Footnotes

• Handling editor Stephen R A Jolles.

• Contributors MTK, KS and OM planned the project. KS collated and analysed data and maintained quality assurance. MTK and KS drafted manuscript and all co-authors critically reviewed and approved final version. All authors were involved in clinical management.

• Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests The department received funds from ALK Abello, Thermo Fisher, MEDA, Allergopharma and other pharmaceutical companies for annual PracticAllergy course. MTK received funds from ALK Abello to attend an international conference. MTK has received research grants from MRC CiC, NIHR, FSA and GCRF; none related to this study. CM reports grants from ALK Abello, grants from Allergy Therapeutics, from null, outside the submitted work. APH reports personal fees from ALK Abello, outside the submitted work.

• Patient consent for publication Not required.

• Ethics approval Registered as an audit with Governance Unit, University Hospitals Birmingham National Health Service (NHS) Foundation Trust.

• Provenance and peer review Not commissioned; externally peer reviewed.