Scope

This Transform Clinical Reference Group (CRG) covers specialised neurosurgery and complex spinal surgery.

Membership

• Clinical lead: David Cumming, National Clinical Director Neurosurgery and Spinal Surgery
• Nick Phillips, national clinical lead, neurosurgery
• Sam Eldabe, national clinical lead, specialised pain
• Bryan Foreshew, pharmacy lead
• Robert Wilson, public health lead
• Carolyn Brennan, lead commissioner
• Mark Wilson, clinical member
• Stuart Blagg, clinical member
• Mario Ganau, clinical member
• John Leach, clinical member
• Jibril Farah, clinical member
• Elaine Buchanan, clinical member
• Vinay Jasani, clinical member
• Sue Thomas, patient and public voice representative
• Rosalind Jacobs, patient and public voice representative

Affiliated members:

• Mike Hutton, GIRFT Clinical Lead – Spinal Surgery
• Nick Phillips, GIRFT Clinical Lead – Neurosurgery
• David Hargroves, National Clinical Lead, Stroke (Thrombectomy Lead)
• Andy Bennett, National Clinical Director MSK Conditions
• Andrew King, Society of British Neurosurgeons (SBNS) representative
• Rajat Verma, British Association of Spinal Surgeons (BASS) representative

Non-core members of the group may be drawn upon for specialist advice and expertise required to deliver the key objectives of the CRG work programme.

Products

A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the Regional 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:

• Complex spinal surgery
• Neurosurgery (adult)
• Stroke thrombectomy service for acute ischaemic stroke – delivered in a non-neuroscience centre. (adults) -cross CRG work with Neurology
• Neurointerventional services for acute ischaemic and haemorrhagic stroke

Policies

Commissioned:

• Deep brain stimulation (DBS) in movement disorders
• Transcranial magnetic resonance guided focused ultrasound thalamotomy for treatment of medication-refractory essential tremor
• Cervical disc replacement for cervical radiculomyelopathy
• Phrenic nerve pacing following spinal cord injury
• Bone morphogenetic protein-2 in spinal fusion
• MR-guided laser interstitial thermal therapy for treatment of epileptogenic zones in children and adults with refractory focal epilepsy
• Mechanical thrombectomy for acute ischaemic stroke
• Vagal nerve stimulation for epilepsy

Not routinely commissioned:

• Vertebral body tethering for scoliosis (age 8-18 years)
• Non-invasively lengthened spinal rods for scoliosis

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:

• Cerebellar stimulator implants
• Deep brain stimulation (DBS) for indications except movement disorders
• Flow diverting devices for intracranial aneurysms

 Other related links

• Neurosurgery clinical network specification
• Spinal surgery clinical network specification
• Cranial neurosurgery – Getting It Right First Time – GIRFT
• Spinal surgery GIRFT report – Getting It Right First Time – GIRFT

Get involved

If you are interested in the work of the CRG or its NPOC, you can register as stakeholder.

For details on our latest consultations please visit the NHS England consultation hub.

Get in contact

For any questions or queries relating to the work of the CRG or its NPOC, please contact: england.npoc-trauma@nhs.net