Quality standard
Quality statement 2: Referral to specialist allergy services after emergency treatment
Quality statement 2: Referral to specialist allergy services after emergency treatment
Quality statement
People who have received emergency treatment for anaphylaxis are referred to a specialist allergy service. [2016, updated 2024]
Rationale
Specialist allergy services can identify the cause of an anaphylactic reaction. Referral to these services after emergency treatment for anaphylaxis will ensure that people receive the correct advice and treatment. If people are not referred to a specialist allergy service, their safety might be compromised and they may receive inappropriate management, have an increased risk of recurrent anaphylactic reactions and feel anxious about possible recurrence.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
Proportion of cases of emergency treatment for anaphylaxis that are followed by referral to a specialist allergy service.
Numerator – the number in the denominator that are followed by referral to a specialist allergy service.
Denominator – the number of cases of emergency treatment for anaphylaxis.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records. General practice patient records may be a more reliable source of data as coding of anaphylaxis is limited in emergency care data sets.
What the quality statement means for different audiences
Service providers (such as general practice, emergency departments and paediatric services) ensure that people who have had emergency treatment for anaphylaxis are referred to a specialist allergy service.
Healthcare professionals (such as GPs, emergency department staff, and members of paediatric and adult medical teams) refer people who have had emergency treatment for anaphylaxis to a specialist allergy service. The referral can be made by the person's GP, staff in the emergency department or by other members of secondary care medical teams, after initial treatment in an emergency department or by hospital staff.
Commissioners ensure that local specialist allergy services are available and agree pathways for referral to specialist allergy services for people who have had emergency treatment for anaphylaxis.
People who have had emergency treatment for anaphylaxis (a severe, life-threatening allergic reaction) are offered an appointment at a specialist allergy service. This is to find out the cause of the reaction and to get advice on what to do in the future.
Source guidance
Anaphylaxis: assessment and referral after emergency treatment. NICE guideline CG134 (2011, updated 2020), recommendation 1.1.9
Definitions of terms used in this quality statement
Specialist allergy service
A service consisting of healthcare professionals with the skills and competencies needed to accurately investigate, diagnose, monitor and provide ongoing management of, and patient education about, anaphylaxis. The service should be age appropriate if possible. [Adapted from NICE's guideline on anaphylaxis, recommendation 1.1.9]
Details of local allergy services are available from the British Society for Allergy and Clinical Immunology (BSACI) 'find a clinic' search, including information on services with expertise, particularly in food, drug or venom allergies, or from the NHS website allergy service finder. [Expert opinion]
Equality and diversity considerations
When referring people to a specialist allergy service, any potential difficulties in access, such as travelling distance, disability or financial barriers, should be taken into account.