Outpatient and day-case services

Outpatient Allergy clinics
Allergic illness could affect various systems within the body. We know that the adults who are affected by one allergic condition, such as food or pollen are more likely to suffer from another, such as asthma or eczema. For most adults these conditions can be managed by the allergy service alone. However, we are seeing an increasing number of patients with complex, interacting allergic conditions and there are opportunities to refer those patients internally to other specialists like Dermatology, ENT, Gastroenterology and other medical specialities. We also run transitional clinics with our paediatric allergy colleagues in order to offer optimum care for the adolescent age group with more complex allergy conditions and thereby providing continuation of care thorough this service. .

We currently run 10 adult allergy out-patients’ clinics per week. Any patient requiring review in the transitional clinic will be added to the clinics on a pre-arranged basis based on the prior discussion at the allergy MDT.

Adult allergy clinics at Homerton Hospital
Prof Raj K Rajakulasingam – Lead Consultant Allergy & Immunotherapy (Tuesday PM, Thursday PM and Friday AM)
Dr Sheena Barnett    – Consultant Allergy (Thursday AM and Friday AM
Dr Timothy Watts      - Consultant Allergy (Monday AM, Wednesday AM, Thursday AM & Friday AM)

Day case procedures

Generally all our patients referred to the service will have their suspected allergy investigated, diagnosed and a management plan devised and discussed during their outpatient appointment. The majority of patients with a suspected allergy will have skin and blood tests at the outpatient appointment. However, any patient who would require further investigation for allergy or require  Immunotherapy, Anti Ig-E treatment or allergy education would be given an appointment to attend our specialist allergy unit  as a day case.

As a tertiary service, we offer expert clinical opinion supported by appropriate investigations including skin prick, prick to prick and intra-dermal testing, oral food provocation test and drug provocation testing.

Food provocation tests are led by Professor Raj K Rajakulasingam, Lead Allergy Consultant. Drug provocation tests are led by Dr Timothy Watts, Consultant Physician in Adult Allergy

All of the investigations for drug allergy testing take place on our adult allergy day case unit. We additionally provide drug patch testing for non-immediate drug hypersensitivity, working collaboratively and receiving referrals across London from dermatology colleagues and other allergy centres requiring this specialist drug patch testing service.  

The activities in the adult allergy unit are led by Lead Nurse, Thippeswamy Billahalli with a team of specialist allergy nurses. We perform food and drug challenges, allergy education, anaphylaxis management training as well as administration of immunotherapy and anti-IgE therapy on the adult allergy day unit.

If you require a food or drug challenge, immunotherapy, anti-Ig E treatment, allergy education or anaphylaxis management training, your clinician will advise you of this at your consultation and/or in writing after the multi-disciplinary meeting. . You will be contacted by a member of our allergy administration team via email/phone/text/letter inviting you to contact us to book an appointment.  However, following your outpatient consultation with one of our clinicians above, if you have any queries regarding booking your appointment or planned procedures please contact us on the contact details below.

Find out more information regarding any of your planned procedures here.

We currently operate the following clinics from our Adult Allergy Services;

Monday: Immunotherapy Clinic & Ad hoc Food Allergy Testing Clinics
Tuesday: Drug Allergy Testing - AM & PM Challenge Clinics
Wednesday: Food Allergy Challenge Clinic – AM & Multi-Disciplinary Meeting – PM
Thursday: Food Allergy Challenge Clinic AM & Ad hoc Immunotherapy AM/PM
Friday: Anti IgE Clinic for Asthma & Urticaria AM & Ad hoc Immunotherapy PM

The adult allergy service is closed during weekends and bank holidays.

 

We provide a comprehensive immunotherapy (desensitisation) programme throughout the year for our service users locally and within the North East region of London.
The service is run by Prof Rajakualsingam – Lead Consultant Allergist and Thippeswamy Billahalli – Lead Nurse adult allergy service and our team of Allergy Clinical Nurse Specialists.

Specific immunotherapy is a treatment for some severe specific allergies that do not respond to optimal medical treatment. We offer immunotherapy for allergy to:

• pollen (grass & tree)
• house dust mites
• animal dander – only in selected cases as an exception
• insect venom (bee & wasp)

In some cases, immunotherapy may be given as a subcutaneous injection or a sublingual (oral) treatment. This is chosen based on the individual patient profile and the availability of a particular product.

Any patient who is being considered for the treatment will be assessed by the allergy consultant in the outpatient clinic followed by an allergy clinical nurse specialist via a telephone assessment clinic where different treatment options and suitability for treatment is discussed in detail.

Treatment is initiated on our adult allergy service unit under the supervision of our specialist nurses. Subcutaneous immunotherapy requires visits to the unit at weekly and then every 4 to 8 weeks intervals. In the case of sublingual immunotherapy, this is continued at home with regular visits at 2 monthly intervals. We do not currently offer immunotherapy for food allergies. We also provide a immunotherapy programme for patients who have had anaphylaxis to wasp and bee stings. Immunotherapy treatment is an intensive three year (minimum) treatment programme, requiring regular visits to our unit. We need your commitment on this to complete the treatment over the 3 year period.