By David Reading OBE, co-founder and honorary vice-president of the Anaphylaxis Campaign, the only UK-wide charity solely focused on supporting people at risk of severe allergic reactions 

People living with a life-threatening food allergy can find mealtimes a source of enormous stress, particularly when eating out. 

Catering businesses have become more aware of the implications of serving food to people with allergies as dramatic, tragic cases of negligence make sensational headlines. During 2017 there were seven reported deaths in Britain from food-induced anaphylaxis (a severe allergic reaction) and most were triggered by food eaten out. Many other incidents involve “near misses” – where the allergic customer has been revived thanks to prompt medical treatment. 

Often problems are caused by poor communication; if the chef changes the recipe but fails to inform waiting staff, then customers are likely to receive inaccurate allergy information. Or there may be a cross-contamination issue; in one case, a wedding guest took crisps from a bowl that had previously contained peanuts and suffered a severe reaction. 

Since 2014, EU regulations mean it is a legal requirement for catering businesses to have systems in place to provide customers with accurate information about any of the 14 food allergens. In our view, to make their systems work, managers should ensure there is always a nominated person on duty who knows, or can find out, the ingredients of all dishes. 

After the regulations came into force, an informal survey by the Anaphylaxis Campaign found heartening examples of good practice. For example, staff at a village pub have taken photographs of food labels on their phones to show to any allergic customer who asks about a particular dish. At a leading hotel, when someone declares they have a food allergy, the shift manager takes charge of the whole meal – checking the ingredient records, briefing the chef and serving the food. 

What to do in an emergency 

Staff trained in first aid should make a point of learning how to recognise symptoms of an allergic reaction and know what to do if a customer suffers anaphylaxis, a severe allergic reaction that can be fatal. 

If a customer says that they are experiencing an allergic reaction, or anaphylaxis: 

• You should check whether they have an adrenaline auto-injector (AAI). If they have their own adrenaline, and can self-administer, this must be given as soon as a severe reaction is suspected to be occurring. 

• You should immediately send someone to dial 999. 

When dialling 999, give the following information: 

This is an emergency; a customer has collapsed and we believe they are suffering from anaphylaxis (pronounced ana-fill-axis). 

Give the address and postcode of your establishment – clear enough so that the ambulance crew will know exactly where to come. 

If adrenaline has been given, make a note of the time this was administered. A second dose can be given after five minutes if there has been no improvement. 

Someone should be sent to stand at the outlet entrance to direct the ambulance crew to the patient. 

If the person’s condition deteriorates after making the initial 999 call, a second call to the emergency services should be made to ensure an ambulance has been dispatched. 

The Food Standards Agency (FSA) seven golden rules

1 CHECK THE INGREDIENTS LIST OF ALL BRANDED PRODUCTS 

2 ALWAYS CHECK THAT WHAT IS DELIVERED IS WHAT WAS ORDERED

3 KEEP ALLERGEN INFORMATION UP TO DATE

4 TRAIN STAFF

5 USE THE SAME RECIPES EVERY TIME

6 LABEL PRE -PACKED FOODS WITH ALLERGEN INFORMATION 

7 KEEP INGREDIENTS IN ORIGINAL OR LABELLED CONTAINERS