title: The RCPCH care pathway for food allergy in children: an evidence and consensus based national approach.
abstract: OBJECTIVE
  The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies; food allergy is the second pathway. The pathways focus on defining the competences required to improve the equity of care received by children with allergic conditions.
  
  
  METHODS
  The food allergy pathway was developed by a multidisciplinary working group and was based on a comprehensive review of the evidence. The pathway was reviewed by a broad group of stakeholders including the public and approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee. The National Institute of Health and Clinical Excellence simultaneously established a short guideline review of community practice for children with food allergy; close communication was established between the two groups.
  
  
  RESULTS
  The results are presented in two sections: a pathway algorithm and the competences. The entry points are defined and the ideal pathway of care is described from initial recognition and confirmed diagnosis through to follow-up.
  
  
  CONCLUSIONS
  The range of manifestations of food allergy/intolerance is much more diverse than hitherto recognised and diagnosis can be problematic as many patients do not have classical IgE mediated disease. The pathway provides a guide for training and development of services to facilitate improvements in delivery as close to the patient's home as possible. The authors recommend that this pathway is implemented locally by a multidisciplinary team with a focus on creating networks.
authors: Paediatric Allergy, St Thomas' Hospital, London SE1 7EH, UK. adam.fox@gstt.nhs.uk
authors: Adam T
authors: AT
authors: Fox
authors: Kate
authors: K
authors: Lloyd
authors: Peter D
authors: PD
authors: Arkwright
authors: Debi
authors: D
authors: Bhattacharya
authors: Trevor
authors: T
authors: Brown
authors: Philip
authors: P
authors: Chetcuti
authors: Mandy
authors: M
authors: East
authors: Jackie
authors: J
authors: Gaventa
authors: Rosie
authors: R
authors: King
authors: Ana
authors: A
authors: Martinez
authors: Rosan
authors: R
authors: Meyer
authors: Ami
authors: A
authors: Parikh
authors: Michael
authors: M
authors: Perkin
authors: Neil
authors: N
authors: Shah
authors: David
authors: D
authors: Tuthill
authors: Joanne
authors: J
authors: Walsh
authors: Lisa
authors: L
authors: Waddell
authors: John
authors: J
authors: Warner
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D019091:Critical Pathways / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D019317:Evidence-Based Medicine / Q000379:methods; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012307:Risk Factors; D012955:Societies, Medical; D006113:United Kingdom / Q000453:epidemiology