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NHS England strengthens clinical leadership in urgent care and specialised services

NHS England has announced the appointment of one of the country’s top urgent and emergency care consultants, Dr Clifford Mann, as Clinical Lead for the Accident & Emergency Improvement Plan, as well as forty of the nation’s leading doctors to drive reform of specialised services.

Dr Mann – the outgoing President of the Royal College of Emergency Medicine – will work closely with NHS England’s National Urgent and Emergency Care Director, Pauline Philip, and Director for Acute Care, Prof Keith Willett, on the joint NHS England and NHS Improvement programme to redesign urgent care services and improve A&E performance.

The role of Clinical Lead – which is a three year appointment – will include chairing the programme’s Clinical Reference Group and supporting local CCGs and trusts to implement changes to care pathways.

Announcing the appointments, NHS England Chief Executive Simon Stevens said: “Today’s appointments are another concrete step towards NHS England’s commitment to harness the nation’s top clinical leadership as we get going on the implementing of the NHS Five Year Forward View in every part of the country.”

Dr Cliff Mann said: “This new opportunity to represent the collective views of frontline emergency medicine clinicians is both welcome and timely.  Current challenges require us to ensure our emergency care systems are sustainable as well as effective. The creation of this role recognises the importance of emergency medicine clinicians within the system and I am pleased to be their representative.”

NHS England also announced the appointment of 41 leading clinicians to support and advise it on the direct commissioning of specialised services. These clinical experts and practitioners in their specialist fields have been appointed as Chairs of NHS England’s Clinical Reference Groups (CRGs). Their role is to help identify and develop new treatments, services and standards across specialised commissioning, and ensure best value is achieved within the resources available.

The specialised services commissioned by NHS England – which have a combined annual budget of around £15.7 billion in 2016/17 – are grouped into six National Programmes of Care (NPoC), each of which is then supported by CRGs focussing on specific clinical specialties.

CRGs and their members play a significant role: leading the development of clinical commissioning policy, service specifications and quality dashboards, advising on service reviews (what is done where and how), horizon-scanning and advising on innovation, identifying opportunities to reduce clinical variation and delivering value.

The full list of Chairs appointed is below.

In addition to CRG Chairs, Antonio Pagliuca, Professor of Stem Cell Transplantation at Kings College Hospital, has been appointed as National Clinical Lead for Regenerative Medicine,  and Dr Richard Fluck, Consultant Renal Physician at Royal Derby Hospital, has been appointed as Co-Chair Internal Medicine National Programme of Care.

Dr Jonathan Fielden, NHS England’s Director of Specialised Commissioning and Deputy National Medical Director, said: “NHS England is committed to transforming and improving outcomes for patients and achieving best value for the resources available. Ensuring that we draw on the best clinical advice and leadership available is essential in achieving this.

“I am delighted with the appointments made across the spectrum of specialised commissioning, and am confident that each Chair – along with their respective CRG members – will make a significant contribution to developing and delivering our strategy for excellent and efficient specialised services over the coming years.”

Dr Wai Lup Wong, Chair of the Cancer Diagnostics CRG, said: “I look forward to working with members of the newly-formed Cancer Diagnostic CRG, NHS colleagues, and with other healthcare bodies to contribute directly to improving the care of patients with cancer in England by supporting NHS England to deliver the best and most appropriate cancer diagnostics with the resources available.”

Dr Bridget Griffiths, Chair of the Specialised Rheumatology CRG, said: “I hope the Specialised Rheumatology CRG will build on the excellent achievements of the last three years. A good number of drug policies were successful and we will continue to work in this area, as well as further developing regional and national networks, particularly focusing on patient outcomes.”

Miss Alison Davis, Chair of the Specialised Ear, Nose, Throat & Ophthalmology CRG, said: “Having previously worked as a CRG chair, I think the new role offers exciting opportunities to build on our previous work to develop specialised services in partnership with our patients and affiliated organisations.  In particular, the new structure develops the link between research and specialised services, as well as challenging us to define the outcomes that are important for patients and clinicians.”

