Re-opening & redesigning of the Ocrelizumab (Ocrevus ®) infusion service following the first wave of the COVID-19 Pandemic

Advanced MasterClass 9, November 2020

Aim

To review the impact of the COVID-19 pandemic on King’s College Hospital’s ocrelizumab infusion service with a view to restarting and developing it.

Headlines

• Before the pandemic, the ocrelizumab service at King’s was running three times a week, with a capacity for 12 patients
• When the service was suspended, on 20 March 2020, the average wait time for therapy was 12 to 16 weeks
• By June 2020, 206 patients (64 new and 142 previously treated) were awaiting therapy
• Among the 142 previously treated patients, the delay varied from three weeks to five months

Key findings

To reinstate the service, the team:

• Flagged the urgent need to service managers
• Worked to make the supplied space suitable for the service – this included working with other departments to secure equipment and deep cleaning or de-cluttering
• Produced a standard operating procedure
• Adopted strict infection control and isolation procedures
• Implemented an MDT-managed traffic light system to prioritise patients in order of clinical need
• Implemented urgent MS nurse clinics to rescreen patients before re-starting treatment

The unit reopened on 13 July 2020. As of 23 October 2020:

• 175 patients (41 new and 143 previously treated) have received treatment at the King’s unit
• 13 have had their care repatriated to local MS services
• 18 decided not to start or continue therapy due to concern over COVID-19 risk

There is currently no waiting list.

Recommendations

The review demonstrated the need for a complete redesign of the ocrelizumab infusion service in the light of the COVID-19 pandemic.