Clinical immunology is defined by the World Health Organisation and the International Union of Immunological Societies as “a clinical and laboratory discipline dealing with the study, diagnosis and management of patients with diseases or disease processes resulting from disordered immunological mechanisms, and conditions in which immunological manipulation form an important part of therapy and/or prevention”.
Consistent with this definition, immunologists in the UK generally have a dual role of being both a pathologist (laboratory role) and a clinician. The Certificate of Completion of Training (encompassing the FRCPath qualification) awarded by the General Medical Council accredits them to work in the clinical fields of adult immunodeficiency, allergy and some autoimmune rheumatological disorders as well as leading and directing a diagnostic immunology laboratory. A significant minority of immunologists also have a management role or an academic position as part of their duties.
Laboratory immunology consists predominantly of the assessment of integrity and pathology of the immune system and most immunology laboratories would have defined or integrated autoimmunity, immunochemistry, allergy and cellular immunology sections. In most NHS services, the responsibilities of laboratory leadership & direction, supervision, quality management, clinical interpretation and clinical liaison rest with the immunologist.
As patient-facing clinicians, most immunologists would be principally responsible for the management of patients with primary immunodeficiency disorders, services for these patients usually being organised on a regional basis. This would encompass primary defects of innate and/or adaptive immunity which have a known or suspected genetic basis but many immunologists nowadays also care for a range of patients with disorders of immunity which are secondary to environmental or iatrogenic factors. The majority of UK immunologists also provide specialist allergy care services, which would routinely encompass assessment and management of patients with food allergy, anaphylaxis, rhinoconjunctivitis, complex urticaria and angioedema, drug allergy or insect venom allergy. Where there is no local arrangement or structural provision of a consultant paediatric immunologist-led service for children, the adult immunologist may jointly manage children with immunodeficiency or allergy problems in concert with general paediatrician colleagues.
In addition to these core working elements a minority of immunologists would also provide a range of highly specialised clinical or laboratory services, sometimes at a national level, which are focused on specific aspects of autoimmune, immune deficiency, allergic or inflammatory diseases. External accreditation processes which underpin quality assessment of a number of components of immunology services are now organised and available through the Royal College of Physicians (allergy and immune deficiency services) and the Royal College of Pathologists (laboratory diagnostic service). The acquisition and retention of accredited status for these service components is a core responsibility of the working clinical immunologist.
Immunology Committee
Dr H Bourne – Chair, Education RepDr L Mutlu – Vice Chair
Elected members
Dr R Sargur
Dr E Staples
Trainee members’ representative
Dr C Akhoon
Co-opted
Dr S Chee – Clinical Immunology Training Days Organiser
Council members
Dr T El-Shanawany
Dr A Pugh
Dr B Wilkins
Related specialty organisations
Members of the Immunology Committee represent the ACP on the following:BSI Clinical Committee
JRCPTB Immunology SAC
RCP/RCPath Joint Committee on Immunology & Allergy
RCPath SAC on Immunology
UKPIN Steering Group
QPIDS Steering Group
Useful links
American Academy of Allergy, Asthma and ImmunologyBritish Society of Allergy & Clinical Immunology
British Society for Immunology
Clinical Immunology Society
European Academy of Allergy & Clinical Immunology
European Society for Immunodeficiencies
Joint Royal Colleges of Physicians Postgraduate Training Board
Royal College of Pathologists
Royal College of Physicians
UK NEQAS Immunology, Immunochemistry & Allergy