The launch of the 6th National Audit Project - BSACI
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Summer 2018 Issue 31 through education, training and research The launch of the 6th National Audit Project Anaesthesia, Surgery and Life-Threatening Allergic Reactions Page 4 Editor’s choice Spare pens in schools Personal allergic march Page 6 Page 7 Page 12
FOR HEALTHCARE PROFESSIONAL USE ONLY
Breastfeeding is best for babies THE FIRST
AND ONLY EHF
TO CONTAIN
GOS/FOS‡ PREBIOTICS
Aptamil
Aptamil Pepti
Pepti
Clinically proven to REDUCE
allergic manifestations
for up to five years1–3
the step
step
in the effective
management of
cows’ milk allergy
is extensively hydrolysed formula†
†
For the management of mild to moderate cows’ milk allergy, the iMAP guideline 4 recommends an Extensively Hydrolysed Formula (EHF) as the first step for formula
feeding or mixed feeding (if symptoms only with introduction of top-up feeds) infants.
‡
Galacto-oligosaccharides and fructo-oligosaccharides.
References: 1. Arslanoglu S et al. Early dietary intervention with a mixture of prebiotic oligosaccharides reduces the incidence of allergic manifestations and infections during the fi rst two years of
life. J Nutr. 2008;138:1091-5. 2. Arslanoglu S et al. Early neutral prebiotic oligosaccharide supplementation reduces the incidence of some allergic manifestations in the fi rst 5 years of life. J Biol Regul
Homeost Agents. 2012;26:49-59. 3. Pampura AN et al. Ros Vestn Perinatol Paediat 2014;4:96-104. 4..Venter C et al , 2017. Better recognition, diagnosis and management of non-IgE-mediated cow’s
milk allergy in infancy: iMAP-an international interpretation of the MAP (Milk Allergy in Primary Care) guideline. Clin Transl Allergy. August, vol. 7, no. 26.
IMPORTANT NOTICE: Aptamil Pepti 1 & 2 are foods for special medical purposes for the dietary management of cows’
milk allergy. They should only be used under medical supervision, after full consideration of the feeding options available
including breastfeeding. Aptamil Pepti 1 is suitable for use as the sole source of nutrition for infants from birth, and/or as 18-044 (GOS/FOS)/Date of Prep: March 2018
part of a balanced diet from 6-12 months. Aptamil Pepti 2 is suitable for babies over 6 months as part of a mixed diet. © Danone Nutricia Early Life Nutrition 2018
Healthcare Professional Helpline: 0800 996 1234 www.eln.nutricia.co.uk/cma
Editorial Allergy update
Welcome to Issue 31! Contents
Anaesthesia, surgery and
Team based at Hull & East life-threatening allergic
Yorkshire and we also, for the first reactions 4
time, have an Regional Allergy
Network spotlight on Dr Rubaiyat Message from the President 5
Haque’s Guy’s Regional Allergy Happy retirement, Chris! 6
Network (GRAN) - please do get in
touch if you wish to feature your Spare pens in schools 7
regional network in Allergy Update. Regional Allergy Service
It is also with great delight
spotlight 9
that Allergy Educator, Associate
Professor Jude Holloway, has Award winners 10
written an article on Allergy
Dr Tak Chin, (Editor)
Education. Our Allergy Registrars,
My personal allergic march 12
Consultant Allergist,
Dr Shalini Chandel & Dr Erika National Allergy Registrar
Southampton General Hospital
Harnik also report on Allergy training day and National
Registrar training days this year. allergy SpR training day
Plus, we wish Professor Chris reports 13
In this issue, our feature is the Corrigan a very happy retirement
report on the Royal College of and highlight his significant Committee & Group updates 14
Anaesthetists’ 6th National Audit contributions to the Specialty of
Project: Perioperative Anaphylaxis Guy’s Regional Allergy Network
Allergy and give congratulations to
(NAP6) summarised by Professor the winners of this year’s awards (GRAN) 18
Nigel Harper. (Professor Hannah Gould, Dr
Dr Paul Turner and Dr Gary Claudia Gore and Professor Graham BSACI staff
Stiefel report on the new Roberts). Chief Executive:
legislation on spare pens in Also please find enclosed Fiona Rayner
schools. election papers for the posts of fiona@bsaci.org
Our Allergy Service spotlight BSACI Secretary and BSACI Council Clinical Guidelines
this issue is Dr Bryan Fernandes’s Member. & Research Co-ordinator:
Maryam Shayeghi
maryam@bsaci.org
Contributions should be e-mailed to: Finance & Administration
Officer:
tak_chin@hotmail.com Ethlyn Johnson-Bellot
ethlyn@bsaci.org
Editor Elected Council Members Membership Officer
Dr Tak Chin Dr Nicola Brathwaite Gill Cotton
Dr William Egner gill@bsaci.org
Feature Editor
Ms Roisin Fitzsimons Training & Education
Dr Shelley Dua
Dr Elizabeth Griffiths Coordinator:
Layout Dr Nicola Jay Marie Gibbs
INQ Design Ltd 020 737 5775 Dr Tom Marrs marie@bsaci.org
(Deputy Meetings Secretary) Managing Editor, Clinical &
BSACI President
Dr Mohamed Shamji Experimental Allergy:
Dr Shuaib Nasser
Catherine Hyland
President Elect Ex-Officio Members catherine@bsaci.org
Dr Adam Fox Dr Andrew Clark
Secretary Dr Pamela Ewan BSACI
Dr Stephen Till Dr Adam Fox Studio 16, Cloisters House
Dr Tariq El-Shanawany 8 Battersea Park Road
Treasurer Professor Syed Hasan Arshad
Dr Susan Leech
London SW8 4BG
Dr Helen Howells
Editor of Clinical & Ms Kathryn Powrie E-mail: info@bsaci.org
Experimental Allergy Tel: 0207 501 3910
Prof Graham Roberts Co-opted Members Fax: 0207 627 2599
Meetings Secretary Professor Chris Corrigan Website: www.bsaci.org
Dr Guy Scadding Dr Erika Harnik
Ms Hannah Hunter Registered charity no: 1069199
3
Feature Allergy update
Anaesthesia, surgery and
life-threatening allergic reactions
perioperative anaphylaxis. The NAP6
Professor Panel included BSACI representation.
Nigel Harper Guidelines published by BSACI, NICE,
NAP6 Clinical Resuscitation Council (UK) and
Lead, Honorary Association of Anaesthetists of Great • UK anaesthetic workload,
Consultant Britain and Ireland (AAGBI) were patient demographics
anaesthetist, used. The project comprised a case- and anaesthetic
Manchester reporting phase and several surveys. techniques.
University NHS
• Exposure to potentially-
Foundation Trust NAP6 main case-reporting phase allergenic drugs and
• Local co-ordinator anaesthetists other substances
in every NHS hospital reported during the perioperative
The report of the Royal College of anonymised cases over a period, providing
Anaesthetists’ 6th National Audit one-year period, including the denominator data for
Project: Perioperative Anaphylaxis information provided to the incidence estimation.
was launched in May 2018. anaesthetist by allergy clinics. • Anaesthetists’ perceptions
A panel of anaesthetists, of perioperative anaphylaxis
allergists, clinical immunologists NAP6 surveys and avoidance behaviours.
and patient groups audited the • Services provided by UK
clinical management, investigation specialist adult and paediatric Of the 541 cases submitted, 266
and outcomes of life-threatening allergy clinics. had complete data and were
analysed. Shortfalls in immediate
management, investigational
Key findings from case-reports in relation to investigation pathways and reporting were
• Adherence to existing guidelines is poor and confirms deficiencies identified and recommendations
in service availability, capacity, harmonisation of investigation and made. Ten patients died and adverse
reporting. outcomes were not uncommon. The
• The average wait time before being seen in allergy clinic was 101 anaphylaxis rate for teicoplanin was
days. (range 0–450 days). Only 39 (16%) were seen within the ideal higher than for any other antibiotic
six weeks and 7% waited longer than six months. or any muscle relaxant. Patent Blue
dye had the second highest rate.
• Waiting times for urgent referrals were not shorter than for
Chlorhexidine accounted for almost
non-urgent referrals.
10% of cases. Reporting to MHRA
• Mast-cell tryptases (MCTs): was extremely poor.
– at least three MCT samples were available in 67% of cases, two in There is space in this article
19% and one in 8% only to present some key findings
– 45% of early samples met BSACI guidance for ‘immediate’ in relation to investigation (see
sampling, panel): the full report, including
– earlier samples gave higher MCT levels which rapidly fell within clinical management, outcomes,
30 minutes epidemiology, reporting,
– MCT level did not correlate with severity of clinical features recommendations and resources
– the dynamic-tryptase algorithm [(baseline tryptase x1.2) for allergy clinics, as well as results
+2 mcg/L] was found useful for detecting mediator release of the surveys can be accessed via
especially when peak tryptase was within the reference trance the home page of the new BSACI
and increased yield by 16%. website www.bsaci.org.uk
• Clinic investigations adhered fully to AAGBI guidance in 32% and The author would like to thank
to BSACI guidance in 17%; most non-adherence was through failing everyone who completed the
to test for all potential culprit agents and poor communication. surveys, the Local Co-ordinators,
the NAP6 Panel and NAP6
• All potential culprit agents had been adequately investigated in Moderator for freely giving their
only 27%. time, and the NAP6 team at the
• 10% of assessments were good, 49% good and poor, 41% poor. Royal College of Anaesthetists
which funded the project.
4
President’s message Allergy update
Message from the President
is also an election for the new and provides a reliable protocol to
Junior Members’ representative desensitise appropriate patients. I
as Erika Harnik will be rotating hope to be able to follow up with
off later this year. Two election new sections on the website to
papers are enclosed in this edition support our members practicing
for Secretary and Council member food allergy, urticaria, eczema and
and I would encourage interested immunotherapy. Over the coming
members to consider applying in months, these sections will come
order to contribute to the future on-stream.
success of your Society. Finally, BSACI members who
BSACI co-badged the Dubai wish to join EAACI can now do so
Dr Shuaib Nasser Allergy Society which took place at a reduced membership rate of
President, BSACI on the 5th/6th April 2018. Many 30 euros via a joint scheme that
of the speakers were from the is available via the BSACI website.
UK and I have heard that this was This constitutes a considerable
a successful meeting with many saving on the full membership price
attendees. BSACI supported this and allows access to EAACI journals
BSACI Council has a number of new meeting as allergy is in its infancy and to the member rate for most
members. Kathryn Powrie is the in the Middle East and we hope EAACI meetings except for the
new chair of the Nurses Committee to cultivate a relationship that annual congress.
and Helen Howells has taken over will allow the growth of allergy
from Joanne Walsh as chair of the education and practice in that part
Primary Care Committee. Council of the world.
welcomes back Sue Leech who BSACI have launched the new
was elected BSACI treasurer at the Drug Allergy section on the website.
AGM last year. Stephen Till has The section contains resources
completed his three year term as supporting our members in their
Secretary and there will be four drug allergy practice. There is also
further vacancies on Council as a drug desensitisation calculator
current members rotate off. There which safely removes the arithmetic
Fast Publication Times – Submit your article today!
Clinical & Experimental Allergy
Free to BSACI members
Impact
Impact
The Official Journal
Factor
Factor of the British Society for
5.587
5.264 Allergy & Clinical Immunology
wileyonlinelibrary.com/CEA
5
Editor’s choice Allergy update
Happy retirement Chris – we shall miss you!
Not many people know that
Professor Corrigan obtained his
BA in Physiological Sciences at
Oxford with the highest first class
honours in his year, the start of
a star-studded career in science
over 40 years. Having completed
his PhD with Barry Kay at the
National Heart and Lung Institute,
their partnership led the way in
demonstrating the role of T cell
activation and Th2 cytokines in
asthma, key observations that took
20 years to evolve into the current
avalanche of novel biologics that
successfully target the Th2 pathway
in severe therapy-resistant asthma.
His other achievements include
landmark studies on steroid-
resistant asthma, the role of innate
epithelial-derived cytokines in
asthma and, with Hannah Gould,
the role of IgE in non-atopic
set up a formative Knowledge-based
asthma. He has demonstrated the “Chris is not only gifted in
role of allergoids (modified allergen Assessment that Allergy SpRs take
vaccines) as effective, shorter,
science, he is a stunning in their final years of training.
more convenient strategies of musicologist and an Chris is not only gifted in science,
immunotherapy for hay fever. extraordinary stand-up he is a stunning musicologist and an
Chris has supported the specialty comic.” extraordinary stand-up comic - as
of Allergy in so many ways. At Guy’s we all know from his after-dinner
hospital, having followed on from performances at BSACI annual
a highly successful Adult Allergy
Tak Lee, he has led and developed meetings! He is dedicated to his
Service and Severe Asthma and
wife Annie and their two boys,
Allergen Immunotherapy clinics.
Jonathan and Philip, who have
Within BSACI, he is a former Hon.
Secretary, a longstanding Council provided him amazing support over
Member and has contributed as the years. We recently celebrated
Scientific Meetings Organiser and with Chris over Annie’s receipt of
Editor of Clinical Reviews, the her Alphege Award from Archbishop
companion journal of Clinical and Justin Welby, the Archbishop of
Experimental Allergy. He has been Canterbury. Chris is also a very keen
honoured by receiving both the naturalist and birdwatcher – so we
BSACI William Frankland Award need not worry about his being at a
for Clinical Excellence in Allergy loose end during his retirement!
and the Jack Pepys Award for his The society and your many
outstanding contribution to allergy friends congratulate you on a life-
research. He is best known and
time of service to our specialty and
appreciated by our allergy trainees
on a great job, well done. We wish
as the Chair of the Specialist
Advisory Committee on Allergy of you, Annie and your family a very
the Royal College of Physicians and happy and enjoyable time for the
as Training Programme Director future.
and Lead for the Specialist Training
Committee for the London and South Professor Stephen Durham
East Deanery. With Dr Alex Croom he and Dr Stephen Till
6
News Allergy update
Spare pens in schools
Dr Paul Turner
Honorary
consultant in
paediatric allergy
and immunology,
Imperial College
London
Dr Gary Stiefel
Consultant in
paediatric allergy,
NHS Leicester
From October 2017, schools
have been able to purchase,
without prescription, adrenaline
(Amendment) (No. 2) Regulations
autoinjectors (AAIs) for use in
the emergency treatment of 2017 now provides an exemption to “This project had significant
anaphylaxis. This follows a change school staff with regards to ‘spare’ support from parents of
AAI, and was the culmination of
in legislation (similar to that in children with allergies,
USA and Australia) to improve the over 2 years’ work by a working
group representing BSACI, RCPCH, teachers and healthcare
management of food-allergic school
Allergy UK and the Anaphylaxis professionals, which resulted
children.
The rationale for this change Campaign. This project had in significant support from
was simple: 1 in 5 cases of fatal significant support from parents the Department of Health
anaphylaxis in children occur in of children with allergies, teachers in making the case for a
schools. AAIs may be left at home and healthcare professionals, which
resulted in significant support from
change in legislation
(a common problem in secondary
the Department of Health in making to MHRA and the
schools), used incorrectly or misfire,
or perhaps be out of date. The the case for a change in legislation Minister of Health.”
schools’ ‘spare’ back-up AAIs would to MHRA and the Minister of Health.
therefore offer an additional safety The ‘spare’ AAI(s) are in addition parental approvals are in place on
net, as well as opportunities to to any AAI devices a pupil might that child’s care plan.
improve education and guidance for be prescribed and bring to school, The BSACI emergency action
schools about food allergy. something still required by MHRA. plans have been updated to provide
The new legislation was needed However, ‘spare’ AAI devices can
a single page document which
because AAIs were previously be used in any pupil known to
meets the requirements of the new
prescription-only medicines, so be at risk of anaphylaxis so long
legislation, and can be downloaded
legally an AAI could only be used as there is medical approval and
written authorization from parents. via the BSACI website or at
for the person it was prescribed to
(with the exception of healthcare Importantly, this includes those www.sparepensinschools.uk, a
professionals, the law does not children with a diagnosed IgE- new website funded by DoH to
allow someone to administer an mediated food allergy who have provide a one-stop resource for
AAI belonging to person A to not been prescribed an AAI, so long school staff, parents, school pupils
person B). The Human Medicines as the appropriate medical and and healthcare professionals alike.
7
2
es
de on
lin
ui ed
l G lud
na nc
io w i
E PTE
CC
a t No
D
BY • A
N
BY • A
1
D
CC
E PTE
fluticasone propionate/
azelastine hydrochloride
Mild Moderate/Severe
More effective AH INS
than FP or AZ
at treating
Rx
entire rhinitis
failure
spectrum3
Check use, concordance, dose
Combination Rx with INS and INAH
Rx
Onset of action failure
30 minutes
in clinical
Check use, concordance, dose
practice4
Watery rhinorrhea Itch/sneeze/ Catarrh Blockage, Add (briefly) IN
Add ipratropium extra-nasal itch/rash switch to Add LTRA if asthmatic decongestant
non-sedating oral anti-H1
Rx Inflammatory rhinitis,
Infection/structural problem,
Course of OC,
Surgical referral failure
continue local Rx
Efficacy
confirmed in Consider immunotherapy
real life5 if Rx predominantly due
to one allergen
Algorithm shows treatment pathway for allergic rhinitis, adapted from Scadding GK, Kariyawasam HH, Scadding G, et al. BSACI guideline
for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clin Exp Allergy. 2017;47:856-889
Abbreviations: FP - fluticasone propionate, AZ - azelastine, AH - antihistamine, INS - intranasal corticosteroid, INAH - intranasal antihistamine, LTRA - leukotriene receptor antagonist, IN - intranasal, OC - oral corticosteroids
References:
1. https://www.scottishmedicines.org.uk/General/Homepage_Search_ 3. Meltzer E et al. Clinically relevant effect of a new intranasal therapy (MP29- allergic rhinitis: A randomized, double-blind, placebo-controlled trial of
Results?q=dymista&Submit=Search 02) in allergic rhinitis assessed by responder analysis. Int Arch Allergy efficacy and safety. Allergy Asthma Proc 2012;33(4): 324–32.
2. Scadding GK,Kariyawasam HH,Scadding G,et al. BSACI guideline for the diagnosis Immunol 2013;161(4):369–77. 5. Klimek L et al. Effectiveness of MP29-02 for the treatment of allergic rhinitis
and management of allergic and non-allergic rhinitis (Revised Edition 2017; 4. Meltzer E et al. MP29-02 (a novel intranasal formulation of azelastine in real-life: Results from a noninterventional study. Allergy Asthma Proc
First edition 2007).Clin Exp Allergy. 2017;47:856-889. hydrochloride and fluticasone propionate) in the treatment of seasonal 2015;36:40–47.
