An allergy medical management plan is a personalised, written document that helps individuals, carers, schools, and employers respond safely to allergic reactions — including life-threatening anaphylaxis. Developed by a healthcare professional, it outlines known allergens, symptom recognition, prescribed medications, and clear step-by-step emergency instructions. In the UK, these plans are aligned with guidance from BSACI, Anaphylaxis UK, NICE, and the Resuscitation Council UK. Whether you are a parent of a child with a severe food allergy, an adult managing venom allergy, or a clinician supporting a patient, understanding what an allergy management plan contains — and how to obtain one — is essential for safe, confident day-to-day living.

What Is an Allergy Medical Management Plan?

An allergy medical management plan is a personalised, written document developed by a healthcare professional that outlines how an individual should manage their allergic condition on a day-to-day basis and in the event of an allergic reaction. It serves as a practical reference for patients, carers, schools, and employers, ensuring that everyone involved in a person's care understands what to do — and when to act — if an allergic episode occurs.

These plans are particularly important for individuals at risk of severe allergic reactions, including anaphylaxis. They typically detail the patient's known allergens, their usual symptoms, the medications prescribed, and clear step-by-step instructions for responding to reactions of varying severity. In the UK, allergy action plans are aligned with guidance from organisations such as the British Society for Allergy and Clinical Immunology (BSACI), Anaphylaxis UK, and the Resuscitation Council UK (RCUK), whose emergency treatment guidance sets the clinical standard for acute anaphylaxis management.

It is helpful to distinguish between two overlapping elements: the allergy action plan, which focuses on recognising and responding to acute reactions, and the broader allergy management plan, which also covers longer-term strategies such as allergen avoidance, symptom monitoring, and scheduled clinical review. For children, these plans are frequently shared with schools and childcare settings to ensure a consistent and safe approach across all environments. The document is not a static prescription — it is a living tool that should evolve alongside the patient's clinical needs.

BSACI and Anaphylaxis UK both provide standardised action plan templates that clinicians can adapt for individual patients. These are widely used across NHS allergy services and are available to download from their respective websites.

Who Needs an Allergy Management Plan in the UK?

Not everyone with an allergy will require a formal allergy management plan, but certain groups are strongly advised to have one in place. NICE guideline CG134 (Anaphylaxis: assessment and referral after emergency treatment) and NICE guideline CG116 (Food allergy in under 19s) support timely specialist referral and structured written planning for individuals at significant risk. Those most likely to benefit from a formal plan include:

• Anyone who has experienced a confirmed or suspected anaphylactic reaction

• Individuals with a diagnosed severe food allergy (e.g., to peanuts, tree nuts, milk, or egg)

• Those with venom allergy (such as bee or wasp stings)

• People with poorly controlled allergic asthma

• Individuals with occupational allergies (e.g., latex allergy in healthcare workers, flour allergy in bakers)

Children are a particularly important group. Under the Department for Education's statutory guidance Supporting pupils at school with medical conditions, schools in England are required to support pupils with medical conditions, which includes ensuring that children with serious allergies have an individual healthcare plan (IHP) in place. This document often incorporates or references the allergy action plan provided by the child's GP or allergy specialist. Separate DfE guidance (2017) also permits schools to hold stock adrenaline auto-injectors for use in emergencies.

It is important to distinguish between food allergy — an immune-mediated response that can cause anaphylaxis — and food intolerance, which does not involve the immune system in the same way and does not carry a risk of anaphylaxis. Individuals with food intolerance alone do not require an anaphylaxis action plan, though they should still receive appropriate dietary and medical advice from their GP or a dietitian.

Individuals with milder allergic conditions, such as seasonal allergic rhinitis (hay fever), may not require a formal written plan, though they should receive clear guidance from their GP or pharmacist about appropriate management.

Key Components of an Allergy Action Plan

A well-constructed allergy action plan should be clear, concise, and immediately actionable. While the exact format may vary depending on the issuing clinician or organisation, most UK allergy action plans — including those based on BSACI and Anaphylaxis UK templates — share several core components:

• Patient details: Full name, date of birth, photograph (particularly useful in school or childcare settings), and emergency contact information.

• Known allergens: A specific list of confirmed triggers, ideally supported by allergy testing results (skin prick tests or specific IgE blood tests).

• Symptom recognition: A description of the patient's typical allergic symptoms, ranging from mild (itching, urticaria, rhinorrhoea) to severe (throat swelling, difficulty breathing, loss of consciousness).

• Graded response instructions: Clear, step-by-step actions corresponding to symptom severity. For suspected anaphylaxis, these should align with RCUK guidance:

• Administer the adrenaline auto-injector (AAI) without delay.
• Lie the person down with their legs raised — or allow them to sit up if they are having difficulty breathing. Do not allow them to stand suddenly.
• Call 999 immediately and state 'anaphylaxis'.
• If there is no improvement after 5 minutes, administer the second AAI.

• Await emergency services; all individuals who have received adrenaline for anaphylaxis should be observed in hospital.

• Medication details: Names, doses, and instructions for all prescribed allergy medications, including AAIs (e.g., EpiPen® or Jext®), antihistamines, and any other relevant treatments.

• Device logistics: Carry two AAIs at all times (per MHRA advice). Check expiry dates regularly, ensure the solution is clear and colourless (replace if discoloured), store at room temperature away from direct light, and do not refrigerate.

• Allergen avoidance advice: Practical guidance on reducing exposure to known triggers in daily life.

The plan should be written in plain language accessible to non-medical individuals, including teachers, family members, and first aiders. Anaphylaxis UK and BSACI provide template action plans that clinicians can adapt for individual patients. A copy should be kept with the patient at all times, and additional copies shared with relevant settings such as schools or workplaces.

