The approach to treatment does vary throughout the world and I am glad to hear that the Spanish treatment worked well, but you cannot conclude it is more advanced from your experience: there's too many other possible explanations. I'm definitely not saying the NHS couldn't improve, obviously. But i'd be interestwd to her if the Spanish people did allergy teats. If they dodn't it is possible they were just lucky in the one they picked, for example. In my (equally anecdotal) experience, the NHS is reluctant to start treatment before they have done lots of tests to convince themselves it is most likely the right treatment. This adds delays as you wait to have the tests and wait for the results. I know other countries which start the treatment based on an initial assessment then try to correct things later if they were mistaken. I'd be hard pushed to decide which is most advanced.