Dymista® Nasal Spray, Suspension (azelastine hydrochloride/fluticasone Dymista®. In patients with infections, recent surgery or injury to nose or mouth, weigh
propionate) Prescribing Information benefits against risks of use. Contains benzalkonium chloride. Experience of use in
Adverse events should be reported. Reporting forms and information
pregnancy and lactation is limited. Dymista® should only be used if the potential
can be found at www.mhra.gov.uk/yellowcard. Adverse events should
Presentation: Nasal spray suspension. Each gram of suspension contains 1000 benefit justifies the potential risk. Dymista® has minor influence on ability to drive and
also be reported to Mylan by phone: 0800 121 8267 or by email:
micrograms of azelastine hydrochloride and 365 micrograms of fluticasone use machines. Undesirable Effects: Epistaxis, headache, dysgeusia, unpleasant
ukpharmacovigilance@mylan.com
propionate. Indications: Relief of symptoms of moderate to severe seasonal and smell, hypersensitivity reactions including anaphylactic reactions, angioedema,
perennial allergic rhinitis if treatment with intranasal antihistamine or glucocorticoid bronchospasm, glaucoma, increased intraocular pressure, cataract, blurred vision,
alone is not considered sufficient. Dosage and administration: Adults and septal perforation, nasal irritation, throat irritation, nausea, dizziness, sleepiness,
adolescents (12 years and older): One actuation into each nostril twice daily. Children fatigue, rash, dry mouth, growth retardation may be possible in adolescents Meda Pharma GmbH, a Mylan company
below 12 years: not recommended as safety and efficacy has not been established receiving prolonged treatment and growth should be monitored regularly. Consult DYM-2018-0210 Date of preparation: May 2018
in this age group. Contra-indications: Hypersensitivity to azelastine hydrochloride the Summary of Product Characteristics for other side effects. Package Quantities
or fluticasone propionate or any of the other ingredients in this medicine. Warnings and Basic Price (UK): £14.80 for 23g bottle. Each spray (0.14 g) contains 137
and precautions: Avoid concomitant use with ritonavir. Systemic effects of nasal mcg of azelastine hydrochloride and 50 mcg of fluticasone propionate. Legal
corticosteroids may occur. Systemic exposure in severe liver disease may be category: POM. Product Licence Holder: Meda Pharmaceuticals Ltd, Skyway
increased. Dymista® may result in clinically significant adrenal suppression. Patients House, Parsonage Road, Takeley, Bishops Stortford CM22 6PU. Tel 0845 460 0000.
may experience blurred vision or other visual disturbances. Monitor patients who Marketing Authorisation Number: PL 15142/0258. Date of preparation of
experience changes in vision or have a history of ocular pressure, glaucoma and/ prescribing information: Nov 2017
or cataract. If adrenal function is impaired, take care when changing medication to UK/DYM/17/REF-28715
News
Allergy services spotlight Allergy update
Hull & East Yorkshire allergy service
The East Yorkshire Regional Adult
Immunology and Allergy Unit
started out at the former Kingston
General Hospital in 1986 with the
arrival of Dr Philip Dore, Consultant
Immunologist, followed by Jackie
Moor Clinical Nurse Specialist, in
2001. The Unit is currently based at
Castle Hill Hospital in Cottingham,
and provides diagnostic and
therapeutic allergy and immunology
services for patients over 16 years
from a wide geographical area
including Hull, East and North
Yorkshire, and North and East
Lincolnshire, covering an extended
population of around 1.2 million. The
Unit is registered with the IQAS and Above: Front row: Dr Bryan Fernandes,
QPIDS accreditation schemes. It Sarah Sholtysek, Rebecca Avison, Nada
sees patients referred from primary Al-Muhandis, Jackie Moor. Back row: Beverley
Fish, Pavels Gordins. Left: Rebecca Avison
and secondary care with suspected performing intradermal testing
drug, inhalant, venom and food
allergen related conditions, as
well as primary and secondary subcutaneous venom and pollen
immunodeficiency. It also supports immunotherapy, and 35 receiving
the Paediatric Immunology Service sublingual immunotherapy. The
and Sheffield working together to
where complex immunological department offers Omalizumab
treatment for patients with severe develop standardised protocols and
conditions are managed. The guidelines, conduct multi-centre
Paediatric Allergy Department urticaria.
The drug allergy clinic sees audits and organise educational
is based at Hull Royal Infirmary
complex patients referred for sessions for trainees. The Unit has
managed by a Paediatrician
suspected antibiotic, general and close links with Hull York Medical
with a special interest in Allergy,
local anaesthetic, analgesic and School.
and supported by Paediatric
latex allergy. Comprehensive allergy Rebecca Avison and Beverley
Immunology nurses.
tests are performed including skin Fish, Immunology and Allergy
The team consists of one
prick and intradermal testing, oral Specialist Nurses feel the
Consultant in Allergy, one Consultant
food and drug challenges, as well greatest successes have been
in Immunology and Allergy,
four Specialist Immunology and as drug desensitisation therapies offering the modified rush venom
Allergy Nurses, one Healthcare and monthly patch testing clinics. immunotherapy regimen, as well
Assistant and a Specialty Trainee The team meets fortnightly for as the range of preparations
in Immunology. There are nine discussion of challenging cases. tailoring immunotherapy to those
Consultant-led clinical sessions and The clinical diagnosis of allergic presenting with troublesome pollen
one nurse-led allergy assessment and immunological conditions is allergy. Jackie Moor, Clinical Nurse
session weekly. The Department supported by a highly specialised Specialist, has worked within the
sees around 600 new general UKAS accredited Immunology service for 17 years and during this
allergy, 150 new drug allergy and 100 Laboratory based at Hull Royal time has witnessed many changes
new immunology patients per year. Infirmary. and challenges. She is proud to
The nurse-led allergy clinic provides The Unit collaborates closely be part of such an enthusiastic
initial assessment, investigations with the Dermatology and team of clinicians and nurses
and management advice, seeing Gastroenterology Teams, and runs a who have worked hard to develop
around 350 new allergy patients regular Respiratory multidisciplinary highly specialised services for both
per year. Along with this, the nurse- meeting. It forms part of the immunology and allergy patients.
