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.
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:
- 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 (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
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
- cuh.add-tr.eastofeng-iapcoordinator@nhs.net (from Nov 2022)
- ivig-coordinator@addenbrookes.nhs.uk will be monitored less frequently and will eventually be closed.
Regional allocations are monitored by the IAP and a summary of the set allocations can be requested from the regional IVIG coordinator