A new report by The Royal College of Pathologists has found that three quarters of UK immunology services do not have enough staff to meet current clinical demand — leaving primary and secondary immunodeficiency patients at serious risk of delayed diagnoses, disrupted treatment, and preventable harm.
The Consultant Immunology Workforce Report highlights a growing crisis in the specialty responsible for diagnosing and managing immune system disorders — including primary and secondary immunodeficiencies such as common variable immunodeficiency (CVID) and severe combined immunodeficiency (SCID).
For immunodeficiency patients, timely diagnosis and treatment can be lifesaving. Without adequate consultant immunologists, patients face longer waits for specialist input, delays in starting immunoglobulin replacement therapy, and interruptions in the careful monitoring that helps prevent life-threatening infections.
Dr Bernie Croal, President, The Royal College of Pathologists, commented:
“Immunology is a small but vital specialty which is fragile and vulnerable to collapse. The shortages we see have a direct effect on patient care – patients face delays to diagnosis and treatment, lack of access to specialists, and worsening health.”
Key risks for immunodeficiency patients
Delayed diagnosis – many patients wait months or even years for their condition to be identified, leaving them vulnerable to repeated infections and long-term damage.
Interrupted treatment – shortages of staff can disrupt delivery of immunoglobulin replacement therapy and other essential treatments, risking hospitalisation or worse.
Loss of continuity of care – in areas with only one consultant, patients can be left without specialist support if that consultant retires, moves, or takes leave.
The report found that 39% of immunology services have at least one consultant vacancy, over half unfilled for a year or more. A quarter of services currently rely on just one consultant immunologist, leaving them highly vulnerable to collapse.
The situation is set to worsen, with 21% of consultant immunologists expected to retire within five years — many earlier than planned due to burnout and poor work-life balance.
Dr Patrick Yong, Chair of the College Specialty Advisory Committee for Immunology, said:
“This is a sobering report. Consultant immunologists are incredibly dedicated to their patients and most services are relying on goodwill – unpaid overtime – to keep services running. This isn’t the way to provide safe, effective patient care. As well as establishing more training posts, we must focus on ways to retain the experienced consultants we have.”
Urgent action needed
The Royal College of Pathologists is calling for:
- establish additional immunology training posts to cover long-standing vacancies and meet future workforce demand
- invest in modernised diagnostic equipment
- improved administrative support and facilities to enable immunologists to focus on clinical duties and deliver the best possible care
- greater protection of time for professional development to support retention
- strengthening workforce planning to ensure the right numbers of consultant immunologists are in post to deliver safe and effective patient care.
For patients with immunodeficiencies, these measures could mean the difference between stable health and repeated hospitalisations — or even preventable deaths. The College warns that without urgent investment; many vulnerable patients will continue to face dangerous delays in diagnosis and treatment.
Posted 25th September 2025
