We currently have multi-disciplinary allergy clinics Monday to Friday located both at Starlight Outpatients in Homerton Hospital, Hackney and the Sir Ludwig Guttman Centre, Stratford. Furthermore, we have additional nurse-led clinics and dietician clinics running regularly.
Our team also run transitional clinics with our adult allergy colleagues in order to offer optimum care for the adolescent age group with more complex allergy conditions and thereby providing continuation of care throughout this service.
Before the appointment
Any children 16 years and under must be accompanied by their parent or guardian. Antihistamine medications such as piriton, cetirizine, loratadine and fexofenadine should be stopped at least 3 days before attending the appointment as they will affect allergy tests and may cause incorrect results. Please note that some cough and cold medicines may also contain antihistamine. All other medications such as inhalers, nasal sprays, eye drops, creams etc can be continued. Please bring all regular medications with you to the clinic.
We request that you also bring photographs of any visible symptoms such as skin rash, swelling or hives to the appointment as this will help us to take a more accurate history. You should also make note of the foods, medicines or other products that you think may be causing allergic reactions so that the team can perform accurate testing.
During the appointment
Please ensure that you arrive on time for the appointment. Our patients usually see multiple members of the team on the day so the appointment can last up to 2 hours. You will initially have a consultation with the doctor who will take a detailed history of allergy symptoms and what may be triggering them. This is usually followed by an allergy test which helps to formulate a diagnosis. The two main types of tests are:
Skin prick tests: an allergy test which can tell us how likely your child is to be allergic to specific allergens (foods, pollens or other substances). It is a very safe procedure usually carried out by the clinical nurse specialist. We place tiny drops of extract allergen solution (or fresh foods) onto the skin of the forearm and touch the skin gently with the tip of a small lancet. This may feel a little sharp but is usually not painful. If testing is positive, the skin will develop a raised itchy wheal within 15 minutes. The size of the wheal is then measured and interpreted. There may be the odd occasion where we do not have a certain food available- in this case the team may request that you bring a small quantity of that particular food for testing.
Blood tests: can be used to measure the level of antibodies produced by the body’s immune system against many specific allergens. This can be useful if skin prick testing is not possible. In some cases, we may decide to carry out a blood test as well as skin prick testing to make a more detailed assessment. Blood tests are carried out by trained professionals. We will offer cold spray to numb the area of skin before the blood test.
Once testing is completed the team will offer advice, such as allergy management on how to recognise and treat both mild-moderate and severe reactions (anaphylaxis). This includes education on how to take antihistamines and the use of adrenaline auto-injectors (e.g. EpiPen). Please note that not every child with a food allergy will be prescribed an adrenaline autoinjector, as this depends on certain risk factors which will be assessed by the doctor on the day. We also provide information on allergen avoidance, asthma education, use of inhalers/ spacers, management of allergic rhinitis, use of nasal sprays and eczema management.
For children who have allergic asthma, our service runs a weekly clinic with the respiratory nurse who will carry out extra investigations including spirometry (lung function tests) and Fractional Exhaled Nitric Oxide (FeNO), which measures the amount of inflammation in an airway.
Following this, the allergy dietician may provide dietary support to children and their families, such as: advice on avoidance of foods that your child is allergic to, offering information on having a balanced diet to maintain nutritional needs and where appropriate home introduction of foods that your child is not allergic to.
After the appointment
If food allergies are identified, the child and their family will be supplied with an Allergy Action Plan to give to the nursery/ school. Our team will also write a letter to the GP with details of the consultation, treatment plan and medications that will need to be supplied. Occasionally, parents/carers may also be given a prescription (FP10) for any medications required and these can be dispensed by any pharmacy outside the hospital.
Following the consultation, the doctor will decide if another appointment is needed. If children require further investigations or treatment such as an allergy challenge or immunotherapy, the allergy team will liaise with our admin team to organise an appointment for this. We would highly recommend that all personal information such as correspondence address, phone numbers, email address and GP details are verified with the Outpatients reception team on the day of the appointment.
If you need to cancel or reschedule the appointment, please call our bookings team as soon as possible.
