The Allergy service

The Allergy Service at Nottingham University Hospitals is based at QMC campus and manages patients with allergic problems and urticaria and angioedema.

We are a regional centre for adults with allergy. The regional catchment areas mainly include Nottingham, Derby and Mansfield but we also see patients from Lincolnshire and Leicestershire.

Adult out-patient allergy clinic appointments are held in Clinic 2 at QMC Campus daily (Monday to Friday)

The adult allergy service manages patients with the following conditions: 

  • Seasonal or perennial (all year round), allergic or non- allergic rhinitis not controlled with over the counter medications or by the GP
  • A previous anaphylactic reaction
  • Urticaria (nettle rash) and/or angioedema (swelling) which cannot be managed by the GP or where an allergic cause is suspected
  • Suspected food allergy
  • Ongoing food allergy that requires re-assessment or a change of management
  • Suspected drug allergy causing problems with medical management
  • Anaphylaxis or serious allergic reaction occurring under general anaesthetic

Referrals

Patients are seen in the allergy department following a referral from a GP, other doctor or specialist.

Internal referrals (within the hospital) for allergy/anaphylaxis can be made via the NOTIS system

GPs and other doctors can refer through the “choose and book” system or by sending a referral letter to the Clinical Immunology and Allergy department, A46, South Block, Queens Medical Centre campus. Alternatively, referral letters can be faxed to the Immunology secretaries on 0115 8493260

All referrals for suspected anaesthetic allergy should be accompanied by scanned drug charts and appropriately filled in anaesthetic allergy referral form here: http://nuhnet/acute_medicine/immunology_allergy/Documents/AAGBI%20referral%20form.docx These documents should either be emailed to anaestheticallergy@nuh.nhs.uk or sent to the department.

Preparing for your clinic appointment

It is very important that you read the instructions in your appointment letter

If you are attending an adult allergy appointment, allergy skin tests may be carried out

In order for these tests to be effective it is important that you do not take anti-histamine tablets for 72 hours prior to your  clinic visit.

Antihistamines include – Cetirizine/Zirtec, Loratidine/Clarityn, Chlorphenamine /Piriton, Fexofenadine/Telfast, Levocetirizine/Xyzal  Neo-Clarityn/Desloratidine, Acrivastine/ Benadryl,  and Hydroxyzine

If you are concerned that  stopping anti-histamines will make you unwell and/or you feel unable to do so, or if you feel unsure if any of the medications you take need to be stopped before your appointment , please telephone the department on 0115 970 9130 to speak to one of the nurse specialists who can advise you.

When you come to your appointment, please bring:

  • Your appointment  letter.
  • A list of your medications, including how much you take and how often.
  • Glasses or hearing aids that you use.
  • Your up to date mobile phone number (if you wish to receive text reminders in the future).

In order for us to test your allergy you may also have been asked to bring “offending foods” i.e. foods, drinks or substances that you feel may have caused allergic reactions to clinic for skin prick testing.

If you are a carer or assisting a patient with dementia, please tell reception when you arrive.

Getting to your appointment

Parking is limited at our hospitals.  Please use public transport if you can.

The Medilink bus stops at the 'Park and Ride' at Queens Drive or Wilkinson Street and drops off at the QMC and City Hospital.  Many local bus services stop at QMC and City Hospital. There is a small charge for this service.

 The tram stops at QMC. You can use the tram if you are coming from the city centre. Other areas along the tram routes include Beeston, Chilwell, Hucknall and Hyson Green.

We have a very limited number of Blue Badge (disabled) parking spaces at each site.

 You can find out more information about getting to our hospitals (including maps) here: https://www.nuh.nhs.uk/travel-to-qmc

 

Finding the clinic

All allergy clinics are held in Clinic 2 or 3 at QMC campus.

Clinic 2 is on the Central route on B Floor in between the X-ray department and the Tram bridge exit and clinic 3 is on B Floor in East Block

A map of B Floor which includes the clinics is available here: https://www.nuh.nhs.uk/download.cfm?doc=docm93jijm4n2408.pdf&ver=3489 

If you are unable to find the clinic please ask a member of staff or volunteer for directions

 

Arranging medical transport

If a medical condition prevents you from using public or private transport, please ring the following non-emergency transport providers a few days before your appointment:

If you are registered with a GP in:

• Nottinghamshire – call Arriva Transport Solutions: 0345 266 9662

• Derbyshire – call EMAS: 0300 300 3434

• Leicester, Leicestershire and Rutland - call Thames Ambulance Service: 0345 241 3012

• Lincolnshire – call Thames Ambulance Service: 0808 164 4586

• North and North East Lincolnshire – call Thames Ambulance Service: 0808 164 3030

Changing your appointment

If this is your first appointment in the allergy department you need to cancel or change your appointment you will need to ring 0115 849 3392

If you do change this appointment, it might not be possible to change this again and you may be referred back to your GP.

If you need to change the time or date of a follow-up appointment with us for the same condition please telephone the department secretaries on 0115 970 9130

What to expect at your appointment

When you arrive for your appointment at clinic 2 please check in at the reception and take a seat

Shortly after your arrival you will be called by one of the clinic staff who may ask to weigh you before directing you to an area where you can wait to be seen

At your appointment you may be seen by a consultant, a registrar (experienced junior doctor) or nurse specialists. All staff are trained and experienced in carrying out consultations in allergy.

