Aims The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies. The pathways focus on defining the competences to deliver the highest standard of care for such children. By defining competences rather than criteria for onward referral, the authors have sought to create flexibility in delivery of care which will be responsive to regional variations in knowledge, skills and service.

Method All pathways were developed by multidisciplinary working groups, based on a comprehensive review of evidence. The pathways were reviewed by a broad group of stakeholders and approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee.

Results The results for all pathways are presented in two sections: a pathway algorithm and the competences. The entry points for each pathway are defined at the point where symptoms first occur and the ideal management is described from self-care through complete diagnosis to monitoring of progress. From the evidence review the working groups were able to make research recommendations.

Conclusions The authors present eight national care pathways for allergic conditions based on evidence review, expert consensus and stakeholder input. They provide a guide for training and development of services to facilitate improvements in delivery as close to the patient's home as possible. The authors recommend that these pathways are implemented locally by a multidisciplinary team with a focus on creating networks between primary, secondary and tertiary care to improve services for children with allergic conditions.