The neuroscience Clinical Reference Group (CRG) covers specialised neuroscience services and specialised adult neurosurgery.
Chair: Professor Adrian Williams, Consultant Neurologist, University Hospitals Birmingham NHS Foundation Trust.
Dr Sreeman Andole Clinical Member
Dr Helen Grote Clinical Member
Mr Paul Grundy Clinical Member
Dr Christopher Kipps Clinical Member
Dr Andria Merrison Clinical Member
Dr Catherine Mummery Clinical Member
Prof Phil White Clinical Member
David Burn, Affiliate Member
Michael Dilley, Affiliate Member
Geraint Fuller, Affiliate Member
Nick Phillips, Affiliate Member
Yaiza Rivero, Lead Commissioner
Shelley Jones, Pharmacy Lead
Mark Lambert, Public Health England lead
Phillip Anderson, Patient and Public Voice representative
Katharine McIntosh, 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.
Treatment Algorithm for Multiple Sclerosis Disease-modifying Therapies
This algorithm provides a framework to aid decision-making for multiple sclerosis treatment, to help reduce variation in practice, and ensure safe and effective prescribing.
- Treatment Algorithm for Multiple Sclerosis Disease Modifying Therapies
- Treatment Algorithm for Multiple Sclerosis Disease-Modifying Therapies: Graphic
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:
- Stroke Thrombectomy Service for Acute Ischaemic Stroke – delivered in a non-neuroscience centre. (adults)
- A Diagnostic service for rare neuromuscular disorders (All Ages)
- Neurointerventional Services for Acute Ischaemic & Haemorrhagic Stroke
- Neurosurgery (Adult)
- Neurosciences Specialised Neurology (Adult)
- Neuromyelitis optica service (adults and adolescents)
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:
- Deep brain stimulation (DBS) in movement disorders
- Disease modifying therapies for patients with multiple sclerosis (MS)
- Infliximab for refractory or progressive neurosarcoidosis (adults and post-pubescent children)
- Intrathecal baclofen (ITB)
- Levodopa-carbidopa intestinal gel (LCIG)
- Mechanical thrombectomy for acute ischaemic stroke
- Transcranial magnetic resonance guided focused ultrasound thalamotomy for treatment of medication-refractory essential tremor (effective from April 2021)
- Vagal nerve stimulation for epilepsy
Not routinely commissioned:
- Amifampridine phosphate for the treatment of Lambert-Easton Myasthenic Syndrome
- Deep brain stimulation for refractory epilepsy (all ages)
- Deep brain stimulation for refractory tourette syndrome (adults)
- Fampridine for multiple sclerosis
- Rituximab for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy (MMN), vasculitis of the peripheral nervous system and IgM paraprotein-associated demyelinating neuropathy (adults)
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:
- Alemtuzumab for treating relapsing-remitting multiple sclerosis – third cycle (all ages)
- Amifampridine (Firdapse) for lambert easton myasthenic syndrome (LEMS)
- Cerebellar Stimulator Implants
- Deep brain stimulation (DBS) for indications except movement disorders
- Flow Diverting Devices for Intracranial Aneurysms
- Natalizumab-induced progressive multifocal leukoencephalopathy in relation to immune reconstitution inflammatory syndrome in multiple sclerosis
- Rituximab biosimilar for the treatment of myasthenia gravis (adults)