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Views wanted on specialised services commissioning policies

Views wanted on specialised services commissioning policies
29 February 2016



NHS England has launched a 30-day consultation on proposed new products for specialised services, including service specifications and clinical commissioning policies.

These national policies have already been developed with support and input of lead clinicans and patient and public representatives. However, NHS England now wants to gather the views of wider groups of stakeholders on the issues below.

NHS England has launched a 30-day consultation on proposed new products for specialised services, including service specifications and clinical commissioning policies.

These national policies have already been developed with support and input of lead clinicans and patient and public representatives. However, NHS England now wants to gather the views of wider groups of stakeholders on the issues below.

Urethroplasty
NHS England has concluded that there is sufficient evidence to support the proposal for routine commissioning of urethroplasty for benign urethral structures in men.

Sperm retrieval procedures
Similarly, there is evidence to support the routine commissioning of certain surgical sperm retrieval procedures to specific patient groups, for men who are having fertility problems to have children. However, the criteria for commissioning is dependent on the patient having confirmed funding for subsequent stages of the pathway (cryopreservation and/or IVF treatment).

Penile prosthesis surgery
The consultation also seeks views on commissioning penile prosthesis surgery for men  at end-stage erectile dysfunction, where either a semi-rigid rod would be inserted in the penis, or  a device that can be pumped to cause an erection.

Fampridine for multiple sclerosis
There is not enough evidence to support routine commissioning of fampridine for patients with multiple sclerosis to improve their walking, NHS England stated.

Autologous chondrocyte implantation
NHS England also found that there is not sufficient evidence to support a proposal for routine commissioning of autologous chondrocyte implantation (a cartilage alternative) for patients with lesions in the talus (one of the bones in the ankle joint that supports the weight of the body).

Bone material alternative
NHS England also concluded that there is sufficient evidence to support a proposal for the routine commissioning of bone morphogenetic protein-2 (which acts as an alternative product for patients own bone material) for specialised spinal fusion surgeries. This would only apply to selected patients who are deemed to have the most benefit.

Everomilus for non-cancerous growths
Tuberous sclerosis complex (TSC) is a genetic condition affecting one in 6,000 babies, which can lead to non-cancerous growths developing in different organs, such as the brain. These growths can be reduced with drugs such as everolimus, and NHS England found there is enough evidence to support routine commissioning of everomilus for patients with TSC whose growths can’t be removed by surgery.

See the survey here.

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