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.
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.
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:
- 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)
- Intrathecal Baclofen (ITB)
- Levodopa-Carbidopa Intestinal Gel (LCIG)
- Mechanical thrombectomy for acute ischaemic stroke
- 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 & 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
- Flow diverter / Pipeline Embolization Device (PED) 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)