Clinical practice

Clinical practice

Clinical practice

Information is available here to support the clinical practice of the delivery of advanced therapies to patients, including patient assessment, handling advanced therapies, product administration, infusion, treatment and monitoring and recording treatment and side-effects.

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pdf

Adult CAR T Cell Shared Care Guidelines

This exemplar guideline suggests roles and responsibilities between CAR T cell referring centres and treatment centres. It also outlines common late adverse effects that may occur when patients have returned to their referring centre.
pdf

Ambulatory Care for Lymphodepletion Prior to CAR-T Cell Infusion

An example SOP from University Hospitals Bristol and Weston NHS Foundation Trust to provide a safe and effective framework by which lymphodepletion can be performed in the outpatient setting, prior to admission for CAR-T Cell infusion.
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Apheresis process flow

A document summarising the challenges and solutions the the collection of starting materials for ATMP manufacture though apheresis
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Apheresis Weekly Cleaning Log

A template of an apheresis weekly cleaning log.
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Assessment of Suitability for Ambulatory Care BMT at BHOC

An example SOP from University Hospitals Bristol and Weston NHS Foundation Trust detailing the inclusion and exclusion criteria when referring patients to the Ambulatory Care (AC) BMT service.
Online Article

Care of CAR-T patients; The nursing perspective webinar

The CAR T cell patient journey from a nursing perspective, some of the challenges faced, and a some of patient case studies.
pdf

Cellular ATMP fresh autologous example receipt checklist

This document sets out an example generic checklist for receipt and storage of fresh, autologous, cellular Advanced Therapy Medicinal Products.
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Checklist for receipt of empty shipper

Form to complete when receiving, processing and releasing fresh cells for manufacturing
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Checklist for receipt of frozen product

A checklist to confirm ATMP is received appropriately from the manufacturer prior to administration to a patient
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Christie Aseptic and Cellular Therapies pharmacist Job Description

Job Description detailing the key responsibilities, skills and behaviours applicable for an Aseptics and Cellular Therapies Pharmacist
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Collection of Tissues for Isolation of Tumour Infiltrating Lymphocytes – A Process Overview of SOPs

An overview of points to consider and SOPs required when establishing a new pathway for the collection of tissues to isolate tumour infiltrating lymphocytes (TIL). Relevant for both research and clinical tissue collection.
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Consent for CAR-T therapy treatment for ALL

Example of a patient consent form for CAR-T therapy to treat Relapsed/ Refractory Acute Lymphoblastic Leukemia
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Consent for CAR-T therapy treatment for DLBCL

Example of a patient consent form for CAR-T therapy to treat Diffuse Large B-Cell Lymphoma
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Consenting Hepato-Pancreatico-Biliary (HBP) patients for Bio-bank SOP

SOP re: consenting Hepato-Pancreatico-Biliary (HBP) patients for biobank

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  • Governance

    Governance

    Read more about this section.

    This section is intended to assist NHS organisations to create or modify governance structures to permit the introduction of advanced therapies, encompassing all levels of governance responsibilities and reporting within hospitals.

  • Business and financial planning

    Business and financial planning

    Read more about this section.

    The introduction of advanced therapies into hospital treatment pathways requires a significant financial investment in resources and facilities. Information available here will help organisations to develop the appropriate business and financial plans as they prepare to deliver advanced therapies.

  • Quality assurance and risk management

    Quality assurance and risk management

    Read more about this section.

    This section provides examples of, and guidance on, the implementation of quality systems and risk assessments for safe delivery of advanced therapies towards preparing for regulatory inspections.

  • Operational delivery

    Operational delivery

    Read more about this section.

    The documents in this section will assist in the implementation of new advanced therapy services in a clinical setting, supporting the transition of guidance into practice.  Documents include process and patient flow charts to map the treatment pathway and information on the in-hospital logistics requirements.

  • Clinical practice

    Clinical practice

    Read more about this section.

    Information is available here to support the clinical practice of the delivery of advanced therapies to patients, including patient assessment, handling advanced therapies, product administration, infusion, treatment and monitoring and recording treatment and side-effects.

  • Education and training resources

    Education and training resources

    Read more about this section.

    To safely deliver advanced therapies to patients, staff need to be trained in this new modality of therapeutic intervention. This section includes resources that enable staff to learn more about ATMPs including e-learning, facilitating face to face training and competency assessments, and materials to support patient education.

  • Long term follow up

    Long term follow up

    Read more about this section.

    A regulatory feature of advanced therapies is the need for longer-term follow up than for other therapeutic modalities.  The information provided here speaks to the methods of data collection for extended follow up patients after treatment.

  • Clinical trials

    Clinical trials

    Read more about this section.

    This section has a range of resources – split into 8 sub-sections – which will assist NHS sites to prepare for the set up and delivery of advanced therapy clinical trials. Its objective is to disseminate learnings from the ATTCs regarding the governance, infrastructure and processes which underpin successful trial set up and delivery.