A04. Vascular Disease

This Clinical Reference Group (CRG) covers vascular disease. Vascular services manage the treatment and care of patients with vascular disease relating to disorders of the arteries, veins and lymphatic system. The diseases can be managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction.

Patients with vascular disorders are cared for by specialist vascular teams, which include vascular surgeons, vascular interventional radiologists, vascular anaesthetists, vascular scientists, nurses, radiographers, physiotherapists and rehabilitation specialists.


This Clinical Reference Group (CRG) covers:

  • the management of people with lower limb ischaemia, abdominal aortic aneurysm (AAA), stroke prevention (carotid artery intervention), venous access for haemodialysis
  • suprarenal and thoraco-abdominal aneurysms, thoracic aortic aneurysms, aortic dissections, mesenteric artery disease, renovascular disease, arterial/graft infections
  • vascular trauma, upper limb vascular occlusions, vascular malformations and carotid body tumours
  • deep vein reconstruction and thrombolysis for deep vein thrombosis (DVT).


  • Chair: Professor Robert Sayers, Consultant Vascular Surgeon, Leicester Royal Infirmary.
  • Mr Arun Pherwani, clinical member
  • Mr Jonathan Boyle, clinical member
  • Dr Simon McPherson, clinical member
  • Mr Marcus Brooks, clinical member
  • Professor Ian Loftus, clinical member
  • Kathy Blacker, lead commissioner
  • Dr Annette Wood, Public Health England lead
  • Michael Wilson, Action on Vascular lead
  • Professor Mike Horrocks, Vascular GIRFT lead
  • Mr Michael Jenkins, Vascular Society, Affiliate Member
  • Cliff Shearman (Royal College of Surgeons), Affiliate Member
  • Eric Fisher, Patient and Public Voice representative
  • Gareth Owens, Patient and Public Voice representative


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:


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:


Not routinely commissioned: