Climate change has a profound impact on the phenology and abundance of plankton in the NE Atlantic and North Sea. There is concern that harmful algal bloom (HAB) species may increase, accompanied by negative socio-economic impacts, including threats to human health and marine harvesting. We reviewed historical major UK outbreaks of poisoning and attempted to examine the epidemiology on a finer scale by linkage of hospital admissions, GP and pathology records. As expected the incidence of shellfish poisonings was very low but accurate identification of poisoning was generally unreliable. The current UK shellfish monitoring programme is the key indicator for monitoring trends in the risk of human exposure. Using the Continuous Plankton Recorder (CPR) survey, we mapped spatial and temporal trends of various phytoplankton, including HAB species, and zooplankton (Tintinnids and Calanus). We found fundamental shifts in the relative abundance of diatoms versus dinoflagellates, with a dramatic dinoflagellate decline in recent years. Northward shifts in abundance were found for some Tintinnid and Calanus taxa. Using criteria of statistical causality, these changes were linked to climate, in particular sea surface temperature and increasingly windy conditions in the summer, with a notable non-linear interaction between these factors. Focusing on Calanus, we showed the strength of statistical links between abundance and climate variables can wax and wane as the time series lengthens. We found tentative evidence for adaptation of Calanus to climate change, but not at a level that could reverse overall long-term patterns. Links with climate are often argued to be proxies for unobserved mechanisms that determine species abundance, such as stratification. We developed a new stratification index, covering the whole NE Atlantic from 1970 to 2009. We propose that this has wide applicability in marine climate change studies. Throughout, our work demonstrates the importance of consistent long-term ecological survey data.