led immunotherapy clinics review wider Trent Regional Allergy
patients receiving subcutaneous and and Immunology Consortium Dr Bryan Fernandes
sublingual immunotherapies. There (TRIAC) network with centres in Consultant Allergist at Hull and
are around 80 patients receiving Scunthorpe, Leicester, Nottingham East Yorkshire Hospitals NHS Trust
9
Awards Allergy update
Jack Pepys Lecturer
Professor Professor Hannah Gould started her career in science as an undergraduate at
Hannah Gould Radcliffe College, which was then the women’s part of Harvard. She graduated
Professor of Cell in Biochemistry, and followed on to earn her MSc at Radcliffe and PhD at
and Molecular Harvard with Paul Doty. The title of her PhD thesis was The Antigenicity of
Biophysics Polypeptides. It was a time when the field of protein synthesis was emerging in
King’s College an exciting way, and so she moved to London to work at the National Institute
London for Medical Research on the structure of ribosomes and translation of globin
mRNA. After a further year at University College London, continuing this work,
and imperial College, changing to work on chromatin structure, she settled
at King’s College London. Hannah carried on with her chromatin studies until
the breakthrough of recombinant DNA technology. Returning to her interest
in immunology, she made the critical decision to clone and express the human
IgE epsilon heavy chain gene cDNA. This led to her research on the structure,
function, and regulation of IgE and allergy, her continuing passion.
William Frankland Award
Dr Claudia Gore Dr Claudia Gore graduated in Germany 1995. Her MD (res) was awarded in 1996,
Consultant in in Germany. She undertook her medical and specialist training from 1996 to
Paediatric Allergy 2009 in the United Kingdom, with time out for a PhD in paediatric allergy. She
and Immunology, has been a consultant since 2009, and is currently a consultant in paediatric
Imperial College allergy and immunology at St Mary’s Hospital/Imperial College Healthcare
Healthcare NHS NHS Trust.
Trust St Mary’s
As clinical lead for paediatric and adolescent allergy she has build and
Hospital
expanded the paediatric & adolescent allergy services in North West London
together with her dedicated and passionate multidisciplinatry team.
Claudia and her team, have built the most comprehensive, holistic ambulatory care
service for children and adolescents with complex multisystem allergic disease and
severe atopic eczema in the UK and are now one of the leading UK centres.
Research and publication areas include probiotics and the gut microbiota in
infant eczema, quality of life in allergic diseases, nutrition in allergic disease,
allergen avoidance measures, impact of severe disease on adolescent patients
and families.
Harry Morrow Brown Award
Professor Graham Roberts describes himself as a translational epidemiologist. He has been
Graham Roberts involved in many of the landmark prevention trials in the last decade. Firstly,
Professor of the 18 year follow-up of the Isle of Wight prevention trial that confirmed the
Paediatric Allergy potential long-term impact of early life interventions. Secondly, the Mite Allergy
and Respiratory Prevention Study demonstrating proof of the principle for using sublingual house
Medicine at dust mite to prevent allergic sensitisation in early life. Lastly, the Learning Early
University of About Peanut (LEAP) study which has re-shaped the international weaning
Southampton, recommendations. These interventional studies have emerged from longitudinal
Director of the epidemiological data. With Isle of Wight colleagues, he has just completed the 26
David Hide Asthma year follow up of the 1989 Birth cohort. With colleagues from across the UK, he is
and Allergy recruiting a new birth cohort to investigate pre-school wheeze. Finally, Professor
Research Centre Roberts has developed a research programme directed at understanding
adolescents in order to assist healthcare professionals for a better management
of this age group.
Professor Roberts has been Editor-in-Chief of Clinical and Experimental Allergy for
the last few years. He has overseen its successful transition into an online format.
10Annual Meeting 2017 Allergy update
bsaci
The British Society for Allergy
and Clinical Immunology
Annual Meeting
September 30th – October 2nd 2018
Telford International Centre UK
For further information regarding the programme,
registration and ongoing updates pleases visit:
www.bsacimeeting.org
Facebook “ f ” Logo CMYK / .eps Facebook “ f ” Logo CMYK / .eps
#BSACI
11Education Allergy update
My personal allergic march
or the Postgraduate Certificate, for genetic recombination on
and upgrade to a Postgraduate a familiar background (patient
Professor Diploma and finally the MSc itself. clinical cases), allows my students
Judith Holloway This stepwise approach allows to access a subject that can feel
Associate you to choose the modules that incomprehensible to them. Our
Professor, most interests you and to tailor innovative curriculum is designed
Programme the course to your needs. We also to promote students’ confidence
Leader MSc offer full-time, and part-time study and familiarity in all areas of
Allergy, University options, so you can take the course allergy, giving them a holistic
of Southampton at the speed that suits you best. At understanding of the whole disease
Southampton, we have trained over process, so improving their ability
250 students and currently have to make a complete and informed
56 allergy postgraduates studying appraisal of the treatment options
My passion to influence the world with us. They come from across all for their patients.
of allergy education stems from corners of the UK, Europe and the I was recently awarded the huge
my own battle with allergies, world. honour of becoming a National
my personal allergic march that Our modules are the building Teaching Fellow of the Higher
started with severe eczema in blocks that can be used to make Education Academy in recognition
infancy, and has nearly ended up whichever award you choose. for my work to inspire and educate
a couple of times with severe A range of choices cover the more a new generation of allergy experts.
anaphylaxis. My lifelong experience traditional aspects of clinical allergy I took over as Programme Leader
as a patient with allergies that (such as Food Allergy, Eczema, of the MSc Allergy in Southampton
affect both mine and my family’s Urticaria and Anaphylaxis, and in 2008 and since then, we have
quality of life, has driven my Allergic Airways Disease), while been awarded the accolade of
passion to be involved in research innovative modules allow you to World Allergy Organization Centres
and education in allergy. I give drive your learning, such as our of Excellence, and been accredited
my students the knowledge and Work Based Learning module where by the BSACI and recognised by
skills to enable them to save lives students have developed innovative EAACI.
and improve quality of life for patient education material, new Our students acknowledge
thousands of people living with referral guidelines, staff training the impact of their learning at
allergy worldwide. My vision is to days and more. The Dissertation Southampton.
deliver a fit-for-purpose course module completes the MSc itself, Dr Carina Venter completed
that prepares students to be the and over the years our students her PG Diploma Allergy with us
future allergy leaders nationally have done some amazing projects in 2003. She said: “It is thanks to
and internationally, improving that have really contributed to my training at Southampton that
health care provision through clinical practice
their ability to cascade education in all aspects of MSc Allergy students at Southampton learn practical skills
to their institutions, colleagues, allergy. Look out including skin prick testing and inhaler techniques and are taught
patients and their families. for our students how to assess the workforce for competency
The unmet need for trained who regularly
allergy professionals and leaders is present their work
greater than ever, and postgraduate at the annual BSACI
courses, such as our MSc Allergy conference.
at the University of Southampton, I am passionate
are an excellent way to obtain the about creating
specialist knowledge and skills authentic, fit-for-
required. One of the challenges of purpose learning
choosing to combine working with experiences. Framing
postgraduate study, is to find the a difficult subject
right course for you that fulfils your such as immunology
career needs and aspirations, and is using memorable
flexible enough to give you choice. analogies like
An MSc might feel like a very big ‘Bisto gravy’ for
commitment, so at Southampton chemokines, ‘pick
you can start on single modules, ‘n’ mix sweets’
12Education Allergy update
BSACI SpR Training
I am a world-leading dietitian in
the field of allergic diseases, with
over 100 publications to my name...
