This Respond and Advise Clinical Reference Group (CRG) 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.

Scope

This clinical reference group covers the following services for adults; Intestinal failure, Colorectal Distal Sacretomy, Colorectal complex Inflammatory Bowel Disease, Faecal Incontinence, Transanal Endoscopic Microsurgery, Cytoreductive Surgery, Pseudomyxoma Peritonei, Autologous intestinal reconstruction and bowel transplantation.

Membership

• Chair: Mr Baljit Singh, Consultant Colorectal Surgeon and Honorary Associate Professor.
• Yasmin Stammers, Lead Commissioner
• Phillip Allan, Clinical member
• Heather Weaver, Pharmacy Lead
• Angeline Walker, Public Health Lead
• Sarah Squire, Patient and Public Voice Representative
• Mike Molete, Patient and Public Voice Representative

Affiliates

• Mia Small, Chair of Home Parenteral Nutrition Stakeholder Group
• Trevor Smith, British Association of Home Parenteral Nutrition
• Charles Maxwell-Armstrong, Association of Coloproctology

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:

• Autologous intestinal reconstruction (adult)
• Colorectal complex inflammatory bowel disease (adult)
• Colorectal faecal incontinence (adult)
• Colorectal cytoreductive surgery (adult)
• Severe intestinal failure (adult)
• Pseudomyxoma peritonei service (adult)
• Small bowel transplantation service (children and adults)
• Specialised services for service users with complications of mesh inserted for urinary incontinence, vaginal or internal and external rectal prolapse (16 years and above)

Policies

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:

Commissioned

• Cytoreductive surgery for patients with peritoneal carcinomatosis
• Parenteral nutrition for the treatment of adults and children with type 2 and type 3 intestinal failure requiring home parenteral nutrition
• Sacral nerve stimulation (SNS) for faecal incontinence (adult)

Not routinely commissioned

• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma
• Gastroelectrical stimulation for gastroparesis

Get involved

If you are interested in the work of the internal medicine NPOC or its CRGs, you can register as a stakeholder.  For details on our latest consultations please visit NHS England » Consultations

Get in contact

For any questions or queries relating to the work of the internal medicine NPOC or any or its CRGs, please contact: england.npoc-internalmedicine@nhs.net