This Clinical Reference Group (CRG) covers complex obstetrics and complex gynaecology services.
The complex obstetrics element covers specialised maternity and fetal medicine services, including specialised elements of maternity care and in particular, how individuals with conditions which might materially affect their choices and care during pregnancy and birth can best be supported. It also covers the more complex and rare fetal conditions.
The Specialised Women’s Services CRG also covers the more specialised elements of gynaecological care, which would typically fall outside of the experience of local GP and hospital care.
Chair: David Rowlands, Consultant Obstetrician & Gynaecologist; Clinical Lead Maternity, North West Coast Strategic Clinical Network Maternity Children & Young People; Associate Medical Director Strategy & Partnerships, Wirral University Teaching Hospital NHS FT
Mr Alastair McKelvey
Dr Sarah Winfield
Mr Pranav Prandya
Dr Teresa Kelly
Mr Andrew Kent
Dr Rohna Kearney
Mr Rehan Khan
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 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 gynaecology: Congenital gynaecological anomalies
- Complex gynaecology/female urology: Genito-urinary tract fistulae (girls and women aged 16 years and above)
- Complex gynaecology: Severe endometriosis
- Fetal medicine
- Gestational trophoblastic disease (Choriocarcinoma – all ages)
- Perinatal pathology
- Reconstructive surgery service for adolescents with congenital malformation of the female genital tract
- Specialised complex surgery for urinary incontinence and vaginal and uterine prolapse (16 years and above)
- Specialised maternity care for patients (child bearing age) diagnosed with abnormally invasive placenta
- Specialised maternity service specification insert for inclusion in other relevant specifications
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:
- Clinical Commissioning Policy: Sacral Nerve Stimulation for Overactive Bladder
- Clinical Commissioning Policy: Management of fetal anaemia secondary to red cell alloimmunisation (fetal transfusion)
- Clinical Commissioning Policy: Sapropterin for Phenylketonuria – Use in Pregnancy
- Clinical Commissioning Policy: Management of twin to twin syndrome
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: