When visiting your local surgery about allergies for the first time, you should see a doctor or nurse with some knowledge of allergy
The doctor should know where to send you for an allergy referral, the level of service offered at the nearest clinic, and where there is a specialist-led clinic
If your allergy is serious or potentially life-threatening, you should be given an urgent allergy referral, to a doctor with the appropriate expertise
You have the right to request a referral to a specialist-led clinic, even if there isn’t one in your immediate local area
Each child should be referred to a doctor with the appropriate competence in allergy – in many cases that will be a consultant paediatric allergist
All patients who require it should have access to a full allergy service with a dedicated allergy team
If you think you have an allergy, see your GP as soon as possible, even if you’re unsure about just how serious it is.
Your GP can refer you to an allergy clinic for further investigation and allergy testing. They can find allergy clinic information by visiting the British Society for Allergy and Clinical Immunology (BSACI).
Right to a second opinion. If you feel your current care is not adequate, you may request a second opinion from another allergy specialist.
Who should be referred. Mild seasonal conditions (such as hay fever or mild eczema) can often be managed in primary care (e.g. by your GP). People whose allergies affect their daily life, who have had severe reactions, or who have complex/multiple allergies should be offered specialist assessment.
Thorough assessment. The specialist will review your medical history, tests and reactions, and identify likely triggers. They may arrange targeted tests (skin or blood tests) or supervised challenges if needed. Find out more about allergy testing.
Individualised care plan. You should receive a personalised plan that explains medicines (including whether you need prescribed adrenaline), how to use them, what to do in an emergency, and practical avoidance advice.
Adequate appointment time. Clinics should provide sufficient time to discuss symptoms, treatment options and your concerns so the plan is practical and agreed with you.
If you’re at risk of life-threatening allergies, you should be able to feel confident that during any emergency those responsible for your care are following agreed, standard emergency management protocols.
After any serious reaction, you should be referred to an allergy specialist irrespective of whether you have seen a consultant in the past. This referral appointment should investigate the triggers that caused the reaction, and focus on future avoidance and treatment.
If you’re suspected to be at risk from a serious allergy, you should have at least one visit to a local, consultant allergist who provides a dedicated allergy service.
This service should include modern diagnostics and the ability to administer allergen-specific immunotherapy.
Having a written allergy action plan is crucial to help you reduce the risks of a serious allergy. An allergy action plan will help you and others (such as relatives, close friends and colleagues) recognise if you’re beginning to have a reaction and know what to do in an emergency.
Your allergy clinic or GP can help you set this up, or our helpline can also advise you.
Adrenaline is the first line of treatment for serious allergic reactions (anaphylaxis).
Because anaphylaxis can happen very quickly, adrenaline is available in different forms that are designed to be easy to use. It’s important to know exactly how and when to use your prescribed adrenaline. Healthcare professionals can show you how to use it, and there are also resources such as practice devices and videos on manufacturer websites.
Options currently available on prescription in the UK include:
You must carry two in-date forms of prescribed adrenaline at all times as a second dose may be needed if symptoms do not improve after five minutes or get worse.
Find out more about what to do in an emergency.
A healthcare professional can show you how to use your adrenaline. You can ask your doctor, practice nurse, pharmacist or school nurse to show you how.
Our AllergyWise online training courses can also help, or you can watch demonstration videos on the manufacturer’s website.
The manufacturers of EpiPen, Jext and EURneffy offer free trainer devices so you can practise using your adrenaline device.
Remember that children who have been prescribed 150mcg/0.15mg AAIs need to go on to the 300mcg/0.3mg dose when they weigh 25kg or over. This is likely to be somewhere between 5-10 years old, depending on the child’s growth.
Simon talks to Dr Matt Doyle about how to use the different types of AAI, when to use them and what to do in an emergency.
Adrenaline degrades over time and may be less effective after the expiry date, so make sure you replace your adrenaline devices on time.
Check your adrenaline auto-injector devices (EpiPen and Jext) regularly to make sure the liquid is clear and colourless. If it seems discoloured or contains particles, replace it.
If you have just got new adrenaline devices and they look defective, return them immediately and report this using the MHRA’s Yellow Card Scheme.
Remember to sign up to the expiry alert service with your adrenaline device brand.
If you have asthma as well as allergies, your asthma should be well controlled. Poorly controlled asthma raises the chances of any allergic reaction being serious. If your asthma needs more treatment than usual, you should take extreme care to avoid those foods or substances that might cause a reaction. You will also need to discuss your asthma with your GP. Everyone with asthma should be seen at least once each year by their GP or asthma nurse to ensure their symptoms are well-controlled.
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