The doctor or nurse will ask you questions about your symptoms and about your medical history. If allergy is suspected an allergy test may be performed, this may be a skin-prick-test and/or a blood test.

Skin Prick Testing

Skin Prick testing (SPT) is an accurate way to test possible allergic substances to see if they cause an allergic reaction. It can be used to test for food and aeroallergen (substances in the air e.g. pollen) allergies.

SPT alone cannot diagnose allergy and in many cases a SPT may not be required to make a diagnosis.

Most SPTs are carried out using commercially prepared liquid allergens. If you think you have been asked to bring a food, beverage or substance to clinic for skin testing then this should not be mixed with any other products, for example sauces. It should also be individually packaged. For example, bring a whole piece of fruit rather than a pre-prepared fruit salad. If the food is usually eaten cooked, such as chicken, please bring both a raw and cooked sample.

Skin-prick testing is carried out on the inner forearm as follows:

  1. A small amount of the allergen solution liquid is dropped onto the skinSkin Prick Testing image 1
  2. The location of each droplet is marked on the skin with a pen and the skin under the drop of allergen is then pricked with a lancet. This is felt as a small scratch or prickle and is not usually painfulSkin Prick Testing image 4
  3. The droplets are blotted away with a tissueSkin Prick Test image 3
  4. The skin prick test will start to work immediately and may cause itch or irritation to the skin. It is important that you do not scratch the test area as this can make the test difficult to interpret.
  5. After approximately 15 mins the nurse or doctor will be able to read the test result on the skin. Positive results appear as a small itchy wheal on the skin which can be measured with a ruler and recorded in the medical notes​​​​​

Skin Prick Test image 4

Following the skin-prick testing the doctor or nurse will interpret the test results and explain these to you.

Diagnosis

It is often possible to make an allergy diagnosis during the first clinic appointment but sometimes it may be necessary to wait for blood test results and/or to refer you on to a further clinic for more testing.

Drug Allergy

The Allergy Service provides diagnosis and management advise about drug allergy.

If you have been referred to the allergy clinic with a suspected drug allergy or a reaction whilst under general anaesthetic then a diagnosis may not be possible at your first appointment.

After a detailed history of your reaction has been taken in clinic a blood test may be performed and you may then need a further appointment in the drug allergy/challenge clinic for further testing and/or a challenge (introduction of a medication in a controlled environment with medical supervision).

Food Challenge

The Allergy Service provides food challenges.

Diagnosis of food allergy may be possible in a single clinic visit. In some cases however it may be necessary to wait for blood tests and/or to carry out an oral challenge with the food. This involves consumption of a food in increasing amounts, in a controlled environment, with medical supervision.

Immunotherapy

The Allergy Service provides Immunotherapy, also known as desensitisation to pollens, house dust mite, animal dander and wasp and bee venom.

People who have little or no relief despite full, early treatment with steroid nasal spray, higher dose anti-histamines and eye drops may benefit from immunotherapy.

Immunotherapy is an effective and lasting treatment for allergy which is given by subcutaneous injection (under the skin) to the upper arm.

Immunotherapy must be given in a designated allergy clinic and although each injection only takes a few seconds patients must remain in the clinic for 1 hour after the injection in order to observe for any side-effects

Immunotherapy is not suitable for all people, particularly those with other medical problems, poorly controlled or severe asthma or people with multiple allergic problems.

Inpatients

The Allergy service does not have any inpatient beds.

We provide clinical liaison service for in-patients both by telephone advice and ward consultation. Advice can be sought by contacting the secretaries or registrars or by getting in touch with consultants through NUH switchboard.

Useful links

Useful information about allergy can also be found at:

The British Society for Allergy and Clinical Immunology (BSACI)

 http://www.bsaci.org/

Tel: 0207 501 3910 

Fax: 0207 627 2599          

Address: BSACI, Studio 16, Cloisters House, 8 Battersea Park Road, London SW8 4BG

 

The Anaphylaxis Campaign

https://www.anaphylaxis.org.uk/

General Enquiries

Tel: +44 (0)1252 546100

Email: admin@anaphylaxis.org.uk

Helpline and Information Team

National helpline available Monday-Friday 9am-5pm.

Tel: +44 (0) 1252 542029

Email: info@anaphylaxis.org.uk

Address:  1 Alexandra Road, Farnborough, Hampshire, GU14 6BU

 

Allergy UK

https://www.allergyuk.org/

Helpline Tel: 01322 619 898

Address: Allergy UK, Planwell House, LEFA Business Park, Edgington Way, Sidcup, Kent, DA14 5BH

Email: info@allergyuk.org

 

Medic Alert

https://www.medicalert.org.uk

Tel: 01908 951 045

Email: info@medicalert.org.uk

Address: The MedicAlert Foundation, 327 Upper Fourth Street, Milton Keynes, MK9 1EH

 

Food Standards Agency

Allergy advice: https://www.food.gov.uk/safety-hygiene/allergy-and-intolerance