I would suggest the University
of Southampton to any medical Day
professional who wish to enhance
their career in allergy and increase The Allergy Department , The training day was
their knowledge.” University Hospital Southampton, well attended by 13 trainees
Dr Adam Fox completed his PG successfully hosted the BSACI in total - 6 Adult Allergy, 6
Diploma Allergy in 2004 and is Allergy Registrar training day on Paediatric Allergy trainees and 1
Consultant Children’s Allergist and 19th February 2018 . Immunology trainee.
Clinical Lead Director of the very The venue was The Cherbourg The feedback received was
successful Allergy Academy. He meeting room in the Southampton
said: “I was very impressed with positive with all the trainees
Novotel Hotel. This was carefully thoroughly enjoying the day.
the University of Southampton. chosen keeping in mind the
There are excellent networking They felt that the faculty
convenience for delegates understood the needs of the
opportunities. The University
attending from all over the
provides students with an excellent trainees faced by the speakers,
country, given its proximity to
grounding in the immunology and being able to change the focus
the Southampton central railway
clinical aspects of allergy from a of the lectures. The trainee
station.
world class faculty coupled with feedback also reflected on the
This was well appreciated as was
unrivalled support from course fact that the training day met
evident from the trainee feedback.
leaders.” their expectations.
The teaching was organised
Have I inspired you to find out For future BSACI training
more about studying allergy as a on topics selected for various
aspects of food allergy. These were days, there is a suggestion for a
postgraduate student? As well as complex allergy case discussion
my MSc Allergy at the University Food allergy in children, Inducing
tolerance in Food Allergy, Food session, which would be useful
of Southampton, there are other
allergy – from a Dietary perspective, for all trainees.
courses around the UK offering
slightly different opportunities In vitro testing in T cell mediated
for students, including the MSc drug allergy, Oral Food Challenge Dr Shalini Chandel
Allergy at Imperial College, the (OFC) standards and Eosinophilic Allergy Registrar (ST5),
MSc Immunology and Allergy at oesophagitis overview and update. University Hospital Southampton
the University of Nottingham and
the online Postgraduate Certificate
in Clinical and Health Sciences
with Allergy offered by Newcastle Joint RSM and BSACI
University.
Allergy SpR Training Day
Links
MSc Allergy, University of This February the Clinical Allergy discussion. Polly James shared
Southampton and Immunology Section of the her experiences as one of the
www.southampton.ac.uk/allergy, RSM and BSACI joined for a national only dedicated paediatric allergy
follow us on twitter @mscallergy, allergy SpR training day. The focus psychologists in the country
twitter.com/mscallergy of the day was the controversies while Tabi Leslie, spoke on itch,
MSc Allergy, Imperial College in allergy and the juxtaposition of a symptom we all recognise
https://www.imperial.ac.uk/study/pg/ the paediatric and adult allergy as difficult and frustrating
medicine/allergy/ approach to certain disorders to treat. The day ended with
MSc Immunology and Allergy, such as food allergy, urticaria and Lauri-Ann Van Der Poel and
University of Nottingham angioedema. Our keynote speaker Chris Rutkowski talking about
https://www.nottingham.ac.uk/ was visiting professor Jörg Kleine- the myths and potential pitfalls
pgstudy/courses/molecular-medical- Tebbe, who spoke on advanced in managing drug allergy and
sciences/immunology-and-allergy-
test interpretation of component urticaria. The day was well
msc.aspx
resolved diagnostics. attended and the feedback was
PGCert Clinical and Health Sciences
Isabel Skypala continued with incredibly positive.
with Allergy, Newcastle University
https://www.ncl.ac.uk/postgraduate/ this theme and described the use
courses/degrees/clinical-health- of CRDs in influencing the dietary Dr Erika Harnik
sciences-allergy-pgcert/#profile intake in patients with food allergy Paediatric Allergy registrar,
with both talks generating a lot of Royal London Hospital
13Committee and Group News Allergy update
Paediatric Group News
Dr Adam Fox of constructive
Consultant collaboration.
Paediatric Whilst work
Allergist and continues on the
Deputy Medical Code of Conduct
Director at Guys for the interaction
and St Thomas’ between Healthcare
Hospital. Chair Professionals and
of the BSACI Industry in regard
Paediatric Group to Products in
Paediatrics Clinical
Nutrition as well
Since my last update, the as the Paediatric
committee has continued to work Immunotherapy
hard. I am particularly grateful to Registry, there has
Dr Paul Turner for his continued also been focus on
work around the successful change the concerns around deprescribing and we recently received a positive
in legislation to allow schools to of hypoallergenic milk formulas. response from Jacquie Cornish,
hold their own auto-injectors. The This has been raised by numerous National Clinical Director, Children,
new Spare Pens in Schools website CCGs as part of consultations to Young People and Transition to
(www.sparepensinschools.uk) reduce pharmacy spends. The Adulthood at NHSE to say this is
has now successfully launched BSACI worked successfully in now on their agenda so we are
and is looking great. It is very collaboration with Allergy UK and hoping for a more centralised
comprehensive and has dedicated BDA (British Dietetic Association) response.
areas for all the stakeholders with to prevent this from happening, This will be my last update, as
a helpful focus on myth-busting. through lobbying and press I will be handing over the chair to
It is endorsed not only by BSACI, attention, in Croydon but other Dr Mich Lajuenesse. I would like to
but also the Department of Health, CCGs have since been raising this. wish him all the best for his term.
RCPCH and the allergy charities We have lobbied RCPCH, who have and also to thank the committee
and is an excellent example joined us in raising this with NHSE for all their efforts and support.
