People with allergies often feel let down by the NHS, and can wait months to see a specialist, a government review of services has found.
The report said charities and other groups were often left to plug the gaps in NHS care.
It said more should be done to help the third of people who are affected by allergies at some point in their life.
But doctors said the government could not devolve responsibility for allergy care to local health groups.
The report was compiled after submissions from groups and individuals with an interest in allergy care.
It followed criticisms of NHS allergy services by the House of Commons health select committee.
Quality of life
Around a third of the total UK population - 20 million people - suffer from allergies at some stage in their lives.
And about three million people visit their doctor or hospital suffering from conditions related to allergies every year in England - costing the NHS around £1 billion.
"Without funding, targets, and an increase in the number of doctors with expertise in allergy, we will be going backwards"
Another, 2,400 people are admitted for eczema, most of whom are children. There are also more than 3,000 admissions every year for potentially dangerous allergies.
Anaphylaxis, a severe allergic reaction, causes 10 to 20 deaths every year - but it is often not recorded on the death certificate, the report added.
However, the report found many people with allergy felt their GP did not understand their condition.
In a foreword, care services minister Ivan Lewis said there was a need "to remedy the shortage of specialist allergists".
He added: "The review has heard that people with allergies often feel let down by a poor and frequently unobtainable service.
"For those living with an allergy severe enough to require specialist care, the lack of allergy services is a problem which can greatly affect their quality of life.
"Not-for-profit organisations help, through helplines and other information services, to fulfil an important need that is yet to be addressed by the NHS, but this is not enough.
"Some people can wait three to nine months for an appointment to see a consultant in secondary care."
He said GPs should also be able to offer the information and guidance people needed to manage their allergies.
But Dr Pamela Ewan of the Royal College of Physicians , who helped compile a 2003 report on allergy services, said: "The Department of Health review has tried to address the issues, but their recommendations will hardly scratch the surface of the problem.
"This needs central direction and funding and cannot be left to devolved local systems.
"That has been the situation for the last decade, and patient care has not improved."
She added: "Without funding, targets, and an increase in the number of doctors with expertise in allergy, we will be going backwards."
A spokesman for the British Society for Allergy and Clinical Immunology said: "The Department of Health recognises there is a problem, but fails to adequately address this and fails to make any recommendation that will ensure change.
"What is needed, to meet the very large patient need, is to create more specialists in allergy and to improve the knowledge of allergy in primary care doctors.
"This needs central direction and funding and cannot be left to devolved local systems, as the department proposes."
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