Cutaneous Allergy Service Provision in the UK
For more than 50 years, patch and prick testing have been established, low cost outpatient investigations for the diagnosis of allergic reactions affecting the skin.
Predominantly hospital based, they are commonly used in the diagnosis of individuals suspected of contact allergy, but also in situations where skin disease such as eczema/dermatitis may be caused or aggravated by an allergic reaction, to exclude a potentially curable trigger for the disease. This includes work related disease.
Investigation has to be undertaken by clinicians knowledgeable of the many indications as well as the potential exposures. This enables a decision on how best to investigate a patient, with a minimum risk of a false negative outcome and subsequent false reassurance to the patient with continued morbidity.
There is a great variation in the quality of service provided between centres and moves by some commissioners to provide community based allergy services, gives rise to concerns over the care pathway and quality standards for service provision.
As expert bodies the British Association of Dermatologists (BAD) and the British Society for Cutaneous Allergy (BSCA) felt it important to pre-empt service variations by providing members, PCTs, CCGs, Trusts and patients with a robust consensus from experts in the field. The working party report on minimum standards for cutaneous allergy services recommends minimum service standards for cutaneous allergy and supporting guidance to inform service provision.
This includes a cutaneous allergy service review toolkit to provide a framework for assessing any service against these minimum standards. Achieving a consistent standard for cutaneous allergy investigation across the UK is essential for patient safety and quality of care.