Primary Care Committee update
primary care group on the BSACI
website so that interested GP’s recent activities:
and primary care professionals can • We continue to recruit more
directly reach out to someone local. GP’s with an interest in allergy
We have upcoming allergy to our group
training days with the Royal College • Allergy training days have
Dr Helen Howells of General Practioners where several been arranged in London and
GP, Southampton of our members are teaching. We Birmingham in the next few
Chair of the Primary had an allergy stream at the PRIME months
Care Committee conference in May, which was chaired • Further work planned to
by us. As well as these, many more update the primary care
section of BSACI webpage
local training sessions continue to
We have recruited several more educate those within primary care.
GP’s from across the country to our We hope to work with Allergy UK issued with adrenaline autoinjectors.
primary care group within BSACI. this year to provide all primary care Further updates are planned for the
We have been using our What’s app surgeries with training packs for primary care webpage within BSACI.
group to communicate regularly adrenaline autoinjectors. We hope Interested parties can contact us
and keep each other up to date. this may combat the lack of training via Marie Gibbs at BSACI – Marie@
Work has begun to map out our given to patients when they are bsaci.org
14Committee and Group News Allergy update
Adult Allergy Group
cover most of allergy services in allergy services. This was discussed
England. at the national CRG special meeting,
Professor Details of the networks can held at the Telford Conference Centre
Hasan Arshad be found at the BSACI website during the annual meeting of the
Allergy with a tab “Adult allergy network” British Society of Allergy & Clinical
Consultant, under “Professionals”. The site
Southampton Immunology. This information is
is populated with information on
General Hospital, required for future NHSE specialist
existing allergy networks. There is
Chair of the Adult commissioning and clinic coding.
an option to contact each network
Allergy Group Allergy CRG members will continue to
for further information or to seek
patient information leaflets/SOPS raise this matter at the CRG meetings.
for local adaption. I am still looking for a successor.
Adult allergy group is now in its 4th No further progress has been So if you are an allergist and have the
year. The group has organised itself made with regards to the revision of enthusiasm and organisational skills
through various regional allergy the criteria to define specialist versus to lead the group, please do contact
networks. These networks now non-specialist case workload in our me through the BSACI.
Food Allergy Specialist Group of the BDA
once or twice a year. Many FASG
dietitians have a high level of
recent activities:
Ms Tanya Wright expertise in the care of children and • We have collaborated with
Dietitian, adults with food allergies. the BSACI PAG to produce
Oxfordshire. Our members are also actively a guidance document for
Dietetic Council involved in research projects within parents and healthcare
Representative the field of food allergy presenting professionals
for BSACI, this work in publications and at • Four new free resources are
Member of national and international allergy now available
FASG conferences. They are also active
in the BSACI, EAACI, AAAAI and
formula to extensively hydrolysed
INDANA and FASG members are
formula and home reintroduction
chair of the Allied Healthcare
We have collaborated with the guides for non-IgE mediated allergy
Working Group, EAACI Executive
BSACI PAG to produce a guidance to egg, soya and wheat.
Committee, INDANA chair for US
document for parents and We have also been focussing on
and Europe. This work contributes
healthcare professionals on “Allergy social media, in particular our Twitter
significantly to the development
prevention in infants at higher risk of practical approaches to the presence. Our followers are growing
of food allergy”. This is under the diagnosis and management of in numbers every day (now almost
final stages of review and will be food allergy. We have regular 400) and our regular tweets make
available shortly. communications with our group 10-20,000 impressions per month.
Four new resources are now members where we share allergy
available free to all BDA member news, research, and educational Tanya has now stepped down as
dietitians: home reintroduction events as well as allergy product FASG Representative on Council.
of egg/ wheat/ soya for non-IgE information and queries about BSACI would like to thank Tanya for
allergy, stepping down from amino complex cases. all her contributions.
acid feeds. Further resources are During the last year, with Twitter: @BDA_FASG
under final review: food-dependent the support of a grant from the Email: mary.feeney@kcl.ac.uk
exercise-induced anaphylaxis and Anaphylaxis Campaign and the
(FASG Secretary)
three diet sheets for eosinophilic BDA, we have completed three
oesophagitis. projects on complementary feeding Next FASG Food Allergy day:
Our group has over 325 in infants at higher risk of allergy, 2nd July 2018 at St Mary’s
members and holds meetings stepping down from amino acid Hospital, London
15Committee and Group News Allergy update
Clinical Immunology Committee
The 6th National Audit Project
on Perioperative Anaphylaxis recent activities:
Dr Tariq (NAP6) received input and data • Subcommittee reviewed the
El-Shanawany analysis from Bill Egner, member Consensus Document on 22q11
Consultant of the subcommittee. NAP6 was deletion syndrome
Clinical launched at the Royal College • The 6th National Audit Project
Immunologist, of Anaesthetists on 14th May, on Perioperative Anaphylaxis
University and included presentations (NAP6) received input and
Hospital, Wales, from anaesthetists, allergists, data analysis from Bill Egner,
Cardiff immunologists and patient member of the subcommittee
representatives.
At the 2018 BSACI Annual the Immunology community and
The subcommittee reviewed the Meeting there will be a joint encourage membership of the
Consensus Document on 22q11 session with the British Society BSACI. Further information on the
deletion syndrome by the Max of Immunology on Urticaria, Subcommittee’s activities can be
Appeal with regards to co-badging angioedema and auto-inflammation. found at www.bsaci.org/about/
the document with the BSACI. We continue to engage with clinical-immunology.
National Allergy Strategy Group
down of Stephen McPartland MP election. Parliamentary activity
and are very pleased to announce continues with a recent Westminster
that Jon Cruddas MP has taken Hall debate on the subject of
over as chair of the group. Jon Allergy Awareness in Schools and
Ms Mandy East
is a long-term supporter of our continuing Parliamentary Questions.
National Allergy
Strategy work along with his wife Anna, We are also pleased to report we
Group (NASG) Baroness Healy of Primrose will be meeting with NHS England
Parliamentary Hill and another long-term in May to discuss how to work
Officer supporter of improvements to together on the recommendations
allergy services Baroness Finlay in our forthcoming report.
of Llandaff. In addition, we have For more information and to sign
The NASG has recently reformed welcomed back Jo Swinson MP up for regular updates email mandy@
the All Party Parliamentary Group following her successful return nasguk.org or visit www.nasguk.org
for Allergy following the stepping to the House in the last general We also tweet @AllergyCampaign
Standards of Care Committee (SOCC) update
we would value the membership’s Shayeghi, we have submitted our
feedback on this document. updated guideline writing manual
Dr Andrew Clark
The Eczema guideline, led by to NICE for consideration of re-
Chair of SOCC,
Dr Helen Brough, is off the ground, accreditation. They are currently
Consultant in
Paediatric Allergy, with writing group meetings being assessing our compliance with their
Addenbrooke’s organized and an assessment of the recommendations, so we hope for
Hospital, literature is in progress. Questions good news soon.
