NHS Bath and North East Somerset, Swindon and Wiltshire CCG Royal United Hospitals Bath NHS Foundation Trust Great Western Hospitals NHS Foundation Trust Salisbury NHS Foundation Trust
Commissioned by NHS England in line with 'Updated Commissioning Criteria for the use of therapeutic immunoglobulin (Ig) in immunology, haematology, neurology and infectious diseases in England (January 2019)'. For indications not covered by these commissioning criteria, commissioning is in line with the 'DoH Clinical Guidelines for Immunoglobulin Use (second edition update, July 2011)'.
Note: Guidance from NHS England (October 2017) states that the recommended dose of IVIg for the treatment of ITP is a single dose of 1g/kg. A repeat dose of 1g/kg should only be considered at day 7 if there is a failure to achieve a haemostatically adequate platelet count (approval from the local immunoglobulin approval panel is required if earlier use is contemplated in cases of exceptional clinical circumstances such as active mucosal bleeding or the need for emergency surgery).
Prescribe by brand. Various brands available.
NOTE Subgam is the HNIG to use when Tetanus IG is unavailable but indicated as per national guidance. See link below.
In the first instance where VZIG may be required the midwife or doctor should contact the acute trust Microbiologist on call for immunology screening prior to prescribing and supplying.
RUH Pharmacy keep a supply of VZIG which is dispensed only following advice of Consultant Microbiologist. See protocol above for process for obtaining and administering VZIG. NB It is NOT available via community pharmacies.
RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.
Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.
Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.
These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.
Suitable for patient to be directed to buy themselves
Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.
(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.
Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.
