ways in which the indoor environment influences allergy development; reviewing how children with hayfever are supported throughout the examination system; assessing the training that teachers receive in dealing with allergic emergencies; assisting individuals with occupational allergies to return to work; amending food labelling legislation to specify the amount of allergens contained within products; analysing the costs and benefits of immunotherapy treatment; and withdrawing advice which recommends peanut avoidance for pregnant women.
Response to the Committee's 6th report, HCP 696-I, session 2003-04 (ISBN 0215020073)

Allergy

Great Britain: Parliament: House of Lords: Science and Technology Committee

Published: 2007-09-26

Total Pages: 400


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Annual report For 2004 : First report of session 2004-05, report, together with appendices and formal Minutes
One in seven people in England suffer from hearing loss of some kind, and the advent of digital hearing aids proved of great benefit to many patients. The Modernising Hearing Aid Services (MHAS) programme to improve audiology services, introduced in 2000, aimed to provide NHS patients with digital hearing aids. But the demand from people upgrading from older models was not predicted, and this led to very long waiting lists and times. The Committee regards the Government's new framework for audiology, "Improving access to audiology services in England" (Dept of Health, March 2007, http://www.18weeks.nhs.uk/public/default.aspx?main=true&load=ArticleViewer&ArticleId=570) as primarily reiterating previous announcements. A main concern is that audiology is kept outside the 18-week referral to treatment target that applies to consultant-led services, which compounds the waiting time problem. There is a need to increase capacity, and the Department of Health should undertake an examination of the medium- and long-term demand for digital hearing aids. The Committee notes the variation in practice in NHS audiology departments, and believes many could operate more efficiently. They should examine the skill mix and levels of training or experience necessary, and look at more flexible approaches to service provision. The report also comments on the involvement of the private sector to provide additional capacity, and the entry into the market of others such as opticians. The private services need to be monitored and the quality of care assessed on the same basis as that used for the NHS.
Over the past 20 years, public concerns have grown in response to the apparent rising prevalence of food allergy and related atopic conditions, such as eczema. Although evidence on the true prevalence of food allergy is complicated by insufficient or inconsistent data and studies with variable methodologies, many health care experts who care for patients agree that a real increase in food allergy has occurred and that it is unlikely to be due simply to an increase in awareness and better tools for diagnosis. Many stakeholders are concerned about these increases, including the general public, policy makers, regulatory agencies, the food industry, scientists, clinicians, and especially families of children and young people suffering from food allergy. At the present time, however, despite a mounting body of data on the prevalence, health consequences, and associated costs of food allergy, this chronic disease has not garnered the level of societal attention that it warrants. Moreover, for patients and families at risk, recommendations and guidelines have not been clear about preventing exposure or the onset of reactions or for managing this disease. Finding a Path to Safety in Food Allergy examines critical issues related to food allergy, including the prevalence and severity of food allergy and its impact on affected individuals, families, and communities; and current understanding of food allergy as a disease, and in diagnostics, treatments, prevention, and public policy. This report seeks to: clarify the nature of the disease, its causes, and its current management; highlight gaps in knowledge; encourage the implementation of management tools at many levels and among many stakeholders; and delineate a roadmap to safety for those who have, or are at risk of developing, food allergy, as well as for others in society who are responsible for public health.
In England, implementing Electronic patient record (EPR) systems is one of the main aims of the 10-year National Programme for Information Technology (NPfIT). The main plank of the NPfIT programme is the NHS Care Records Service (NCRS) which will create two separate EPR systems: a national Summary Care Record (SCR), containing basic information, and local Detailed Care Records (DCRs), containing more comprehensive clinical information. NCRS will also include a Secondary Uses Service (SUS) which will provide access to aggregated data for management, research and other 'secondary' purposes. On the SCR, this report finds: a lack of clarity about what information will be contained; consent arrangements for creating and adding information have not been well communicated to patients or clinicians; important components have not yet been completed; maintaining security is a serious challenge. The DCR systems are to replace local IT systems across the NHS, but the report points to delays in trials and implementation, difficulty in establishing either the level of information sharing that will be possible, or how sophisticated local IT applications will be. There has also been a lack of local involvement in delivering the project, with hospitals often left out of negotiations between Connecting for Health (the body delivering NPfIT) and suppliers, leading to a lack of enthusiasm for deploying the systems. The Committee recommends Connecting for Health focuses on setting and ensuring compliance with technical and clinical standards for NHS IT systems, allowing local users the final say over which system is procured and how it is implemented. The report points to some notable successes too: agreement on a universal coding language for the NHS, and a single unique patient identifier, the NHS number; and the potential for the SUS and health research is significant.
Healthcare systems have been confronted by multiple, often conflicting, guidelines on the use of medical technologies. The National Institute for Clinical Excellence (NICE) was established in 1999 to address these problems in England. This work looks at what it does, how it works, changes made since its establishment, and the challenges it faces.