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


By Gosia Kuran, Lead MS Nurse Specialist, King’s College Hospital

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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.

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MS Academy was established six years ago and in that time has accomplished a huge amount. The six different levels of specialist MS training are dedicated to case-based learning and practical application of cutting edge research. Home to national programme Raising the Bar and the fantastic workstream content it is producing, this is an exciting Academy to belong to.