Information for Healthcare Professionals

Our charity's guidance is created in collaboration with our Clinical Advisory Panel (CAP) to inform and advise healthcare professionals.

Below you can find information on Addison's and adrenal insufficiency, Surgical Guidelines, our publications for healthcare professionals, information on emergency steroid cards and more!

• Sign up to our Newsletter
• About Addison's disease and adrenal insufficiency
• Time Critical Medication
• Endocrinologists and Endocrine Nurses
• Help us provide emergency injection training
• Surgical Guidelines
• Primary Care - GP education modules
• Prescription Frequency of essential meds
• Dental Care
• Paramedic Training
• Out & About: steroid cards, medic alert jewellery & injection kits
• Leaflets and Publications
• The Addison's Clinical Advisory Panel (CAP) 

About Addison's disease and adrenal insufficiency

For a bite size look at adrenal insufficiency, watch CoMIC's brilliant video infographic explaining everything adrenal insufficiency, from aetiology, signs and symptoms, investigations, management, adrenal crisis and the vital patient training in sick day rules, administering the emergency injection and carrying the NHS steroid card. To learn more read 'What is Addison's disease?'

The content of CoMICs video was critically reviewed by Dr Alessandro Prete, University of Birmingham; Professor Wiebke Arlt, University of Birmingham; Dr Helen Simpson, UCLH and ADSHG Medical Trustee; Professor Stefanie Hahner, University of Würzburg, Germany. Thank you to Dr Punith Kempegowda from Simulation via Instant Messaging – Birmingham Advance (SIMBA) for their permission to share this fantastic resource. On YouTube, watch our videos explaining Addison's for the patient and those who support them, produced with CoMICs. 

If you are working with a patient with adrenal insufficiency, including Addison’s disease, you are in a position of critical influence in terms of helping them to optimally manage their condition, to avoid life-threatening adrenal crises, build confidence and improve their quality of life.

The National Institute for Health and Care Excellence (NICE) has guidelines for the identification and management of adrenal insufficiency, and is clinicians' go-to reference for identifying and managing adrenal insufficiency (hypoadrenalism) in babies, children, young people and adults. 

Time Critical Medication

Patients with undiagnosed or established primary or secondary adrenal insufficiency, as well as those who are at risk of developing tertiary adrenal insufficiency, are all at risk of adrenal crisis. This is a life-threatening emergency resulting from a lack of cortisol, the major glucocorticoid.

Critically, the patient's daily medication is also time-critical. People with steroid dependency are at risk of harm, from low cortisol symptoms (nausea, pain, weakness) to potential death, if they don’t receive their steroids on time, every time.

To help share this message with your colleagues or to learn more, click below to download and print the resources from the Royal College of Emergency Medicine (RCEM), Association of Ambulance Chief Executives (AACE) and UK Clinical Pharmacy Association. 

The RCEM ‘Advisory Statement’ provides clear and practical guidance on allowing patients, who are able to self-administer their own time critical medications, to do so.

RCEM Safety Flash

Glucocorticoid Steroid Dependency (June 2025)

Time Critical Medications Poster

AACE & RCEM (Feb 2024)

Time Critical Medication Self- Administration in Emergency Departments

RCEM Advisory Statement (March 2025)

Endocrinologists and Endocrine Nurses

Consultation Reference Guide

A guide for endocrinologists and endocrine nurses to support patients with Addison's at diagnosis, their follow up reviews, treatment monitoring and shared-decision making. 

Thanks to Dr Sofia Llahana and Professor John Wass.

RCP Medical Care

"Addison's, adrenal insufficiency and patient safety"

In collaboration with RCP, we talk through the NICE Guidelines, changes in ambulance care, 'red flagging' and tragic Prevention of Future Death reports showing the need for improved patient safety.

NICE Guidance

Read the new NICE Guidance, learn more about the ADSHG's involvement and watch Dr Helen Simpson's SfE webinar: "What you need to know about the new Adrenal Insufficiency NICE Guidelines". 

Endocrine Conference Hub

If you can't attend Endocrinology conferences, there's no need to miss out! Visit our Endocrine Conference Hub page, where we've compiled the latest information and resources to support you and your patients. 

Endocrine Hub

Nursing 

We have developed two leaflets for you to give out to your nursing team: the first, Notes for Ward Nurses is for you to give to your nursing team on the ward when you become an inpatient e.g. for elective surgery or during the recovery from an adrenal crisis.

The second, Notes for Primary Care and A&E Nurses, is for you to give to your GP nursing team or A&E nursing staff if you have to visit the emergency department.

Both leaflets will help your nursing team to understand more about your condition, and how it is treated and managed, and to support them in ensuring you receive the appropriate care.

Notes for Nurses

Addison's awareness Hospital Stands: If you're an Endocrine Nurse and would like to set up an awareness stand in your hospital, please visit our page to learn more and how we can support you!  Read our Blog for inspiration and to hear how Endocrine Nurse Joanne Brown created her stand at Stockport NHS Hospital. 

Run an awareness stand 

Digital steroid coding system: Endocrine Nurse Specialist Becci Watling, from the Royal Bournemouth Hospital updates us on the implementation of their digital steroid coding system, a system which identifies all patients admitted with adrenal insufficiency. Visit our blog article 'Ensuring Sufficiency in Addison's when an inpatient' to learn more.

The 4E: Engage, Educate, Equip and Empower: The benefits of care coordination are clear, yet it is difficult to access. Here Sherwin Criseno, Nurse Consultant in Endocrinology at University Hospitals Birmingham NHS Foundation Trust and Chair of the European Society of Endocrinology Nurse Committee, explains 'The 4E’ care coordination initiative, used to support people with Addison’s, adrenal insufficiency and clinicians, and the positive impact this has on quality of life.

Video Steroid Education Sessions: Click to read about the Liverpool Nurses who moved their steroid education sessions for their patients with adrenal insufficiency online during COVID-19. If our charity can support you in creating similar resources or you would like more information please get in touch.

Surgical Guidelines

The ADSHG surgical guidelines are intended for the information of medics and healthcare professionals and have been developed for the ADSHG by our Clinical Advisory Panel. They explain what level of extra medication and monitoring patients with Addison's disease will need in the event of most types of minor or major surgery or dental work.

Read the Surgical Guidelines

Primary Care 

RCGP eModule

BMJ Learning - Medical emergencies in primary care: Addisonian (adrenal) crisis

We are thrilled to have worked with the BMJ team on the content for the BMJ Learning Adrenal Crisis e-learning course for GP’s, to ensure they are aware of Addison’s disease and adrenal insufficiency, the risk of adrenal crisis, and how to manage it. This course offers a practical guide for GPs, providing them with the knowledge and skills required for the recognition and emergency treatment of Addisonian (adrenal) crisis.

Please share https://new-learning.bmj.com/course/30000297 or click the button below.

BMJ Learning

GP Education E-Modules

This poster is an A4 printout to let GPs know about the CPD education modules available on Addison's and adrenal insufficiency.

The poster provides information on both the RCGP module and BMJ Learning module. If you are a GP yourself, why not print out and display as a poster in your staff room to let others know about these courses.

This poster has been created by the ADSHG as a resource for patients to share with their medical professionals.

You can download the poster here.

Diagnosing Addison's: A Guide For GPs

This leaflet, 'Diagnosing Addison's: a guide for GPs', has been developed for the ADSHG by our Clinical Advisory Panel, led by Professor John Wass. It outlines the role of the GP in the early detection of Addison's disease and covers information on symptoms and clinical signs, primary care investigations and referral.

Caring for The Addison's Patient: Information For GPs 

This leaflet, 'Caring for the patient with Addison's: information for GPs', has been developed for the ADSHG by our Clinical Advisory Panel, led by Professor John Wass. It outlines the role of the GP in managing Addison’s disease at each stage in the UK patient life cycle from diagnosis to old age.

Order paper copies of our leaflets

Prescription Frequency of Essential Medications 

Following anecdotal evidence that members were struggling to access sufficient medication for following Sick Day Rules, in 2025 the ADSHG and The Pituitary Foundation surveyed their members to find out more.   

79% of the ADSHG respondents received less than a 3-month prescription of their steroid replacement medication.  For the full survey findings please see our page on Prescption Frequency.

The insights are more than just stories - they reveal a problem with the current system and make it clear how significantly these issues affect patient quality of life and patient safety.

