A07. Specialised Colorectal Services

Specialised colorectal services require a critical mass of expertise in surgery, medicine, radiology, pathology and nursing. This is possible only in units large enough to allow specialisation in all of these disciplines, and it is only in units receiving referrals from a wide geographical area that sufficient experience is gained in dealing with the more difficult and complex cases.


This Clinical Reference Group (CRG) covers:

  • services for patients with Type II and Type III intestinal failure (including the provision of home parenteral nutrition)
  • complex surgery for complex inflammatory bowel disease
  • complex surgery for faecal incontinence
  • complex inflammatory bowel disease
  • interventions for rectal and anal cancers
  • specialised cytoreductive surgery.


Chair: Mr Baljit Singh, Consultant Colorectal Surgeon and Honorary Associate Professor.

Recruitment to this CRG is in progress and the names of the members will be updated shortly.


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:

Adult Intestinal Failure Service Review

NHS England are currently reviewing services for adults with intestinal failure. This review will include nationwide engagement with clinicians, providers, commissioners, patients and the public on the priorities and future model of the service, as well as the interface with the HPN (Home Parenteral Nutrition) Framework and paediatric intestinal failure services, both of which are outside the scope of the review. Once this has been completed, a new commissioning strategy will ensure the right services are commissioned in the right place to meet the needs of patients and the national standards agreed by clinicians.

Register your interest to receive ongoing updates by becoming a registered stakeholder for the specialised colorectal services clinical reference group (CRG) or contactengland.ifservicereview@nhs.net.