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ASCIA Health Professional Allergy Education and Training Initiatives

ASCIA is facilitating education and training initiatives to upskill health professionals, as part of the National Allergy Council Shared Care for Allergy project, funded by the Australian Government. ASCIA invited Expressions of Interests (EOI) from ASCIA members in 2024 for funding of initiatives to improve access and timely delivery of allergy education and training for health professionals.

ASCIA conducted the EOI process to try to best utilise the expertise and ideas of ASCIA members, to optimise the allocation of funding for a range of health professionals. The quality of EOIs was very high, and the selection panel evaluated a range of elements in their decision making, including target audience, budget and potential impact. A total of 18 EOIs were received and reviewed by a selection panel, with the following five projects selected for funding in the 2024 EOI round:

  • Associateship of Clinical Allergy (ACA) and Rural and Regional Clinical Allergy Network (R2CAN)
  • The Regional and Rural Maternal Child Health Nurses Allergy Education Program
  • ASCIA Food Allergy Dietitian Recognition Program and Certification Model
  • A Comprehensive Mental Health Training Program for Allergy Health Professionals
  • Virtual Immunology Clinic for General Practice Rural Initiative for Practice Education (VIC-GP RIPE)
Associateship of Clinical Allergy (ACA) and Rural and Regional Clinical Allergy Network (R2CAN)

Initiative leads: Dr Melanie Wong (National Allergy Council), Dr Peter Goss (Australian Paediatric Society)

Budget: $100,000

Aim: To train and support allergy GPs and allergy paediatricians working in rural and regional areas. 
National Allergy Council consultations identified the need for a capable, qualified, and accessible health workforce to provide high-quality, evidence-based allergy care. It also identified that postgraduate training opportunities in allergy medicine must be accessible, affordable, in context, and result in a specific qualification that is recognised by other health professionals and people in the community.

This initiative aims to improve access to quality allergy care for people living in rural and regional areas by training a cohort of general practitioners (GPs) and general paediatricians in the diagnosis and management of allergic disease. Key design components to ensure patient safety include:

  • Education and training provided in the context of real clinical cases with facilitated discussion around clinical reasoning and documentation.
  • Direct clinical supervision by full ASCIA members who have experience in adult and/or paediatric allergy medicine.
  • Built-in standardisation and clinical competency mechanisms.
  • Development of a collaborative ongoing professional network for readily obtaining advice about patient cases.
  • A defined scope of practice, and clear care pathways for escalation by referral of any patient presentations that are out of scope or require a second or additional diagnostic review.
  • Ongoing mentorship and CPD requirements of alumni to sustain clinical competency.

Training GPs and general paediatricians in clinical allergy with a defined scope of practice will improve access to timely, quality allergy care and also result in more appropriate and better quality referrals to clinical immunology/allergy specialists. Delays in diagnosis and inappropriate management have been highlighted as key factors impacting the quality of life for patients with allergic conditions and those who care for them. Increasing access to appropriately trained allergy GPs and general paediatricians in rural and regional areas will help to reduce the time to diagnosis and also reduce travel barriers in accessing care.

Clinicians are seeking practical case-based learning structured around the principles of adult learning. This will prepare students for clinical practice, through the use of authentic clinical cases and appears to foster effective learning in small groups. Clinical reasoning methodology will be a key focus of this course, in addition to practising using resources such as the ASCIA website, other key international websites and journal resources. The course will integrate assessment into the learner’s ongoing clinical practice, along with dual mentorship from a clinical immunology/allergy specialist and allergy GP or allergy paediatrician. All alumni will be expected to participate in a virtual community of practice (R2CAN) to support CPD and maintain clinical competency. This course limits the amount of time that GPs and general paediatricians are away from their clinical practice, as this has been identified as a barrier to completing additional allergy training.

The Regional and Rural Maternal Child Health Nurses Allergy Education Program

Initiative leads: Dr Paxton Loke, Marianne Tomlin, Elizabeth Steven-Smith (Monash Children's Hospital, Victoria)

Budget: $69,430

Aim: To upskill and increase the knowledge of regional and rural Victorian maternal child health nurses (MCHN) in food allergy, allergy prevention and eczema management.

Maternal child health nurses (MCHN) in Victoria serve a very important role in providing universal primary health care for parents and infants, and are frequently the first point of contact, particularly within the first few months of the infants life. This is a period when education and support for introduction of food allergens is vital for the prevention of food allergy.

