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East of England Immunoglobulin Assessment Panel (EoE IAP)

The East of England Immunoglobulin Assessment Panel (EoEIAP) is hosted by Cambridge University Hospitals. All treatment with immunoglobulins is subject to review or authorisation by the Panel.

Trusts signed up to oversight by the EoEIAP
  • Bedfordshire Hospitals NHS Trust
    • Including Bedford Hospital
    • Excluding Luton & Dunstable Hospital
  • Cambridge University Hospitals NHS Foundation Trust
  • East and North Hertfordshire NHS Trust
  • East Suffolk and North East Essex NHS Foundation Trust, incorporating the former
    • Colchester Hospital University NHS Foundation Trust
    • Ipswich Hospital NHS Trust
  • James Paget University Hospitals NHS Foundation Trust
  • Mid and South Essex NHS Foundation Trust, incorporating the former
    • Basildon and Thurrock University Hospitals NHS Foundation Trust
    • Mid Essex Hospital Services NHS Trust
    • Southend University Hospital NHS Foundation Trust
  • Norfolk and Norwich University Hospitals NHS Foundation Trust
  • North West Anglia NHS Foundation Trust
  • Princess Alexandra Hospital NHS Trust
  • Queen Elizabeth’s Hospital King’s Lynn
  • Royal Papworth Hospital NHS Foundation Trust
  • West Suffolk Hospital NHS Foundation Trusts

Clinical guidelines (Step 1: check the patient's clinical condition fulfils selection criteria)

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 national commissioning 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.

The guidelines provide information about the classification of each indication, the level of approval required and the likely need to commence treatment 'out of hours'. Where clinically appropriate, the panel recommend to treat during standard day hours to minimise risks.

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.

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 cuh.add-tr.eastofeng-iapcoordinator@nhs.net to formally request a clinical review by an associate SRIAP. Ensure communications are appropriately secure when sending patient identifiable data. We recommend sending from an nhs.net account.

Clinical requests (Step 2: Seek clinical approval from the EoEIAP)

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; see Clinical Guideline). Download and complete the form (below) and submit to the EoE IAP for panel consideration.

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

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

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 (below) prior to treatment, along with the opportunity to read and ask questions about treatment before treatment proceeds.

Patient Information Leaflet (Step 3: Provide information to the patient before taking informed consent)

Once clinical approval has been obtained from the panel, the patient should be informed about the risks of treatment inherent with immunoglobulins (it is a blood product), his/her/their data being recorded on a national database, the risk of interruptions in supply. This information and more is contained in the Patient Information Leaflet (PIL) below. The panel suggest this leaflet is given to all patients who have capacity before obtaining informed consent and commencing therapy.

There is no regional consent form. Please use locally available generic consent forms in conjunction with this PIL.

Latest news and updates

Latest news and previous significant amendments

November 2022

Supporting the organisational transition at Cambridge University Hospitals from "@addenbrookes.nhs.uk" to "nhs.net" email accounts, contact details on this webpage have been updated.

August 2022

Updated treatment request form (immunomodulation) updated with 2022 abbreviated indications, dosing and commissioning status

Revisions to Core Practice Standards published to reflect current commissioning position and approval processes

July 2022

Revisions to EOE clinical guidelines including published NICE CG and TA. PHE now UK Health Security Agency: references amended. See end of guidelines for a complete list of revisions.

December 2021

Major revisions to NHS England commissioning documents for polyvalent IgG.

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

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

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

EoEIAP regulatory documents

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