Medications Included in Allergy Management Plans

The medications included in an allergy management plan will depend on the nature and severity of the individual's allergic condition. For most patients, the plan will incorporate a combination of rescue medications for acute reactions and regular treatments for ongoing symptom control.

Adrenaline auto-injectors (AAIs) are the cornerstone of anaphylaxis management. Adrenaline (epinephrine) works by rapidly reversing the life-threatening features of anaphylaxis through its alpha- and beta-adrenergic effects — causing vasoconstriction, bronchodilation, and reducing mucosal oedema. In the UK, commonly prescribed AAIs include EpiPen® and Jext®. Dosing is weight-based and should follow the prescribing clinician's advice and the relevant Summary of Product Characteristics (SmPC):

• 150 micrograms is typically prescribed for individuals weighing approximately 15–30 kg

• 300 micrograms is typically prescribed for individuals weighing more than 30 kg

• Some brands offer a 500 microgram strength for use in higher body weight — follow the prescriber's and SmPC guidance

MHRA advice is clear that patients at risk of anaphylaxis should carry two AAIs at all times. Patients and carers should receive training — ideally using a trainer device — on how and when to use their AAI, and this should be refreshed at each review. If there is no improvement 5 minutes after the first dose, the second AAI should be administered. Emergency services must always be called (999) after AAI use, and hospital observation is required following any episode of anaphylaxis.

Antihistamines — typically non-sedating options such as cetirizine or loratadine — are used to manage mild-to-moderate allergic symptoms, including urticaria, allergic rhinitis, and conjunctivitis. They act by competitively blocking H1 histamine receptors. It is essential to understand that antihistamines do not treat anaphylaxis and must never be used as a substitute for adrenaline or be allowed to delay its administration. The same applies to bronchodilator inhalers, which do not address the cardiovascular or airway compromise of anaphylaxis.

Oral corticosteroids such as prednisolone are not routinely recommended in the management of anaphylaxis. Current RCUK and NICE guidance does not support their routine use, as evidence that they prevent biphasic reactions (a delayed second wave of symptoms) is weak. Steroids may occasionally be considered in refractory or complex cases under direct clinician supervision, but this should not be a standard component of a patient-held action plan without explicit specialist advice.

For patients with allergic asthma, the plan may also include short-acting beta-2 agonists (e.g., salbutamol inhaler) and, where appropriate, inhaled corticosteroids for maintenance. These support asthma control but do not replace adrenaline in the event of anaphylaxis.

All medications should be clearly labelled with dosing instructions. Patients should be advised to report any suspected adverse reactions to medicines via the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).

How to Get an Allergy Management Plan on the NHS

In the UK, the process of obtaining an allergy management plan typically begins with a consultation with your GP. If you or your child has experienced a severe allergic reaction or suspected anaphylaxis, NICE guideline CG134 recommends referral to a specialist allergy service for assessment, even if the acute episode has resolved. Similarly, NICE guideline CG116 supports timely referral for children and young people with suspected food allergy. Your GP should initiate this referral promptly.

During a specialist allergy appointment, a consultant allergist or allergy nurse will review your history, arrange appropriate diagnostic testing, and work with you to develop a personalised allergy management plan. This plan will be provided in writing and should be reviewed before you leave the clinic. In many centres, allergy nurses run dedicated patient education sessions to ensure individuals and their families feel confident in using their medications — including AAI technique with a trainer device — and in following the plan.

For children, the school nursing service or community paediatric team may also be involved in translating the clinical plan into a school-based individual healthcare plan (IHP). Parents are encouraged to share the allergy action plan with the school's designated medical lead. Under DfE guidance (2017), schools in England are also permitted to hold stock AAIs for emergency use, providing an additional safety net.

If access to a specialist allergy clinic is limited — which remains a challenge in some parts of the UK due to workforce shortages — your GP can still provide a basic written allergy action plan, particularly for patients already prescribed AAIs. Resources from Anaphylaxis UK and BSACI offer downloadable template plans and patient support materials that can supplement GP-led care. The NHS website (nhs.uk) also provides accessible patient information on anaphylaxis and allergy services.

Reviewing and Updating Your Allergy Plan

An allergy management plan should never be treated as a permanent, unchanging document. Allergies can evolve over time — some individuals, particularly children, may develop tolerance to certain allergens, while others may acquire new sensitivities. Regular review ensures that the plan remains clinically accurate and continues to reflect the patient's current needs.

As a general principle, allergy management plans should be reviewed at least annually, or sooner if any of the following occur:

• A new or more severe allergic reaction has taken place

• There has been a change in prescribed medications or doses

• The patient's weight has changed significantly (relevant to weight-based AAI dosing, particularly in children)

• New allergens have been identified through testing

• The patient is transitioning between care settings (e.g., from paediatric to adult services)

During a review appointment, the clinician should reassess the patient's allergy history, confirm that medications are in date and stored correctly, and check that the patient and their carers remain confident in using the plan. This should include practising AAI technique with a trainer device to ensure competency is maintained — for both the patient and any relevant carers, school staff, or family members.

For device stewardship, patients should:

• Check AAI expiry dates every few months and request a replacement prescription in good time

• Ensure the solution visible through the viewing window is clear and colourless — replace the device if it appears discoloured or cloudy

• Store AAIs at room temperature, away from direct light; do not refrigerate

• Contact their GP or pharmacist promptly if a replacement is needed

Patients are encouraged to be proactive in requesting reviews rather than waiting for an appointment to be offered. If your symptoms are worsening, your current plan no longer feels adequate, or you have concerns about your medications, contact your GP or allergy team promptly. Staying engaged with your allergy management plan is one of the most effective steps you can take to protect your health and safety.

Frequently Asked Questions