If you are a healthcare professional supporting a patient with adrenal insufficiency please:

• Support them to receive 3-month repeat prescriptions so they can follow Sick Day Rules and prevent adrenal crisis. If medications are dispensed in a dosette box, it is essential to provide a separate supply of steroids to allow for increasing the dose when following Sick Day Rules.
• Take the time to understand their rare condition so you can support them in effectively self-managing it: familiarise yourself with the Adrenal Insufficiency Action Plan and work through it with your patient.
• Signpost them to our template letter to send to their GP to request 3-month prescription or contact their GP on their behalf
• Signpost your patient to the ADSHG for further information, support events, and injection training opportunities.

Dental Care

Visit our dedicated dental care page for more information.

Paramedic Training Sessions

Make our Paramedic Training Sessions for trusts and individuals in managing adrenal crisis part of your continuous professional development (CPD). The sessions are an educational hour on Addison’s and adrenal insufficiency set in context with the JRCALC guidelines for emergency management. Each session is complemented by members’ own experiences, so alongside the theory you hear real life accounts from real people.

Paramedic Training on Adrenal Crisis

Out & About: Steroid Cards, Medic Alert Jewellery & Injection Kits

NHS Steroid Emergency Card

• NHS Steroid Emergency Card: developed by the Society for Endocrinology (SfE), Royal College of Physicians (RCP) and NHS England and NHS Improvement (NHSE&I), the card should be issued to all patients at risk of adrenal crisis. The QR code printed on the card takes you straight to the Society for Endocrinology Adrenal Crisis page.
• Alongside the card, new medical guidance on the prevention and emergency management of adrenal insufficiency was released and a National Patient Safety Alert.
• The British Society for Paediatric Endocrinology and Diabetes (BSPED) have produced a Paediatric Steroid Treatment Card for Adrenal Insufficiency 
• To learn more on education on steroid safety with the steroid emergency card and how to order cards for your patients - please visit the Society for Endocrinology Adrenal Crisis page 
• Please direct your patients to our newly diagnosed page, so they can learn about the importance of carrying steroid cards, medical alert jewellery and injection kits. 
• Please download our steroid card posters - both for patients and healthcare professionals.

• ADSHG Adrenal Crisis Emergency Wallet Card: the emergency wallet card contains advice authored by the ADSHG Clinical Advisory Panel, on the treatment required to prevent an adrenal crisis in the event of serious injury or illness. It is available in printed form and is sent free to every member when they join the charity as a postal member. Additional cards can be bought in our shop.

Steroid emergency cards - adults and children

Adrenal Crisis Care Letter

This simple adrenal crisis protocol gives emergency medical treatment guidance for paramedics or hospital staff in the event of a person suffering an adrenal crisis. This document is also available in eight foreign languages for those who live or travel abroad.

Adrenal crisis letter

Emergency Injection Kits

Every patient should be issued with a prescription for hydrocortisone IM for emergency use as required for a hydrocortisone emergency injection kit and advised of training. Some Endocrinology centres provide the kit as a whole (box including the syringes and needles alongside the prescription) others ask the patients to provide their own storage solution.

This is essential and is included in the NICE Guidance, for patients to manage an adrenal crisis wherever they are and to buy vital time if there is a delay to their admission to A&E.

See inside our emergency kits and explore their life-saving contents.

Download or Order our Leaflets and Publications

Explore and download our healthcare professional and patient-facing leaflets and publications from our website, including Managing Your Addison's and Adrenal Insufficiency, Surgical Guidelines and Fasting with Adrenal Insufficiency. 

You can order copies of our leaflets, or purchase individually or in pre-collated bundles from our online shop.

More information on reducing risk of acute adrenal crisis:

• How to avoid precipitating an acute adrenal crisis (Article by Professor Wass)
• Adrenal Crisis Care Letter
• Pass on to patients our 3-part video series which explains Addison's and what to do in the event of adrenal crisis

The Addison's Clinical Advisory Panel (CAP) 

We couldn't carry out this work without the expert support of our Addison's Clinical Advisory Panel (CAP), a group of healthcare professionals with an interest in adrenal medicine. They advise us on our clinical guidelines, write medical commentaries and review our publications for us. They are led by Professor John Wass of the Churchill Hospital, Oxford. We are always looking for more healthcare professionals to join us, in whatever capacity you are able with your work commitments. If you are interested, please get in touch.

Are you interested in undertaking research in this area of Endocrinology? We fund vital research projects into Addison's disease, adrenal insufficiency and steroid dependency.

Research Grants and how to apply

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