The Joint Committee on Vaccination and Immunisation1 and the British Congenital Cardiac Association2 have produced guidelines for palivizumab prophylaxis. There is conflicting evidence regarding the cost benefits of treatment, which is an important consideration where there are limited resources to provide therapy to all children meeting the broad criteria. A course of five doses of palivizumab can cost up to £6000 per patient. The development of centralised clinics may help reduce the costs associated with administration and improve the quality of the service delivered.3 4

Historically in Cambridgeshire, palivizumab treatment has been administered in an ad hoc manner. Some children were treated in the community and others in hospital either as outpatients or as ward attenders. Children referred to the Cambridge Children’s Community Nursing Teams (CCNT) would receive monthly home visits for the entire respiratory …