Allergy Service - Salford Royal

The Allergy service provides facilities for the investigations, diagnosis and treatment of Immediate Hypersensitivity allergic conditions, including:

•    Airborne allergen hypersensitivity
•    Food allergy
•    Anaphylaxis
•    Urticaria and angioedema
•    Adverse drug including antibiotic and local anaesthetic reactions
•    Allergen (venom and some aeroallergen such as grass pollen) immunotherapy (desensitisation)
•    Oral challenge test
•    Aspirin desensitisation

We do not offer services to patients with:

•    Chronic fatigue syndrome
•    Food intolerance
•    Irritable bowel syndrome
•    Mast cell activation syndrome 

Similarly adult patients with severe eczema are unlikely to have food as a triggering factor for their eczema flare up and do not benefit from our expertise. These patients are best referred to alternative services.

Clinics for allergy diagnosis, assessment and management of the above allergy conditions are held in the Outpatients Departments every Monday, Wednesday, Thursday and Friday. 

Desensitisation treatments for venom allergy and food and drug provocation challenges are held respectively on the Brook Treatment Unit on Wednesday and Friday afternoons.

We carry out skin testing for penicillin allergy and subsequent antibiotic challenges on the Brooke Treatment Unit once a month.

What will happen during my allergy clinic appointment?

One of our doctors or nurses will take the details of your symptoms. Background medical questions will help us to understand other factors that might be involved. From your description of symptoms and the answers to other questions, we will begin to understand what the causes might be.  A short medical examination might be necessary, but you will always be offered a chaperone if you would like one as your safety, privacy and dignity are paramount to us. We may request blood tests at your appointment and there is a phlebotomy service provided within the clinic.

For most patients we can complete the discussion, allergy testing (if required for assessment) and management plan in one visit.

Please allow at least an hour for the consultation, testing and management plan. In order to prepare for your clinic appointment, we recommend you read the following:

• Your Outpatient Appointment

Will I have an allergy test?

The best way to make a diagnosis of allergy is from the symptoms and history that you give, but often allergy tests will also be helpful to confirm the diagnosis.  We will test likely and relevant allergens (e.g. peanut, tree nuts, and pollens). Blanket allergy testing is not performed. Many patients, e.g. those with frequent rash without any obvious trigger, will not require an allergy test.

Please stop taking your anti-histamines for 72 hours before your appointment.

This is so we can carry out skin testing without the medication interfering with the results. If you cannot manage without anti-histamines, please contact the Immunology nurses to discuss.

Skin-prick test for allergens

A skin-prick test is a quick and useful test when looking for an allergen. It is safe and you get the results within about 20 minutes. Your skin on your arms or back is pricked with a tiny amount of the suspected allergen. If you have a reaction, the skin around the prick will very quickly become itchy and red, with a swollen mark called a wheal.

We do a positive control (histamine) which will become red and itchy for most service users. We also do a negative control test (using saline) which should not itch or become red. You may be asked to wait in the waiting room after the skin tests and then come back into the clinic room for us to read the results.

Blood test for allergens

The blood test used to test for allergens is called a specific IgE test. It is used to measure the number of IgE antibodies in your blood that have been produced by your immune system in response to a suspected allergen. The results of this test should be interpreted by a specialist.

Do I need to bring anything to the appointment?

Please make sure you bring an up-to-date list of all your medications.

Sometimes people identify food as a possible cause of their allergic symptoms. Please bring in the main ingredients or a list of ingredients which are of concern to your appointment. Skin testing for fruit and vegetables is best done with fresh, raw ingredients so it is very useful if you can bring these with you e.g. apple, banana, carrot. We will perform the tests which are appropriate to your clinical history. It will be useful if you can complete “reaction diary”. It is available from patient charity called “Allergy UK”. The link for the charity is provided below.

If the possible allergen is a drug, please bring in the actual box/ carton of the drug or the name of the drug if possible. If you wish to discuss this, please contact the Immunology nurses. We would need the drug allergy proforma completed, please find the link for this in the referral information. 

What can I expect by the end of the clinic?

Each patient that attends the service will have an individual written management plan contained within a clinical letter posted to them. Each patient and GP receives a copy of the letter.  For prescriptions required quickly we will give you a form for your GP which should be dropped off at your local surgery for your GP to provide a prescription. Alternatively, we may also provide you with a prescription. 

