Concierge allergy · London
Oral food challenge - private in London.
The gold-standard test to confirm or exclude a food allergy. Your child eats increasing doses of the food under specialist supervision, in a day-case unit with a cannula in place and adrenaline drawn up. Most families arrive uncertain and leave with a definitive answer, in writing, the same day.
- Clinically reviewed
- Vetted London allergy units
- Reply within one working day
- Free
Why families choose us
- 01
A real person, every time
The same clinician stays with your enquiry from first message to the day of the challenge.
- 02
Independent by design
We never accept payment to influence which allergy unit we recommend. Free.
- 03
A vetted London panel
A small network of paediatric and adult allergy day units, re-vetted every six months on protocol, staffing and resuscitation readiness.
What it is
The definitive test for food allergy.
Skin prick and IgE blood tests tell you about sensitisation. Only an oral food challenge tells you whether your child will actually react when they eat the food.
An oral food challenge is the international gold-standard test to confirm or exclude an IgE-mediated food allergy. Under the direct supervision of a consultant allergist and a specialist allergy nurse, your child eats gradually increasing doses of the food, starting from a crumb and building up to a full age-appropriate portion, with structured observation between each dose. Immediate treatment - antihistamine, adrenaline, oxygen, intravenous access - is prepared at the bedside before the first dose is given.
Two things make it useful. First, it answers a binary question that no blood test can. Second, it does so in the safest environment a reaction can happen in, so the small risk of a controlled challenge is far lower than the ongoing risk of an accidental exposure at a birthday party or on a plane. Most families leave the unit the same day with a written answer, and often with a food added back to their child's diet for the first time in years.
When it is used
The six situations that lead to a challenge.
Your allergist chooses a challenge when the everyday tests have taken the case as far as they can and a firm answer will change what your child eats.
-
Skin prick or IgE positive, never eaten
A blood or skin test flags sensitisation, but your child has never actually eaten the food. A challenge is the only way to know whether they are truly allergic.
-
History is unclear
A reaction happened but the trigger is uncertain, or it was mild and years ago. A challenge answers the question definitively.
-
Outgrown allergy suspected
Falling IgE or skin prick numbers, no reactions for years. A repeat challenge confirms tolerance so the food can be reintroduced.
-
Baked egg or baked milk tolerance
Many children tolerate baked forms before raw. A staged baked challenge opens up a much wider diet.
-
Component-resolved risk stratification
Low-risk components (Ara h 2 negative, Cor a 14 negative) with a supportive history. A challenge confirms tolerance safely.
-
Drug and food additive challenges
Non-steroidal anti-inflammatories, antibiotics, colourings and preservatives. Same protocol, same setting.
Types of challenge
Three protocols, one shared safety standard.
Almost all private challenges in London are open. Blinded and placebo-controlled versions are reserved for specific situations.
-
Open oral food challenge (OFC)
You know what you are eating. The everyday clinical standard for most peanut, egg, milk and tree nut challenges.
-
Single-blind challenge
The food is disguised so you do not know when you are eating it. Used when anxiety or subjective symptoms could confuse the result.
-
Double-blind, placebo-controlled (DBPCFC)
Neither patient nor supervising clinician knows the order. The research and legal gold standard, reserved for complex or disputed cases.
Preparation
The week before the challenge.
A challenge only works if the ground rules are followed. We send you a full written checklist in advance.
-
Stop antihistamines
Hold all antihistamines for 5 to 7 days beforehand. They mask early signs and can invalidate the result.
-
Hold oral corticosteroids
Stop for 7 to 14 days if your allergist has told you it is safe to pause. Ask before stopping.
-
Well on the day
No fever, no cold, no active eczema flare, no wheeze. Any of these and we reschedule.
-
Avoid the food for a week
Complete avoidance in the week before, so the challenge is a clean test.
-
Eat lightly beforehand
Arrive fasted or with a light breakfast, exactly as your unit instructs.
-
Plan for the whole day
A parent stays throughout. Bring a book, tablet and snacks unrelated to the challenge food.
On the day
A half-day admission, from crumb to full portion.
Roughly five to six hours in the unit. A parent stays throughout. You go home the same day unless a significant reaction needs longer observation.
- 01
Arrival and cannula
You are admitted to a day-case allergy unit. Height, weight, observations, then a small cannula sited in the back of the hand or forearm so intravenous access is ready.
- 02
Starting dose
A tiny crumb-sized dose of the food. Observations at 15 to 30 minute intervals.
- 03
Dose escalation
Six to eight increasing doses, each after a symptom-free interval, up to a full age-appropriate portion.
- 04
Two-hour observation
After the final dose, a minimum two-hour observation with no symptoms before discharge.
- 05
Discharge and plan
A pass letter with a home reintroduction plan, or a full reaction summary if the challenge is stopped early.
Reactions and management
What happens if the challenge is stopped.
Roughly one in seven challenges is stopped for symptoms. Every possible reaction has a written protocol, drawn-up medications and a consultant in the room.
- Mild
Itching, hives, mouth tingling, single vomit
Stopped immediately. Treated with an oral antihistamine and quiet rest until settled. Usually observed for a further two hours before discharge.
