What allergy patients should expect from the NHS

• When presenting to the local surgery for the first time, the allergy patient should expect to see a doctor or nurse with some knowledge of allergy
• The allergy patient should expect the doctor to know where to send the patient for an allergy referral, the level of service offered at the nearest clinic, and where there is a specialist –led clinic
• An urgent allergy referral is required by patients whose allergy is severe or, potentially life threatening. This must be to a doctor with the appropriate expertise
• Patients have the right to request a referral to a specialist led clinic even if it is out of the immediate local area
• The GP should have sufficient competence in allergy to make this decision
• Each child should be referred to a doctor with the appropriate competence in allergy. In many cases this requires a consultant paediatric allergist
• All patients who require it should have access to a full allergy service with a dedicated allergy team
• All patients have the right to ask for a second opinion from a specialist in allergy if they feel they are not getting the necessary level of service to manage their condition
• Except for the simpler allergies such as mild hay fever, allergy patients should have an accurate allergy diagnosis which must include a search for the allergens causing symptoms and assessment of allergic disease in different parts of the body.
• Just as with other complex disorders, the great majority of patients with severe and more complex allergy need allergy care based on a personalised allergy plan which supports the day-to-day control and management of their condition
• In order to have an individual management plan, adequate time needs to be set aside for full discussion of symptoms, treatment, appropriate medication and trigger avoidance
• All patients at risk of life-threatening allergies such as anaphylaxis, some food allergies and angioedema need to know that during any emergency, those responsible for their care are following agreed, standard emergency management protocols that have been accepted for local implementation.
• After any severe reaction every patient needs to be referred to a specialist in allergy irrespective of whether they have seen a consultant in the past with emphasis on discovery of the causal agent(s), avoidance and treatment.
• Every patient suspected to be at risk of severe allergy should have at least one visit to a local, consultant allergist who provides a dedicated allergy service which includes modern diagnostics and the ability to administer allergen-specific immunotherapy.