The team will upskill and support MCHN from eight MCHN councils, seven of which are located in regional Victoria.  They will develop six lectures for a “live” online education program to each MCHN centre over a 12 month period. This will provide up-to-date knowledge for them to effectively provide evidence-based advice on food allergy and allergy prevention in addition to identifying infants and children who may benefit from further medical care. A range of resources will be provided for the MCHNs to share with parents or for their own further professional development, in support of the lecture program. These resources will include ASCIA dietary elimination advice sheets, ASCIA Fast Facts Eczema, ASCIA Fast Facts Eczema and Food Allergy management, Nip Allergies in the Bub in addition to Monash Health developed resources including “Meeting the Calcium Requirements of Baby and Breastfeeding Mother” for use where maternal milk elimination diet is required.

ASCIA Food Allergy Dietitian Recognition Program and Certification Model

Corrina Michael, Caroline South, Prof Michaela Lucas (National Allergy Council and ASCIA Dietitians Committee)

Budget: $64,650

Aim: To develop standardised evidenced informed best practice training for dietitians in food allergy and to develop recognition pathways for the following levels of certification: Food allergy dietitian – paediatric or adult, and Advanced practice food allergy dietitian - paediatric or adult.

An allergy dietitian requires a complex skill set including understanding of diagnostic methods, recent developments in prevention and management of food allergy, cross-sensitization and coexisting allergies, tolerance development, growth status and risk of nutrient deficiencies specific to the patient with food allergies. Dietitians with expertise in food allergy are well placed to provide support regarding the introduction of common allergens in high risk infants and encouraging broadening of diets in infants and children with eczema to avoid unnecessary exclusion, and thereby potentially prevent these children from developing a food allergy.

Dietitians are often responsible for the nutritional management of non-IgE-mediated food allergies such as food protein induced proctocolitis and food protein induced enteropathy, which may require manipulation of the maternal diet during breastfeeding. A thorough understanding of the nutritional requirements of breastfeeding, appropriate food substitution, and when and how to reintroduce allergens to the maternal and/or infant diet is required. Currently, basic undergraduate training for dietitians includes limited information regarding food allergy management. In addition, dietitians working in food service management require specialist training in allergen handling. To address this knowledge gap, ASCIA offers free online e-training in food allergy, however this does not make a dietitian competent in allergy management. The ASCIA dietitians committee has sought to address this need by development of a two-day, evidence based, peer reviewed face to face ASCIA training course (initially developed in association with the Dietitians Australia Centre for Advanced Learning).

The ASCIA Food Allergy and Adverse Food Reactions course was developed in 2018. While well attended, the course comes at a cost to the individual which limits its accessibility.This initiative will: scope current certification programs for Dietitians and existing training and certification programs in food allergy for dietitians, in addition to the ASCIA training. It will develop a model for an ASCIA Food Allergy Dietitian Recognition Program and Certification and the training requirements to support tiers of post graduate education and completion of this Program. The ECHO platform will be trialled as an ideal platform to support delivery of case based online learning and communities of practice.  This will ensure accessibility for regional and remote clinicians.

A Comprehensive Mental Health Training Program for Allergy Health Professionals

Initiative leads: Monique Kerr, Emma Warner, Dr Richard Nolan (Allergy Support Hub)

Budget: $57,279

Aim:  To equip allergy health professionals with specialised knowledge, skills, and a trauma-informed approach to enhance primary healthcare in immunology. By fostering understanding and empathy, the aim is to empower professionals to effectively understand and address mental health related to allergies.

Comprehensive allergy anxiety training for health professionals in allergy and immunology is essential. It enables a patient-centred approach that recognises the delicate balance between physical and mental health in individuals with allergies. By enhancing a professional's ability to identify, support, and manage patients with allergy-related mental health concerns, the training program will improve patient outcomes and overall well-being. Allergy anxiety presents with distinct symptoms, precursors, impacts, and treatment options. However, it remains relatively unknown among health professionals and even psychologists. Striking the right balance of anxiety is crucial for effective allergy management, with excessive or inadequate anxiety leading to poor health outcomes and impaired management.  Maintaining an appropriate level of anxiety and vigilance to manage allergies while engaging in normal activities, is ideal but challenging. High levels of allergy anxiety can profoundly impact the lives of individuals and their families, leading to unnecessary food avoidance, social restrictions, school refusal, panic attacks, and social isolation.

The World Health Organisation has outlined the importance of mental health training for health professionals. It enables early recognition and intervention by equipping professionals with the skills to identify signs and symptoms of mental health condition.

