Pioneering allergy testing service receives national recognition
Our pioneering penicillin allergy testing pathway has been highly commended in the Improving Medicines Safety Award category at the HSJ Patient Safety Awards 2026, enabling more patients to receive optimal antibiotic treatment.
Penicillin allergy is one of the most commonly labelled drug allergies, affecting 10 to 15% of inpatients. Formal testing shows that around 90% of penicillin allergy labels are inaccurate, with many of these based on childhood reactions, side effects or symptoms later found not to be true allergies.
As a result, patients can be denied the most effective antibiotics, increasing the risk of treatment failure, surgical infections and longer hospital stays.
To address this, in collaboration with the pre-assessment team at The Royal London Hospital, the allergy team at St Bartholomew's Hospital developed an innovative pathway to identify patients with suspected incorrect penicillin allergy labels and provide rapid assessment and testing.
Between January 2023 and January 2024, the team assessed 134 medical patients and successfully de-labelled 92% in a single visit. In the surgical pathway, 93% of patients were de-labelled, with 65% subsequently receiving optimal antibiotics. There were no severe reactions following testing.
What began as a collaboration between pre-assessment and allergy teams to optimise antibiotic use before surgery has expanded across multiple specialties and sites. The programme has safely restored first-line treatment options for hundreds of patients and created a model that can be scaled and replicated more widely.
The benefits are both clinical and financial. For one patient, de-labelling was estimated to save £10,000 in lifetime medication costs. At scale, removing just half of false penicillin allergy labels could save a hospital more than £500,000 each year through fewer complications and reduced bed days.
Ricardo Madrigal, consultant allergist, St Bartholomew's Hospital:
“Barts Health has exceptional clinical teams, and this project shows what we can achieve when we bring that expertise together and proactively redesign care around our patients.
“Seeing the difference this makes, from patients finally able to receive the right treatment for chronic infections to the fantastic feedback we received from patients and their teams, is enormously rewarding. To have that teamwork and innovation recognised by the HSJ Patient Safety Awards makes us incredibly proud.”
Well done to all our teams recognised at this year’s HSJ Patient Safety Awards!