East of England Immunoglobulin Assessment Panel (EoE IAP)

Latest news and panel updates

November 2021

July 2021

New 18 month NHS Framework launched. Significant shortages globally of immunoglobulins that will affect the NHS. Mitigation plans in preparation.

April 2021

Update to clinical guidelines for the following conditions: Treatment of measles and Covid-vaccine associated thrombosis and thrombocytopenia

March 2021

All Trusts must now notify the EOEIAP of all immunoglobulin use either for approval or retrospectively for Class 1

February 2021

UK Plasma now sanctioned for the manufacture of immunoglobulins

• https://www.gov.uk/government/news/ban-lifted-to-allow-uk-blood-plasma-to-be-used-for-life-saving-treatments

Clinical requests

Applications for treatment with immunoglobulins require a completed Immunoglobulin Clinical Approval Request Form prior to treatment (± funding authorisation by IFR, depending on the condition to be treated). Complete the form in the corresponding link (below) and submit to the EoE IAP for panel consideration:

• Immunomodulation with immunoglobulins - Therapy Application Request

All requests for immunoglobulin replacement therapy (in primary or secondary immunodeficiency) should be made using the following form:

• Immunoglobulin Replacement Therapy with immunodeficiency Clinical Application Form

All clinical requests to authorisation to the panel should be made to:

• add-tr.iap-eastofengland@nhs.net - for patients from any member Trust (from an nhs.net account)
• ivig@addenbrookes.nhs.uk - for patients from CUH only (from an addenbrookes.nhs.uk email account only)

All authorised treatment requests require the treating consultant to review the patient’s clinical response in accordance with the specified clinical measures for the indication, or as specified by the panel at the point of approval to treat.

Patients should be informed that panel approval is required before treatment can begin for any Class II-V indications (Class I indications may proceed within defined limits without panel approval).  As part of the process of consent to treatment, patients with capacity should be given a copy of the Immunoglobulin Patient Information Leaflet prior to treatment, along with the opportunity to read and ask questions about treatment before treatment proceeds.

Clinical guidelines

• East of England Comprehensive Clinical Guidelines for Immunoglobulins

The regional (EOE) immunoglobulin treatment guidelines combine the latest guidelines as published by NHS England and the Department of Health, as well as regional standards as specified by the EoE IAP. Local standards include further detail on the approvals required per indication, permission to treat out of hours and the agreed dosing strategies for indications that previously have not been covered by particular guidance. This guidance should be used as the primary reference source by NHS providers in the East of England, and in preference to other documents including those published by commissioners.

Associate Trusts of the EoE IAP agree to adhere to the standards specified by the EoE IAP and to accept the decisions of the EoE IAP as binding. This stance is supported by the medical directors of the Trusts in the East of England.

• Clinical guidelines
• Terms of reference
• Core Practice Standards

A pathway exists for a second opinion to be sought from an associate SRIAP (sub-regional IAP). Where the EoE IAP has declined to support treatment with immunoglobulins, please contact ivig@addenbrookes.nhs.uk directly to request a clinical review by an associate SRIAP. Do not submit patient identifiable data to this email address, unless using an addenbrookes.nhs.uk email account OR by writing [secure] in the title of an nhs.net email to ensure the message is encrypted.

Submission of data to the East of England IAP

The following email distribution list should be used for the submission of purchasing data, allocation change requests and other communications of a general nature that do not involve clinical decision making or data that is patient-confidential

• ivig-coordinator@addenbrookes.nhs.uk - from Trust specific or nhs.net accounts

Regional allocations are monitored by the IAP and a summary of the set allocations can be requested from the regional IVIG coordinator

Other websites

• National Immunoglobulin Database