Research demonstrates that mental health training for health professionals promotes holistic and patient-centred
care by addressing both physical and psychological aspects of health, reducing stigmas associated
with mental health, enhancing communication skills to discuss sensitive issues effectively, and providing an
understanding of treatment options and referral pathways for appropriate support and referrals. The proposed training program will equip professionals to identify signs and symptoms of mental health conditions, allow for holistic care that acknowledges both physical and psychological aspects, enhance skills to discuss sensitive issues effectively and promote referral for specialised support. By understanding and addressing the mental health needs of individuals with allergies, health professionals can deliver more comprehensive and effective care, enhancing overall well-being of allergic individuals.

Virtual Immunology Clinic for General Practice Rural Initiative for Practice Education (VIC-GP RIPE)

Initiative leads: Prof Dominic Mallon, Dr Michael O’Sullivan, Dr Jack Bourke, Terri Williams (Fiona Stanley Hospital, Western Australia)

Budget: $20,760

Aim: To upskill rural GPs and their nursing staff in the assessment and management of commonly referred allergic disorders

The Virtual Immunology Clinic for General Practice (VIC-GP) completed a successful pilot in July 2023. Since then it has formed a part of the routine operations of the Dept of Clinical Immunology at Fiona Stanley Hospital with just under 600 new referrals having been seen through this clinic. The program provides:

  • Timely and equitable access to specialist advice (especially patients in rural and remote settings), with the patient either at their primary care provider’s office or at home.
  • In context education and upskilling of the primary care provider, reducing the need for referral of subsequent patients with similar problems.
  • Care that is shared and coordinated between the primary care provider and the specialist.
  • Facilitated access to in person procedures and treatments at the tertiary hospital (when required).

Online “Community of Practice” tutorials have been initiated via Microsoft Teams, with all registered practitioners being given free access to recordings of the tutorials via a Vimeo web link. This funding will complement these activities by providing face to face education to rural general practitioners, in the form of case scenario based tutorials and skills workshops. Provision of in person training to complement the existing online services and tutorials to primary care providers in these rural and remote regions will build trust between our service and the primary care providers in each region. This will lead to:

  • Increased number of primary care providers registered to refer patients to the VIC-GP
  • An initial increase in number of referrals of patients with allergic and immunological disorders as they become more familiar and comfortable with how to access the service
  • More fluid communication of patient issues between primary carre providers and the consultants at FSH, resulting in an increase in ad hoc review consultations via the VIC-GP platform

With time, the initiative will build competence and confidence amongst primary care providers in the management of allergic and immunological disorders that will be manifest as:

  • Improved primary assessment, quality and appropriateness of referrals.
  • Reduced numbers of referrals of commonly referred conditions (e.g. mild egg allergy in infancy; atopic eczema in infancy; spontaneous urticaria; ACE inhibitor associated angioedema) that are suitable for first line management in primary care.
  • Reduced need for patients to attend Fiona Stanley Hospital for routine procedures.
Development and implementation of the National Allergy Strategy

The Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy & Anaphylaxis Australia (A&AA), as the leading medical and patient organisations for allergy in Australia, are partners in the National Allergy Council, which was launched on Wednesday 31st  August 2022 during the ASCIA 2022 Conference week in Melbourne. The National Allergy Centre of Excellence (NACE) was launched at the same time. The National Allergy Council continues to implement the National Allergy Strategy, which was developed by ASCIA and A&AA, in collaboration with key stakeholder organisations, and launched in August 2015.

The National Allergy Council has received funding from the Australian Government Department of Health from 1 July 2022 to 30 June 2026, to progress the implementation of the National Allergy Strategy in response to the Parliamentary Inquiry into Allergies and Anaphylaxis which led to the Walking the allergy tightrope report. This funding also includes funding provision for the National Allergy Council partner organisations - ASCIA and A&AA.While funding from the Australian Government Department of Health has supported implementation since 2015, development of the National Allergy Strategy, including two Allergy Summits was funded by unrestricted education grants obtained by ASCIA. 

In September 2019 a Parliamentary Inquiry into Allergies and Anaphylaxis was announced, and hearings were held from October 2019 to February 2020. In May 2020 a report on the Inquiry was published, "Walking the Allergy Tightrope - Addressing the rise in allergies and anaphylaxis in Australia". The report is available here

The Australian Government's response to the Walking the allergy tightrope report was tabled in Parliament in April 2023. For information about National Allergy Council projects visit https://nationalallergycouncil.org.au/

Content updated September 2024