This QIPP recommendation for service development was based on evidence before the recent European wide safety review of IV iron products recommending the need for strengthened measures to manage and minimise the risk of hypersensitivity reactions, which may be life-threatening or fatal. The MHRA advice issued following this review recommends that IV iron products should only be administered when staff trained to evaluate and manage anaphylactic or anaphylactoid reactions—as well as resuscitation facilities—are immediately available. In this QIPP case, an anaphylaxis kit was available to appropriately trained staff who administered the drug in the patient’s home, but resuscitation facilities were not, therefore the economics of home delivery of care with the new resuscitation requirements have not been evaluated. These requirements need to be designed into any community service administering parental iron.