NHS England has also announced the establishment for the first time of cross-CRG working parties, including some which will work with other health and care bodies to contribute to improving services, data and efficiency. Those working parties are:

  • Research – building an interface with the National Institute for Health Research to advise how future research strategies align with commissioning and maximising opportunities;
  • Data and Resource – working with NHS Digital and NHS Improvement to provide clinical advice to these organisations in their work to improve information that guides commissioning;
  • Guidance – working with NICE as a stakeholder in their guidance development and providing clinical advice as needed;
  • Value – to better understand, and therefore reduce, variations in services and, where appropriate, ceasing treatments/ways of working that are no longer of clinical or patient benefit

Under the new Strategic Framework for Specialised Services , CRGs will also be expected to identify best practice in different places, helping to spread innovation and improve outcomes for all patients,  as well as identify where outdated and poor value treatments, drugs and devices should no longer be supported, creating space and finance for the new.

Following a recent consultation, CRGs were refocused to reflect feedback from previous members and stakeholders.

The appointment of Chairs to the new CRGs was a competitive process, with the roles – advertised in April – attracting a combined 600 applications for chairs and members across the 42 CRGs. Chairs are appointed to serve for three years.

For the first time, the role of CRG Chair will be a formal, remunerated NHS England position – recognising the importance of the position both in terms of providing expert clinical advice and oversight in their specialist area, as well as contributing to the wider strategic and clinical development of specialised services.

The Chair will guide the policy development work of their respective CRGs, the other members of which will include:

  • Eight regional clinical (doctor, nurse or AHP) members (two from each region);
  • Three patient and public voice (PPV) representatives, an
  • Up to four members nominated by relevant affiliated organisations.

The clinical and patient and public voice members are currently being selected, and will be published on each of the CRG specific web pages.

The full list of CRGs and their Chairs, organised by the six National Programmes of Care, is as follows. The Medicines Optimisation CRG chair had been recently appointed and was not part of the new appointment process.

Internal Medicine

  • Specialised Respiratory – Professor Mike Morgan, Consultant Respiratory Physician at University Hospitals of Leicester
  • Hepatobiliary and Pancreas – Professor Graham Foster, Consultant Hepatologist at Barts Health
  • Specialised Endocrinology – Professor John Wass, Professor of Endocrinology at Churchill Hospital, Oxford
    Specialised Vascular – Professor Robert Sayers, Consultant Vascular Surgeon at Leicester Royal Infirmary
  • Cardiothoracic Services – Professor Huon Gray, Consultant Cardiologist at Southampton University Hospital
  • Renal Services – Dr Richard Baker, Consultant Nephrologist at Leeds Teaching Hospitals Trust
  • Specialised Colorectal Services – Mr Mark Chapman, Consultant Colorectal Surgeon at Heart of England Foundation Trust
  • Specialised Dermatology – was not appointed, the future of this CRG will be discussed with the specialty association
  • Specialised Rheumatology – Dr Bridget Griffiths, Consultant Rheumatologist at The Newcastle upon Tyne Hospitals NHS Foundation Trust

Cancer

  • Radiotherapy – Professor Nicholas Slevin, Consultant in Clinical Oncology at The Christie NHS Foundation Trust
  • Chemotherapy – Professor Peter Clark, Consultant Medical Oncologist at Clatterbridge Cancer Centre NHS FT
  • Specialised Cancer Surgery – Mr Vijay Sangar, Consultant Urological Surgeon at University Hospital of South Manchester NHS Foundation Trust
  • Cancer Diagnostics – Dr Wai Lup Wong, Consultant Cancer Radiologist at East and North Herts NHS Trust
  • Children & Young Adult Cancer – Dr Rachael Hough, Consultant Haematologist and Transplant Physician at University College London Hospital’s NHS Foundation Trust

Mental Health

  • Specialised Mental Health – Dr Steve Pearce, Consultant Psychiatrist at Oxford Health NHS Foundation Trust
  • Adult Secure Mental Health – Dr David Fearnley, Consultant Forensic Psychiatrist at Mersey Care NHS Trust
  • CAMHS – Dr Andrew Cotgrove, Consultant in Adolescent Psychiatry at Cheshire and Wirral NHS Foundation Trust
  • Perinatal Mental Health – Dr Giles Berrisford, Consultant Psychiatrist at Birmingham and Solihull Mental Health Foundation Trust
  • Gender Identity Services – Dr John Dean, Clinical Director at Devon Partnership NHS Trust

Trauma

  • Rehabilitation & Disability – Colonel Alan Mistlin, Consultant Rheumatology and Rehabilitation at Defence Medical Rehabilitation Centre
  • Major Trauma & Burns – Professor Chris Moran, Professor of Orthopaedic Trauma Surgery at Nottingham University Hospital
  • Spinal Services – Mr Ashley Cole, Consultant Spinal Surgeon at Sheffield Children’s Hospital & Northern General Hospital
  • Neurosciences – Professor Adrian Williams, Consultant Neurologist at University Hospitals Birmingham NHS Foundation Trust
  • Adult Critical Care – Dr Jane Eddleston, Consultant in Intensive Care Medicine and Anaesthesia at Central Manchester University Hospitals NHS Foundation Trust
  • Specialised ENT & Ophthalmology – Miss Alison Davis, Clinical Director Moorfields South at Moorfields Eye Hospital
  • Specialised Pain – Dr John Hughes, Consultant in Pain Management at South Tees Hospitals NHS Trust

Women and Children

  • Medical Genetics – Dr Frances Elmslie, Consultant Clinical Genetics at St George’s University Hospitals NHS Foundation Trust
  • Specialised Surgery in Childhood – Mr Oliver Gee, Consultant Paediatric Surgeon at Birmingham Children’s Hospital NHS Foundation Trust
  • Paediatric Medicine – Dr Vinod Diwakar, Medical Director & Consultant in Paediatrics at Great Ormond Street Hospital for Children NHS Foundation Trust
  • Paediatric Neurosciences – Dr Charles Fairhurst, Consultant in Paediatric Neurodisability at Guys and St Thomas’ Foundation Trust
  • Congenital Heart Services – Dr Trevor Richens, Consultant in Congenital Heart Disease at University Hospital Southampton Foundation Trust
  • Metabolic Disorders – Dr Robin Lachmann, Consultant in Metabolic Medicine at University College London Hospitals NHS Foundation Trust
  • Paediatric Intensive Care – Dr Gale Pearson, Clinical Lead in Paediatric Intensive Care at Birmingham Children’s Hospital NHS Foundation Trust
  • Neonatal Critical Care – Professor Neil Marlow, Professor of Neonatal Medicine at UCL EGA Institute for Women’s Health
  • Specialised Women’s Services – Professor Sarah Creighton, Consultant Gynaecologist at University College London Hospitals

Blood and infection

  • Blood & Marrow Transplantation – Professor John Snowden, Consultant Haematologist at Sheffield Teaching Hospitals NHS Foundation Trust
  • Specialised Blood Disorders – Dr Gerard Dolan, Consultant Haematologist at Guy’s and St Thomas’ NHS Trust
  • HIV – Dr Ian Williams, Senior lecturer and Hon Consultant Physician at Central and North West London NHS Foundation Trust
  • Infectious Diseases – Dr Peter Moss, Consultant in Infectious Diseases at Hull & East Yorkshire Hospitals NHS Trust
  • Haemoglobinopathies – Dr Kate Ryan, Consultant Haematologist at Central Manchester University Hospitals
  • Specialised Immunology & Allergy – Dr Siraj Misbah, Consultant in Clinical Immunology at Oxford University Hospitals Trust

Medicines Optimisation

  • Medicines Optimisation – Professor Liz Kay, Clinical Director, Medicines Management & Pharmacy Services at Leeds Teaching Hospitals NHS Trust

The role of the National Clinical Lead on Regenerative Medicine will be to work with experts and officials from across UK Government departments and agencies, industry, researchers and others in this field, helping to guide the development of plans to put the UK, and the NHS, at the forefront of the development, adoption and spread of regenerative medicine – delivering innovative treatment options to patients as quickly as possible.

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  1. kevin riley says:

    What a waste of tax payers money – since the Health And Social Care Act 2012 removed the NHS from democatrtic control, all NHS Hopitals are now run by independent organisations over which NHS England (and it’s numerous and ever increasing offshoots) have no control and neither has the Department of Health or Jeremy Hunt.

    All of the above can now only “advise or recommend” but cannot compel any of the 165+ independent NHS Foundation Trusts to accept that advice or recomendation nor deliver medical services in any particular way.
    This fragmented structure has no other logical purpose (it certainly has not impoved patient care) other than to facilitate privitisation of the NHS by selling off indivdual “independent” NHS Foundation Trusts.
    Currently we no longer have a truly “national” Health Service as each one of the 165 + “independent” Trusts can make it’s own decisions regarding service delivery regardless of anything that NHS England, Jeremey Hunt or the DOH may say. K. S. Riley Sol.