This Clinical Reference Group (CRG) covers specialised treatment of certain immunological and allergic conditions. In relation to immunological conditions, this includes primary immunodeficiencies, autoimmune and autoinflammatory disease where there is associated immunodeficiency, complex autoimmune and vasculitic conditions and autoinflammatory syndromes.
In relation to allergic conditions this includes severe, complex and/or rare sub-group such as angioedema (swelling under the skin), hypereosinophilic disorders (conditions in which there is a marked increase in a type of white blood cell called an eosinophil), mastocytosis (where the presence of a type of white blood cell called a mast call is increased) and urticaria (swelling in the upper layer if the skin).
Highly specialist allergy services include services provided by Highly Specialist Allergy Centres including outreach when delivered as part of a provider network.
Specialist immunology services include services provided by Highly Specialist Immunology Centres, including outreach when delivered as part of a provider network.
Chair: Dr Siraj Misbah, Consultant in Clinical Immunology, Oxford University Hospitals Trust.
Rob Coster, Lead Commissioner, firstname.lastname@example.org
Dr Susan Walsh, Patient & Public Voice
Lynne Regent, Patient & Public Voice
Laura Szutowicz, Patient & Public Voice
Matthew Buckland, London
Dr Magdalena Dziadzio, London
Sarah Goddard, Midlands & East
Shualb Nasser, Midlands & East
Sinisa Savic, North
Susana Marinho, North
Syed Hasan Arshad, South
Claire Bethune, South
Giles Ratcliffe, PHE Lead
Sarah Denman, Pharmacy Lead
Tomaz Gareaz, UKPIN
Bill Egner, RCPATH
Andrew Symes, IANG Immunology and Allergy Nurses Group
A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 Hub Commissioning Teams to contract services on an annual basis.
Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care. The specifications have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe both core and developmental service standards. Core standards are those that all funded providers should be able to demonstrate, with developmental standards being those which may require further changes in practice over time to provide excellence in the field.
The following service specifications fall within the scope of this CRG:
- Specialised Immunology (All Ages)
- Specialised Allergy Services (All Ages)
- Cryopyrin Associated Periodic Syndrome (All Ages)
- Diagnostic Service for Amyloidosis (All Ages)
A commissioning policy is a document that defines access to a service for a particular group of patients. A NICE Technology Appraisal Guideline on the same topic will replace, or be incorporated into, a commissioning policy as appropriate. These are important documents that are developed to ensure consistency in access to treatments nationwide.
The following policies fall within the scope of this CRG:
- Anakinra and tocilizumab for adult onset stills disease
- Anakinra for autoinflammatory
- Treatment of Acute Attacks in Hereditary Angiodema (Adult)
- Rituximab for cytopaenia complicating primary immunodeficiency
- Plasma-derived C1-esterase inhibitor for Prophylactic treatment of hereditary angioesema (HAE) types I and II