A05. Cardiac Services
This Clinical Reference Group (CRG) covers specialised cardiology, including the use of complex invasive devices and cardiac surgery as well as transplantation.
Scope
This Clinical Reference Group (CRG) covers:
- the diagnosis and treatment of fast heart rhythms using cardiac electrophysiology studies
- the use of devices to treat abnormally fast, life threatening heart rhythms
- services to treat people with inherited cardiac diseases
- the use of a tube (catheter) to treat specific heart problems which might otherwise have required open surgery (invasive cardiology)
- opening narrow coronary arteries with a balloon catheter as the first treatment following specific types of heart attack (primary percutaneous coronary intervention)
- magnetic resonance imaging of the heart
- cardiac surgery includes provision of surgical interventions for coronary artery disease requiring surgical revascularisation and valve disease requiring surgical valve repair or replacement.
Membership
Chair: Professor Huon Gray, National Clinical Director for Cardiovascular Disease andConsultant Cardiologist, Southampton University Hospital.
Nicholas Linker, North
Peter Braidley, North
Kiran Patel, Midlands & East
Post vacant, Midlands & East
Andrew Archbold, London
Kulvinder Lall, London
David Hildick-Smith, South
Christina Bannister, South
Haifa Lyster, Lead Pharmacist
Trevor Fernandes, Patient & Public Voice
Anthony Locke, Patient & Public Voice
Richard Fitzgerald, Patient & Public Voice
Carrie Gardner, Lead Commissioner, carrie.gardner@nhs.net
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:
- Cardiology: Implantable Cardioverter Defibrillator and Cardiac Resynchronisation Therapy (Adult)
- Cardiology: Electrophysiology and Ablation Services (Adult)
- Cardiology: Inherited Cardiac Conditions (All Ages)
- Cardiology: Primary Percutaneous Coronary Intervention (Adult)
- Cardiology: Cardiac Magnetic Resonance Imaging (Adult)
- Cardiac Surgery (Adult)
- Ventricular Assist Devices (VADs) as a bridge to heart transplantation or myocardial recovery (All Ages)
- Heart Transplantation Service (adult)
- Lung Transplantation Service (adult)
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:
- Left Atrial Appendage Occlusion for patients with atrial fibrillation and relative or absolute contraindications to anticoagulation (adults)
- Transcatheter Aortic Value Implantation (TAVI)
Not routinely commissioned:
- Renal denervation for resistant hypertension
- Personalised External Aortic Root Support (PEARS) for surgical management of enlarged aortic root
- Everolimus for prevention of organ rejection following heart transplantation
Policy statements
Policy statements are brief documents that define the current commissioning position to support service contracting.
The following policy statements fall within the scope of this CRG: