A01. Specialised Respiratory
Respiratory services deal with patients with breathing difficulties. Respiratory disease services are usually provided by respiratory physicians in local hospitals. However, some diseases are very rare while other more common ones can lead to complex problems.
Scope
This Clinical Reference Group (CRG) covers:
- services for people with severe and difficult-to-control asthma
- services for people with interstitial lung disease
- services for people requiring management of complex respiratory disease who will need complex assisted ventilation at home
- services for people with pulmonary hypertension, including complex surgery
- services for people with cystic fibrosis.
Membership
Chair: Professor Mike Morgan, Consultant Respiratory Physician at University Hospitals of Leicester NHS Trust; Honorary Professor of Respiratory Medicine, University of Leicester; National Clinical Director Respiratory Services, NHS England.
Prof David Kiely, clinical member
Dr Andrew Jones, clinical member
Prof Andrew Menzies-Gow, clinical member
Dr James Calvert, clinical member
Dr Luke Howard, clinical member
Dr Ian Balfour-Lynn, clinical member
Dr Michael Davies, clinical member
Kathy Blacker, lead commissioner
Anna Murphy, pharmacy lead
Annette Wood, Public Health England lead
Nick Medhurst, Patient and Public Voice representative
Sarah Macfayden, Patient and Public Voice representative
Joe Farrington-Douglas, Patient and Public Voice representative
Products
A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 Hub Commissioning Teams to contract services on an annual basis.
Service Specifications
Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care. The specifications have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe both core and developmental service standards. Core standards are those that all funded providers should be able to demonstrate, with developmental standards being those which may require further changes in practice over time to provide excellence in the field.
The following service specifications fall within the scope of this CRG:
- Adult primary ciliary dyskinesia
- Ataxia telangiectasia service (Adult)
- Chronic Pulmonary Aspergillosis Service (Adults)
- Cystic Fibrosis Adult
- Cystic Fibrosis Children
- Interstitial Lung Disease (Adults) Service Specification
- Lymphangioleiomyomatosis service (adults)
- Pulmonary Hypertension Centres (Adult)
- Pulmonary Hypertension Shared Care (Adult)
- Pulmonary Thromboendarterectomy (Adults and Adolescents)
- Respiratory Complex Home Ventilation (Adult)
- Specialised Respiratory Services (adult) – Severe Asthma
Policies
A commissioning policy is a document that defines access to a service for a particular group of patients. A NICE Technology Appraisal Guideline on the same topic will replace, or be incorporated into, a commissioning policy as appropriate. These are important documents that are developed to ensure consistency in access to treatments nationwide.
The following policies fall within the scope of this CRG:
Commissioned:
- Selexipag for treating pulmonary arterial hypertension (adults) (effecive from 1 April 2019)
- Levofloxacin nebuliser solution for chronic Pseudomonas lung infection in cystic fibrosis (adults)
- Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension (all ages)
- Riociguat for Pulmonary Arterial Hypertension
- Ivacaftor for children aged 2-5 years with cystic fibrosis (named mutations)
- Inhaled Therapy for Adults and Children with Cystic Fibrosis
- Ivacaftor for Cystic Fibrosis (Named Mutations)
- Targeted Therapies for Pulmonary Hypertension Functional Class II
- Targeted Therapies for use in Pulmonary Hypertension in Adults
Not routinely commissioned: