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Appendix 6: Review Update - Children's Neurosurgical Services

Introduction

There are currently 15 centres in England that are providers of paediatric neurosurgery (see Appendix A). The review is led by the National Specialised Commissioning Team (NSC Team) on behalf of the 10 Specialised Commissioning Groups. The review aims to identify potential models of care and develop a national strategy for England.

The Need for Change

The review was instigated at the request of members of the British Paediatric Neurosurgeons Group (BPNG) in view of the following concerns:

· The surgical caseload across the 15 centres varies from around 50 to 700 cases each year; this may mean that some centres are not performing the critical mass of surgical procedures necessary to maintain specialist expertise

· Incidence of children being operated on by surgeons who are not paediatric experts, but by adult surgeons who are `emergency competent' to operate on children

· Only 3 out of 15 centres are able to provide a 24/7 paediatric service

Progress to Date

· A Steering Group has been established, chaired by Mr Paul Chumas, a Past President of the BPNG (see Appendix B for membership)

· Draft quality standards have been developed, providing a national quality framework for the future

· A working group has been established to identify potential models of care

· Stakeholders have been engaged, the outcome of which has fed into the development of the standards

Future milestones

In March 2010 each of the 15 centres will be asked to provide the NSC Team with detailed information on current service provision (including staffing, infrastructures and support services). The information template was developed in consultation with members of the BPNG and Society for British Neurological Surgeons (SBNS). Between April and May 2010 a former President of the SBNS will visit each of the centres to clarify issues around the information supplied.

A working group set up to identify potential models of care is expected to report by June 2010. The outcome of this work will assist the Steering Group in the development of a national strategy for England.

It is anticipated that the national strategy will be used as the basis for a review of current service provision, with recommendations for reconfiguration made in March 2011. Formal consultation would take place around April to June 2011.

Engagement with Stakeholders

In November 2009 a national stakeholder event was held, attended by 120 clinicians, professional association and parent groups. 90% of attendees said that the event was well organised, relevant and provided plenty of opportunity for debate. Video excerpts of the day are available on the NSC Team website (www.specialisedcommissioning.nhs,uk).

The NSC Team has issued a newsletter (February 2010) and has made available all relevant literature, including minutes of meeting, on its website.

The Steering Group has convened a group comprised of representatives of relevant parent groups to advise the Steering Group on relevant issues from a parent and patient perspective.

Engagement with Health Overview Scrutiny Committees

The NSC Team has been working with the Centre for Public Scrutiny (CPS) to keep HOSCs informed of progress. The CPS has circulated relevant literature to HOSCs via existing networks

In the summer of 2010 the NSC Team will, via the CPS, will ask HOSCs with an interest in this review to establish a statutory joint HOSC.

END

Appendix A

Current NHS providers of children's neurosurgical services in England

Newcastle General Hospital Newcastle

Leeds General infirmary Leeds

Hull Royal Infirmary Hull

Sheffield Children's Hospital Sheffield

Royal Manchester Children's Hospital Manchester

Alder Hey Children's Hospital Liverpool

Queens Medical Centre Nottingham

Birmingham Children's Hospital Birmingham

Addenbrookes Hospital Cambridge

Oxford John Radcliffe Hospital Oxford

Frenchay Hospital Bristol

Great Ormond Street Hospital for Children London

Kings College Hospital London

St George's Hospital London

Southampton General Hospital Southampton

Appendix B: Steering Group membership