- Moderate
Repeated vomiting, throat symptoms, wheeze, widespread hives
Intramuscular adrenaline as first-line, high-flow oxygen, nebulised bronchodilators, intravenous hydrocortisone. Observed for four to six hours minimum.
- Severe
Anaphylaxis: airway, breathing or circulation
Immediate adrenaline, resuscitation team on the unit, intravenous fluids, senior anaesthetic support if needed. Overnight admission for observation.
Indicative pricing
The cost of a private oral food challenge in London.
Fees vary by unit, foodstuff, staffing ratio and whether overnight observation is needed. Consultant follow-up is included.
In short
Single-food low-risk: £1,500 to £2,500. High-risk or DBPCFC: £2,500 to £3,500. Multi-food same day: £4,500 to £6,500.
| Type of challenge | Indicative range | Time in unit | Result |
|---|---|---|---|
| Single-food low-risk challenge (baked egg, baked milk, tree nut) | £1,500 to £2,500 | 5 to 6 hours | Result on the day |
| Single-food high-risk challenge (peanut, cashew, sesame) | £2,500 to £3,500 | 6 to 7 hours | Result on the day |
| Double-blind placebo-controlled challenge (DBPCFC) | £2,500 to £3,500 | Two half-days | Result on the day |
| Multi-food challenge, same day (two to three tree nuts) | £4,500 to £6,500 | 6 to 8 hours | Result on the day |
| Drug or food additive challenge | £1,500 to £2,500 | 4 to 6 hours | Result on the day |
| Overnight observation if reaction | £800 to £1,500 | 12 to 18 hours | Discharge next morning |
Most UK private policies cover oral food challenges when medically indicated and pre-authorised. We handle the pre-authorisation and confirm your co-payment before booking.
Where challenges happen in London
Vetted London allergy day units.
A small panel of paediatric and adult allergy services with the staffing, protocols and resuscitation capacity to run challenges safely.
-
The Portland Hospital
Paediatric Allergy day unit, HCA. Peanut, tree nut, egg and milk challenges from age two upwards.
-
HCA The Wellington Hospital
Adult and adolescent allergy service with full resuscitation cover for complex or high-risk challenges.
-
Great Ormond Street International & Private Care
Tertiary paediatric allergy for complex or previously severe reactors, including DBPCFC.
-
Chelsea and Westminster Paediatric Allergy Private
Consultant-led paediatric allergy day unit, single-food and baked-form challenges.
-
Guy's and St Thomas' Private Healthcare
Adult allergy service with drug and food additive challenges, run alongside NHS allergy leads.
Related tests and treatments
What usually happens before, and after.
A challenge rarely stands alone. It sits inside a longer pathway of testing, reintroduction and, sometimes, active desensitisation.
-
Skin prick allergy testing (paediatric)
The usual first-line test before deciding whether a challenge is needed.
Read more -
Component-resolved testing (ISAC, ALEX)
Molecular allergy testing that helps risk-stratify who is safe to challenge.
Read more -
Milk ladder reintroduction
Structured home reintroduction after a passed baked-milk challenge.
Read more -
Egg ladder reintroduction
Structured home reintroduction after a passed baked-egg challenge.
Read more -
Multi-food oral immunotherapy
Longer-term desensitisation programme, often preceded by a baseline challenge.
Read more -
Anaphylaxis management and EpiPen training
Written emergency plan and adrenaline auto-injector training for the whole family.
Read more
Recognised by major UK insurers
Coverage varies by unit and policy. We confirm with your insurer before booking.
Frequently asked
The six questions we get before every challenge.
Written for parents booking a first challenge, and adults arranging a challenge for themselves.
-
Is an oral food challenge safe?
It is the safest way to answer the question, because it happens in a day-case unit with a cannula sited, adrenaline drawn up, and a consultant allergist present throughout. The risk of a severe reaction at home from an accidental exposure is far higher than the risk during a supervised challenge.
-
What is the risk of needing adrenaline?
Across published paediatric series, roughly 10 to 15 per cent of open challenges are stopped for symptoms and around 2 to 4 per cent need intramuscular adrenaline. Every challenge is run with adrenaline drawn up, oxygen and resuscitation drugs at the bedside.
-
Will my child need sedation?
No. The challenge relies on you noticing early symptoms, so patients need to be fully awake. Cannulation uses topical local anaesthetic cream.
-
Will my insurance cover the challenge?
Most UK private policies cover oral food challenges when medically indicated by a consultant allergist and pre-authorised. Bupa, AXA, Vitality, Aviva, WPA, Cigna and Healix are recognised. We handle the pre-authorisation.
-
Can more than one food be challenged on the same day?
Only if the foods are low-risk and the allergist judges it safe. Same-day multi-food challenges are usually reserved for two or three tree nuts in a child with a clean history. Otherwise foods are challenged on separate days.
-
If we pass, does the challenge ever need repeating?
Not usually. A properly passed full-portion challenge is definitive. You are given a written home reintroduction plan to eat the food regularly, because ongoing exposure keeps tolerance stable.
Book a private oral food challenge
A definitive answer, in writing, the same day.
Tell us the food, the history and your child's age. We come back within one working day with a shortlisted unit, a firm quote and the next available date.