A new national report has called for urgent action to strengthen and modernise the UK’s infection-specialist workforce. The report, Infection Prevention and Management in the UK: The Infection-Specialist Workforce, was published by the Healthcare Infection Society and partner organisations across the infection community.
At first glance, workforce planning may sound like an issue mainly for hospitals, universities, laboratories and policymakers. However, for people living with aspergillosis and other complex fungal diseases, the availability of specialist expertise can directly affect diagnosis, treatment, access to advice and long-term outcomes.
Why this matters to patients
Aspergillosis is not a single disease. It includes conditions such as Allergic Bronchopulmonary Aspergillosis (ABPA), Chronic Pulmonary Aspergillosis (CPA), Aspergillus bronchitis and invasive aspergillosis.
These conditions are often complex, uncommon and difficult to recognise. Many patients describe long journeys to diagnosis, sometimes involving repeated chest infections, worsening asthma, unexplained fatigue, weight loss, breathlessness, abnormal scans or uncertainty about the meaning of test results.
When specialist infection, respiratory, laboratory and mycology expertise is difficult to access, patients may face longer waits for diagnosis, referral and treatment decisions.
Why this matters to professionals
The report highlights the central role of the infection-specialist workforce in clinical care, diagnostics, infection prevention and control, antimicrobial stewardship, public health and system preparedness.
This workforce includes infectious diseases physicians, clinical microbiologists, virologists, medical mycologists, infection prevention specialists, specialist nurses, antimicrobial pharmacists, biomedical scientists and clinical scientists.
For fungal disease, this multidisciplinary expertise is essential. Diagnosing and managing aspergillosis often requires careful interpretation of clinical history, imaging, fungal culture, Aspergillus antibody testing, galactomannan, molecular diagnostics, antifungal drug levels, susceptibility results and treatment toxicity monitoring.
What workforce shortages can mean in practice
For patients with aspergillosis, workforce pressures may contribute to:
- Delays in recognising possible fungal disease.
- Delays in referral to specialist services.
- Variation in access to expertise between regions.
- Longer waits for interpretation of specialist tests.
- Reduced capacity for multidisciplinary team discussion.
- Greater pressure on specialist centres and laboratories.
- Delays in accessing newer diagnostics, antifungal treatments or clinical trials.
For professionals, these pressures can make already complex work more difficult. Clinicians may be managing patients with rare fungal disease alongside heavy general respiratory, microbiology, infectious diseases or laboratory workloads. Specialist advice networks and reference services therefore become increasingly important.
The importance of medical mycology
Fungal diseases remain under-recognised compared with many bacterial and viral infections, despite causing serious illness in people with chronic lung disease, immune suppression, transplantation, cancer treatment or prolonged critical illness.
Medical mycology is a highly specialised area. It supports accurate diagnosis, antifungal treatment selection, interpretation of complex tests and recognition of emerging resistance. Without sufficient mycology expertise, advances in fungal diagnostics and treatment may not reach patients quickly or consistently.
The role of specialist centres
The UK benefits from specialist services such as the National Aspergillosis Centre, which provides expert assessment, multidisciplinary review and advice for patients with complex forms of aspergillosis.
However, specialist centres cannot work in isolation. Earlier recognition by GPs, respiratory teams, radiologists, microbiologists, infectious diseases teams and local laboratories is vital. Strong referral pathways help patients reach the right expertise at the right time.
For rare fungal diseases, national specialist centres and local services need to function as part of a connected system rather than as separate parts of care.
A patient safety and equity issue
Access to infection expertise is also an equity issue. Patients should not face very different chances of diagnosis or specialist input depending on where they live.
Strengthening the infection-specialist workforce could help reduce variation in care, support earlier diagnosis and improve access to expert advice across the UK.
Looking ahead
New antifungal drugs, improved diagnostics, molecular testing, genomics and clinical trials are creating new opportunities to improve aspergillosis care.
But innovation only helps patients if there are trained professionals available to recognise fungal disease, request appropriate tests, interpret results, prescribe and monitor treatment, and work across multidisciplinary teams.
For patients and professionals alike, the message is clear: strengthening the UK’s infection-specialist workforce is not simply a staffing issue. It is essential for earlier diagnosis, safer treatment, better access to expertise and more equitable care for people living with complex fungal diseases.
What does this mean for people living with aspergillosis?
- Specialist expertise can help shorten the journey to diagnosis.
- Better workforce capacity can improve access to advice and referral.
- Strong laboratory services are essential for accurate fungal diagnosis.
- Medical mycology expertise helps guide safe and effective treatment.
- More consistent access to specialist care could reduce regional inequality.
Further reading
- Healthcare Infection Society: Infection Specialist Workforce Report
- Royal College of Pathologists: New report calls for urgent action to strengthen the UK’s infection specialist workforce
Frequently Asked Questions
Why are infection specialists important for aspergillosis?
Aspergillosis can be difficult to diagnose and manage. Infection specialists, respiratory clinicians, microbiologists and medical mycologists help identify fungal disease, interpret specialised tests and guide treatment decisions.
What is medical mycology?
Medical mycology is the branch of medicine and laboratory science concerned with fungal diseases affecting humans. Specialists in medical mycology help diagnose and manage infections caused by fungi such as Aspergillus.
Why can aspergillosis take a long time to diagnose?
The symptoms of aspergillosis often overlap with those of more common respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and recurrent chest infections. Specialist investigations and expert interpretation are frequently required.
How could workforce shortages affect patients?
Workforce shortages may contribute to delays in diagnosis, referral and access to specialist advice. They can also place additional pressure on laboratories, multidisciplinary teams and specialist centres.
What role do specialist laboratories play?
Specialist laboratories perform fungal cultures, Aspergillus antibody testing, antigen testing, molecular diagnostics and antifungal susceptibility testing. These investigations are often essential for accurate diagnosis and treatment planning.
What is the National Aspergillosis Centre?
The National Aspergillosis Centre (NAC) is a UK specialist service providing expert assessment, multidisciplinary review and management advice for patients with complex aspergillosis.
Will new treatments solve these problems?
New antifungal medicines and diagnostic technologies offer significant opportunities to improve care. However, trained healthcare professionals are still needed to recognise disease, request investigations, interpret results and monitor treatment safely.
How can patients help improve awareness of aspergillosis?
Patients can help by sharing reliable information, supporting awareness campaigns, participating in patient groups and, where appropriate, contributing to research and patient involvement activities.
Last reviewed: June 2026
Suggested audience: Patients, carers, respiratory clinicians, infectious diseases clinicians, microbiologists, medical mycologists, specialist nurses, pharmacists, biomedical scientists, clinical scientists, commissioners and service planners.
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