Additional support / referral

Having an allergy can have a significant psychological impact on patients and we are very privileged to have access to a clinical psychologist at Salford. If the specialist undertaking your consultation feels you may benefit from seeing a clinical psychologist, this will be discussed with you at your appointment. Further information on this service can be found via the link below. We also have access to specialist allergy dietician and if it is felt you may benefit from a dietician review this will be discussed with you at your appointment.

Clinical Health Psychology - information guide

Clinic Information 

Our service is mainly delivered in main outpatients are and in renal clinic department and the day unit at Salford Care Organisation site.

Following positive patient feedback, we continue to offer telephone appointments (if appropriate) as well as face to face appointments.

It is important that you contact our appointments centre with appointment changes or cancellations. The contact number can be found in the ‘contact details’ section of this website. We are under extreme pressure for appointments and to provide timely reviews, we need to utilise them as best we can.

Telephone appointments

Telephone appointments can work well, however please check the following points to make sure you get the most from your appointment:

• We have the correct phone number
• Your phone is working and has reception
• Your phone accepts calls from unidentified numbers
• You are in a quiet place, where you can talk privately
• For young adults we need you to be on the call.  You are welcome to include your parent or guardian on speaker phone.

We will often try and call back if we do not initially get a response. However, this is not always possible as we have a timeslot for each patient in the clinic.

If you are unable to attend your appointment, please call the number on your appointment letter or the appointments centre 0161 206 4100.

Face to face appointments

Face to face appointments are useful, especially if you need examination or an allergy test.  Sometimes interactions and conversations work better when you are there in person, but we understand this may vary for patients depending on circumstances.

For information about car parking, visit our getting here section.  Allow plenty of time for finding a space at busy times and sufficient change for car parking.

Day unit

Allergy challenges, to both drugs and food, and some skin testing is performed at the day unit (Brooke Treatment unit). Not all patients require a challenge for diagnosing an allergy. There are times where skin testing/ blood tests/ the history is not conclusive of allergy. In those circumstances, it may be appropriate to perform a challenge. This involves administering the allergen, whether that is a particular food or medication, and observing for a reaction in a monitored controlled environment. If you do require a challenge, this will be discussed with you at your clinic appointment. Further information on allergy challenges can be found in the link below.

Patients undergoing allergy challenges

General Practitioners (GPs) may refer through the Electronic referral system.  External referrals may be sent through the emails below. 

The Allergy service at Salford Care organisation provides diagnosis and management of Immediate type 1 hypersensitivity reactions. All cases of suspected anaphylaxis should be referred to an allergy service. Cases of suspected peri-operative anaphylaxis should be referred to Manchester Foundation Trust (MFT). Please be aware that we do not offer patch testing. We also do not provide a service for food intolerance or non-allergic gastro-intestinal disorders such as irritable bowel syndrome, as well as mast cell activation syndrome or chronic fatigue. Please review the North West Allergy and Clinical Immunology document for referral of food allergies below. Please also ensure an allergy diary is completed prior to referral, both for food and drug allergies. The link for the allergy diary is noted below. Please complete and attach this to the referral. 

Download your allergy diary.

Please review the NICE guidelines for drug allergy before making a referral. 

For penicillin allergy, please review the document as not all patients require specialist de-labelling.

Food Allergy In Adult Referral Information.

Food Symptoms Diary

For rhinitis/ rhino-conjunctivitis and urticaria/ angioedema referrals, please follow the North West Allergy and Clinical Immunology referral pathway, linked below, to ensure referral is required. Patients with these conditions only require referral if they remain symptomatic despite medical management noted in the pathway has been optimised.

NWACIN Rhinoconjunctivitis primary care pathway

NWACIN Urticaria primary care pathway

External Referrals – salfordcareorgb&s@nca.nhs.uk

Booking Enquiries –   Booking&SchedulingOutpatientsSCO@nca.nhs.uk 

Admin Enquiries – AdminCentreReferralsSCO@nca.nhs.uk

• Adult Allergy Action Plans - BSACI
• Allergy UK 
• Anaphylaxis Campaign 
• British Society for Allergy and Clinical Immunology 
• EPIPEN  
• Food Standards Agency  
• JEXT - single use adrenaline auto-injector pen