Scope

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-groups.

Membership

• Dr. Tomaz Garcez, Chair
• Dr. Anthony Williams, Clinical Member
• Dr. Magdalena Dziadzio, Clinical Member
• Dr. Mark Gompels, Clinical Member
• Dr. Susana Marinho, Clinical Member
• Dr. Chris Rutkowski, Clinical Member
• Dr. Ariharan Anantharachagan, Clinical Member
• John Dempster, Clinical Member
• Dr. Giles Ratcliffe, PHE Lead
• Dr. Sarah Denman, Pharmacy Lead
• Carla Jones, Patient & Public Voice Representative
• Dinakantha Kumararatne, Affiliate Member
• Shuaib Nasser, Affiliate Member
• Anna Kafkalias, Lead Commissioner

Products

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

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)

Policies

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:

• Allogeneic Haematopoietic Stem Cell Transplant for Primary Immunodeficiencies (all ages)
• Anakinra to treat periodic fevers and autoinflammatory diseases (all ages)
• Baricitinib for use in monogenic interferonopathies (adults and children 2 years and over)
• Canakinumab for treating periodic fever syndromes: TRAPS, HIDS/MKD and FMF (ages 2 years and older)
• Plasma-derived C1-esterase inhibitor for Prophylactic treatment of hereditary angioedema (HAE) types I and II
• Rituximab for cytopaenia complicating primary immunodeficiency
• Use of therapeutic immunoglobulin in England
• Tocilizumab for the treatment of adult-onset Still’s disease refractory to second-line therapy (adults)
• Treatment of Acute Attacks in hereditary angioedema (Adult)