National Review Standardises Care in Specialist Immunology and Immunoglobulin Therapy Across Wales
The NHS Wales Joint Commissioning Committee (NWJCC) has completed a national review of specialist immunology services, bringing together for the first time a comprehensive picture of how care is delivered across Wales.
The review, undertaken to understand current provision and future needs, identifies why change is required, highlighting opportunities to develop a more standardised, consistent service model that improves support for people with immune system conditions and those receiving immunoglobulin therapy.
Specialist immunology care, commissioned under the NWJCC’s portfolio, supports people with rare immune disorders who are often diagnosed in childhood and require lifelong monitoring and immunoglobulin treatment to help their bodies fight infections.
As the national commissioner, the NWJCC coordinates this service, funds treatment, and oversees delivery across Wales.
The review was undertaken in response to rising demand, increasing costs, and variation in how services have developed across different Health Boards. It examined commissioning arrangements to ensure they reflect patient need and clinical demand. The review also recognised that immunoglobulin therapy is used beyond immunology, including in neurology and haematology, meaning the findings will benefit a wider group of patients.
Stacey Taylor, Director of Finance and Value at NWJCC, said: “Variation has developed naturally over time, but it means patients can currently experience different pathways depending on where they live.
“This review gives us the clarity we need to understand how to create a more standardised, nationally coordinated approach.
“It highlights where duplication exists, where processes can be streamlined, and where clearer responsibilities will help improve the overall system. A single national approach should help smooth out variation and inequitable access.”
The review identified three key issues:
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That patients in different regions do not currently access specialised immunology services in the same way.
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That approval and monitoring of all immunoglobulin therapy for patients vary depending on where treatment is provided.
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That Wales does not yet have a standardised national system for managing ongoing use of immunoglobulins or tracking demand and outcomes, for these medicinal products.
Stacey added: “These findings will now guide the NWJCC’s commissioning approach for Welsh patients. This includes developing clearer commissioning arrangements, strengthening monitoring of immunoglobulins and aligning more closely with established UK‑wide systems aiming to commission immunoglobulin therapy based on evidence and clinical need benefiting patients across Wales.”
As part of the review, NWJCC worked closely with NHS England commissioning teams, procurement experts, national panels, the Welsh Blood Service and the specialist immunology centre at Cardiff and Vale University Health Board.
Stacey said: “The review marks an important step forward in commissioning using a value-based approach. It focused on how commissioning can help deliver more equitable, sustainable and value‑focused services for patients in Wales balancing resources effectively. It recommends an approach that can strengthen national arrangements for people with primary and non-primary immune system conditions.”
The next phase is to implement the recommendations as part of the Annual Plan 2026/27. NWJCC will continue to collaborate with providers to deliver these changes.