D05. Stereotactic Radiosurgery

Scope and service

This Clinical Reference Group (CRG) covers stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT). SRS and SRT are methods of delivering precisely targeted radiotherapy treatment. SRS is used to treat a wide range of cranial indications including arteriovenous malformations, acoustic neuroma, meningioma, pituitary adenoma, ocular melanoma, trigeminal neuralgia and selected sub-groups of patients with cerebral metastases. SRS/SRT is delivered by Gamma Knife, Cyberknife or any other linear accelerator-based technology.

Chair and membership

A voluntary chair is appointed for a three-year term. Please see the Clinical Guide for CRGs. Clinical members are drawn from the 12 senate areas in England and are voluntary appointments for three years. Up to four patient and carer members and up to four professional/ training organisations join the CRG membership. The accountable commissioner holds the managerial accountability for the work of the CRG; collaborating commissioners hold an interest in the work of the CRG

Chair Matthias Radatz
National Clinical Director Co Chair To be confirmed
N1 North East Alistair Jenkins
N2 Greater Manchester, Lancashire and S Cumbria Claire McCarthy
N3 Cheshire and Mersey Brian Haylock
N4 Yorkshire and The Humber Nick Phillips
M1 West Midlands Ronan Dardis
M2 East Midlands Vacant
M3 East of England Imtuaz Ahmed
L1 London NW Bodo Lippitz
L2 London NE Piers Nicholas Plowman
L3 London S Ronald Beaney
S1 South West Peter Whitfield
S2 Wessex Owen Sparrow
S3 Thames Valley Claire Blesing
S4 South East Coast Carl Hardwidge

The CRG is currently in the process of recruitment to the membership places below; as appointments are confirmed this webpage will be updated.

Patient and Carer Member

Vacant Post
Clive Stone
Vacant Post
Vacant Post

Professional Organisation

British Radiosurgery Society TBC
Society of British Neurological Surgeons Neil Kitchen
The Society and College of Radiographers Joanne Rodgers
Professional Organisation Phil Blackburn
Accountable Commissioner David Stockdale Manchester
Collaborating Commissioner Name Base
Pharmacy Lead Name Base
Public Health Lead Name Base


A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 specialised services Area Teams to contract services on an annual basis.


The service specifications are important in clearly defining what NHS England expects to be in place for providers to offer evidence-based, safe and effective services. They have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe core and developmental service standards. Core standards are those that any reasonable provider of safe and effective services should be able to demonstrate, with developmental standards being those that really stretch services over time to provide excellence in the field. The following service specifications have been prepared by the CRG:

Policy statements

A policy statement is a brief document that defines the current commissioning position to support service contracting. They are interim documents for use whilst a full commissioning policy is being developed or until a formal NICE Technology Appraisal Guideline has been published.


A commissioning policy is a document that defines access to a particular service for a cohort 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 define national consistency.

Quality measures

Quality measures aim to find the most appropriate and deliverable measures that can be used nationally to help organisations improve the quality of care in their services. These are prioritised to form a ‘dashboard’.

Innovation portfolio

The innovation portfolio is an opportunity to collate information on innovative approaches that may have been developed in one or more areas, and to consider whether these might be rolled out more consistently in the future. An innovation might, for example, become a core requirement of all providers, enshrined in the core national service specification.

Tell us about a new innovation which is already developed and available to the NHS that you would like us to know about. You can create a personal account or log in if you have registered previously and already have a personal account to use the CIMIT CoLab® specialised services web platform.


Commissioning for Quality and Innovation (CQUIN) is a framework that was first established as part of the 2009/10 NHS Operating Framework as an incentive scheme which forms part of the contract between a commissioner and a provider. CQUIN schemes link successful delivery of specific outcomes and actions with the release of an additional payment to the provider, which for 2013/14 is a payment of an amount up to 2.5% of contract value.

A CQUIN scheme is made up of a number of separate indicators (“CQUINs”) which address a range of clinical areas and issues. The purpose of a CQUIN scheme is to drive quality improvements across a range of areas. In 2013/14 there are no national CQUIN schemes for SRS. CQUINs, once developed, for the 2014/15 contracting round will be published here in 2014/15


Spending on the NHS will increase each year between 2011 and 2015. However, demand for health services is rising, and what is expected of the NHS changes as society changes. This means that the NHS will need to make up to £20 billion worth of efficiency savings by 2015, so that there are more funds available for treating patients and to allow the NHS to respond to changing demands and new technologies.

Productivity is one of the work streams to deliver those efficiency savings. Productivity is about the redesign and streamlining of healthcare services by examining the way the NHS commissions, manages, works and delivers healthcare services to reduce inefficiencies and maximise efficiencies; ensuring value for money; and reducing unnecessary poor design in its processes and delivery of care that are not cost effective, and have little impact on improved outcomes or improved quality of care for patients.

CRGs have a key role in providing advice about potential opportunities to improve productivity and efficiency, for example by removing any inefficiencies in care pathways or by identifying opportunities where a national procurement of drugs or devices might reduce costs.


NHS England launches consultation on commissioning arrangements for stereotactic radiotherapy and radiosurgery

NHS England has launched a 12-week public consultation on proposals to change the way in which stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) services are commissioned across England. The consultation will run from Monday 3 November, to midnight on Monday 26 January 2015.

The consultation is based on the findings of a needs assessment and service review, which was carried out by NHS England in 2013/14 in order to establish current levels of SRS/SRT provision across the country.

The report highlighted a number of issues, including a duplication of activity in some areas, and concluded that a more strategic approach to the commissioning of SRS/SRT would achieve improved access to services, and better outcomes for patients.

NHS England is consulting on a set of options for change, including a preferred option. Details of the consultation, and how you can submit responses, can be found on the consultation page, where you will find two documents and an online consultation survey. The documents are:

  • A Needs Assessment and Service Review report, which sets out the findings of the review conducted by NHS England; a set of recommendations, and options for change;
  • A Consultation Guide, which repeats the options for change and sets out the questions for consultation.

If you have any questions about the materials listed above, or require them in alternative formats, please contact: David Stockdale, Regional Programme of Care Manager – Trauma (North) at David. Stockdale1@nhs.net