Cambridge for a pre-guideline national audit We will be meeting soon to
are being prepared. finalise the primary care Adrenaline
Prof Angela Simpson is leading Auto-Injector Guidline with our
Three guidelines are currently being the Allergen Avoidance Guideline, and primary care colleagues.
prepared. The Local Anaesthetic the writing group is being assembled We continue to support the
Allergy guideline is about to be for their first planning meeting. nurses group, reviewing SOPs
sent out for BSACI consultation and With a lot of help from Maryam before publication.
16Committee and Group News Allergy update
Nurses Specialising in Allergy
Following on from
the results of the
AAI audit presented
at the BSACI we are
looking at adapting
Ms Kathryn the BSACI children’s
Powrie anaphylaxis action
Chair of the plans for adults to
BSACI Nurses provide continuity for
Committee those transitioning
into adult services
and to support
We have recently welcomed Jill and encourage
Edmonds, senior immunology nurse professionals in both primary and professionals/nurses-specialising-
specialist from Manchester onto secondary care who prescribe AAI’s in-allergies has resources for you
to provide training for patients. to use, including competencies
the committee and will be updating
The group represents all aspects for staff training and SOP’s. We
our webpage with short biographies
of allergy nursing and we are welcome your ideas, questions and
from each member.
looking at issues around transition. comments and our e-mail group
Continuing our work highlighting allows you to network with all the
To begin with we would like to know
allergy in nursing journals we have what arrangements are already in nurses in the UK who are BSACI
recently published an article on the place for children reaching the point members in order to share ideas
identification and management of of transition and plan to circulate or ask questions. If you would like
drug allergy in the Nursing Standard a short questionnaire asking about an enquiry sent out to the group
with further ones planned for your service. or have something you would
their ‘How to’ series on the use of Our webpage, available via the like to share please send it to:
adrenaline autoinjectors. BSACI website www.bsaci.org/ bsacinurses@gmail.com
Junior Members Report
with keynote speaker, Professor
Jörg Kleine-Tebbe, flying in from recent activities:
Berlin to speak on molecular • New BSACI national SpR
diagnostics. training programme 2019 –
Dr Erika Harnik The next training days will be on 2021
Junior Members’ paediatric allergy and transitional • Promoting allergy in medical
Representative medicine at Imperial College schools
Paediatric Allergy London in September and venom • Applications for a new Junior
registrar, Royal allergy at the Royal Brompton Members Representative are
London Hospital Hospital in November. We have also welcome
finalised the training programme
for 2019 – 2021 – in response to at the BSACI annual meeting this
The excellent BSACI teaching trainee feedback we have included
programme for allergy trainees year – please share with them your
basic immunology and are asking
has continued into this year, with experiences of working in allergy.
facilitators to include more
a study day in Southampton Sadly my time as junior
paediatric allergy in the timetable.
focusing on food allergy, with topics members’ representative will be
We are continuing to focus on
including tolerance induction, raising the profile of allergy as a coming to an end this autumn. An
eosinophilic oesophagitis and career and have been in touch with email inviting applications for a
dietary management. We were medical schools across the country new representative has been sent.
fortunate to have an extra study to promote the specialty. As a result Please contact me if you would like
day this year, held in conjunction we are hoping to welcome a larger any information about the post -
with the Royal Society of Medicine, number of undergraduate delegates juniormembers@bsaci.org
17Regional allergy networks Allergy update
Guy’s Regional Allergy Network (GRAN)
long term, attempt to deliver this.
Expectations included education,
research collaboration, assistance
in service development, achieving
Dr Rubaiyat accreditation, protocol sharing,
Haque clinical fellowships and defining
Consultant referral pathways.
Allergist, Guys We currently have 46 individual
and St Thomas’, members from across the country
London – from the south coast, across to
Cardiff and all the way up to East
Yorkshire. We purposely did not limit
On 22nd March, we held the the catchment area of membership
to local geographic region (the
inaugural meeting of the Guy’s
‘regional’ in our name was more
Regional Allergy Network (GRAN)
about producing a pleasing • London (GSTT, Brompton,
at Guy’s Hospital in London. Setting
acronym). Anybody happy to attend Homerton, KCL, Lewisham,
up GRAN was the culmination of
the occasional meeting in London is Luton, Medway & UCL)
work that had been undertaken welcome to join. • Brighton
for the BSACI Adult Allergy Group, Things have been a little quiet • Epsom/St Helier
looking into the current state of since that first meeting – the day- • Southampton
regional allergy networks in the UK. to-day challenges of clinical life • Cardiff
Ten such networks were identified. leave little time to devote to such • Cambridge
Many were informal with infrequent projects. However, we have some • Hull/East Yorkshire
meetings. Some were well- exciting meetings planned for 2018. • Mid-Essex
established and currently active. Topics to be covered will include • Manchester
GRAN was devised to explore ‘Challenges of allergy accreditation’ • Salford
what people really wanted from and ‘The future of allergy training in • Oxford
an allergy network and, over the the UK’.
General Data Key dates for your diaries....
Protection Regulation
The countdown to the BSACI 2018 Meeting
2018 has begun! In preparation, we wanted to
share with you some important deadlines
You may be aware that a major change to
data protection law came into force on so you don’t miss out!
25 May 2018. The General Data
Protection Regulation (GDPR) which Late Breaking Abstract Submission
affects all organisations and significantly Deadline 5pm on Monday 25th June
tightens the processes when handling,
storing and managing personal data. Applications for BSACI Travel Fellowships
Monday 23rd July
BSACI has drafted a Privacy Policy
to help you understand what data we
Early Bird Deadline
collect, why we collect it and what we do
with it. We hope you will take time to read Tuesday 31st July
this on our website at www.bsaci.org.
As always should you have any questions
Should you have any questions regarding regarding any aspect of the meeting, please
this please contact us at info@bsaci.org email the team at bsaci@medivents.co.uk
18You can also read
