List of Recommendations

Recommendation 1

2.130

The Committee recommends that the Australian Government work with the states and territories to establish a National Centre for Allergies and Anaphylaxis in Australia, to ensure there is a national standardised approach to allergy management.

Recommendation 2

2.131

The Committee recommends that the Australian Government dedicate additional funding into food allergies and anaphylaxis research, in particular funding for:

the Centre for Food and Allergy Research (CFAR) so it can continue its work past 2022 (if Recommendation 1 has not been implemented by expanding CFAR to become a National Centre for Allergies and Anaphylaxis);

clinical research into food allergy treatments (including allergies outside of peanut allergy) in particular into food based oral immunotherapy, including head-to-head trials (trials with no placebo);

research into emerging allergic diseases such as eosinophilic oesophagitis and food protein-induced enterocolitis syndrome (FPIES);

research into the social and psychological effects of allergies and anaphylaxis; and

establishing a national register for anaphylactic episodes and death.

Recommendation 3

2.132

The Committee recommends that the Australian Government consider providing a healthcare card to people with severe and chronic allergic conditions and a carers allowance for their carers where appropriate.

Recommendation 4

3.133

The Committee recommends that the Australian Government work with all states and territories to provide a consistent national framework for patients being discharged from an Emergency Department after an anaphylactic reaction. These patients should be provided with the following:

an adrenaline auto-injector script for up to a maximum of 3 adrenaline auto-injectors and an appropriate emergency action plan (including digitised action plans) as per the Australasian Society of Clinical Immunology and Allergy (ASCIA)’s recommendation;

if not already diagnosed with anaphylaxis, the patient should be given a priority referral (this referral must be for the period four to six weeks after discharge) to an immunologist or allergy specialist; and

information pamphlets on allergies and anaphylaxis. For example, information that outlines support and information on allergies from peak bodies such as ASCIA and Allergies and Anaphylaxis Australia (A&AA).

Recommendation 5

3.134

The Committee recommends that the Australasian Society of Clinical Immunology and Allergy (ASCIA) receive ongoing long term funding to continue its partnership work with the Department of Health and the National Allergy Strategy, to develop minimum standards of allergy training for health professionals including:

funding for the promotion of the e-resources ASCIA has already developed to all relevant communities throughout Australia;

minimum standards of allergy training in the curriculum for all university medical schools and training of general practitioners, physicians and paediatricians, nurse practitioners, psychologists, dieticians, and paramedics; and

funding support for ASCIA to provide training for all health professionals listed above.

Recommendation 6

3.135

The Committee recommends that the Australian Government provide telehealth funding support for doctors and allied health workers in order to provide professional services and support to allergy patients in rural, regional and remote Australia.

Recommendation 7

3.136

The Committee recommends that the Australian Government consider an Medical Benefits Scheme (MBS) item number for food challenges carried out by appropriate clinicians.

Recommendation 8

3.137

The Committee recommends that the Australian Government provides funding for a public health system drug de-labelling program including:

developing a program in the public health system to run community education campaigns to encourage people to participate in drug allergy de-labelling programs;

create clinical guidelines for drug allergy de-labelling; and

give consideration to the need for a Medicare Benefits Scheme (MBS) item number for drug allergy testing and drug allergy challenges.

Recommendation 9

3.138

The Committee recommends that the Australian Government should mandate consistent labelling for all products containing chlorhexidine, iodine and latex to ensure consumers and healthcare workers can readily identify these products. In addition:

alternatives for chlorhexidine, iodine and latex should be readily available;

all government procurement should maintain a database of all chlorhexidine, iodine and latex containing products;

the broader healthcare sector should be educated about the risks of anaphylaxis to chlorhexidine, iodine and latex.

Recommendation 10

3.139

The Committee recommends that the Australian Government provide additional funding support to ensure the Royal Hobart Hospital can provide ongoing Jack Jumper Ant venom immunotherapy treatment to Australians in all states and territories.

Recommendation 11

3.140

The Committee recommends that the Australian Government work with states and territories to ensure that all allergy and anaphylaxis fatalities receive an automatic referral to the coroner for assessment.

Recommendation 12

3.141

The Committee recommends that the Australian Government work with the Therapeutic Goods Administration (TGA) to:

proactively encourage competition for pharmaceutical companies to supply alternative adrenaline auto-injectors to the Australian market in order to prevent future shortages;

investigate the expiry dates of adrenaline auto-injectors; and

investigate reasons for intermittent supply of adrenaline auto-injectors.

Recommendation 13

3.142

The Committee recommends that the Australian Government work with states and territories to:

review the sufficiency of the current allergist and immunologist workforce in hospitals throughout Australia; and

ensure that there is funding for increased placements of these specialists in all hospitals (if a need is found).

Recommendation 14

4.130

The Committee recommends that the Australian Government review all work, health and safety standards within vocational education training to ensure all food service and food preparation training modules include training on allergies and anaphylaxis, including the prevention of food cross contact.

Recommendation 15

4.131

The Committee recommends that the Allergen Bureau in collaboration with Food Standards Australia New Zealand (FSANZ), work with the food industry to encourage the consistent use of the VITAL food allergen risk assessment program, including the introduction of a VITAL ‘V’ tick on packaging to inform consumers that a product has been through this process.

Recommendation 16

4.132

The Committee recommends that the Australian Government work with state and territories to mandate allergen regulations for all hospitals, to ensure that allergen free meals are made available to all patients.

Recommendation 17

4.133

The Committee recommends that Food Standards Australia New Zealand (FSANZ) expedites the finalisation of the Plain English Allergy Labelling (PEAL) process before September 2020 and informs the Committee once the process has been finalised.

Recommendation 18

4.134

The Committee recommends that Food Standards Australia New Zealand (FSANZ) prioritises work in relation to reformulation labels on products. Any product that has changed its ingredients should have either new packaging alerting consumers to the reformulation, or should have a sticker placed on the front stating clearly that new ingredients have been added.

Recommendation 19

4.135

The Committee recommends that all staff at Australian primary and secondary schools receive nationally consistent education and training for recognising and responding to anaphylaxis.

Recommendation 20

4.136

The Committee recommends that the Department of Health work with the Australasian Society of Clinical Immunology and Allergy (ASCIA) and all states and territories to ensure that treatment for anaphylaxis be incorporated into a nationally standardised first aid training course, and if necessary to provide additional funding to first aid training providers to facilitate this.

Recommendation 21

4.137

The Committee recommends that the Australian Government work with the Australasian Society of Clinical Immunology and Allergy (ASCIA) and state and territories to include information about allergies and anaphylaxis education and training into undergraduate teacher training degrees, learning support assistant training and childcare worker vocational education training.

Recommendation 22

4.138

The Committee recommends that the Australian Government requires that all airlines in and out of Australia undertake the following to assist with customers requiring anaphylaxis care:

seats of travellers who have emergency care plans for anaphylaxis should be wiped down before boarding;

cabin crew should receive first aid training that includes anaphylaxis training, recognising symptoms of anaphylaxis and an understanding of how to administer an adrenaline auto-injector; and

require all first aid kits on domestic and international flights entering and departing Australia to carry at least two adrenaline auto-injectors.

Recommendation 23

5.186

The Committee recommends that the Australian Government give consideration of how best to increase the utilisation of nurses and allied health care workers to support the care of patients with allergic disease.

Recommendation 24

5.187

The Committee recommends that the Therapeutic Goods Administration and any other relevant authorities, such as the Australian Competition and Consumer Commission (ACCC) conduct an independent, evidence-based review into all therapeutic goods, services, or devices which claim to diagnose or treat allergies.

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