Highly Specialist Services 2019

Highly Specialised Services 2019
NHS England 11 March 2021

• Key information about highly specialised services including
• a description of each service
• a list of the expert centres that deliver the service
• NHS England’s total expenditure for each service
• a measure of the activity that each service undertakes 
• clinical outcomes from the service
•  information about geographical equity of access to the service.

Highly Specialised Services 2018

NHS England updated 13 February 2019

Highly Specialised Services 2017
NHS England 8 March 2018

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project

Establishing a tele-clinic service for kidney transplant recipients through a patient-codesigned quality improvement project.
BMJ Open Qual 2019;8:e000427. 8 April 2019. doi: 10.1136/bmjoq-2018-000427

• Findings from a pilot tele-clinic (telephone consultation) service for kidney transplant patients attending North Bristol NHS Trust Renal Unit shows that they are deliverable and well received by patients with a positive environmental impact and modest financial savings. 
• "It has the potential to be rolled out to other renal centres if a national tele-clinic tariff can be negotiated, and an integrated, appropriately reimbursed community phlebotomy system can be developed to facilitate remote monitoring of patients."

Abstract

National Genomic Test Directories

National Genomic Test Directories
NHS England 3 August 2018

• From October 2018 the National Genomic Test Directory will specify which genomic tests are commissioned by the NHS in England, the technology by which they are available, and the patients who will be eligible to access to a test. 
• Two directories are available - Rare and Inherited Disorders and Cancer.

UK strategy for rare diseases: implementation plan for England

UK strategy for rare diseases: implementation plans for England
Department of Health and Social Care 29 January 2018

• DHSC implementation plan for the UK strategy for rare diseases (2013) and described the key achievements and future activities by DHSC.
• The DHSC implementation plan sits alongside the NHS England implementation plan.

Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases

Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases
Tsao MN et al
Cochrane Database of Systematic Reviews 2018, Issue 1. Art. No.: CD003869.

• A review of the effectiveness and adverse effects of whole brain radiotherapy (WBRT) given alone or in combination with other treatments to adults with multiple brain metastases (54 trials, n=11,898).
• Findings:
• Altered higher biological WBRT dose-fractionation schemes did not confer benefit for overall survival, neurological function, or symptom control compared with standard treatment. However, overall survival and neurological function were worse for lower biological WBRT dose-fractionation schemes than for standard dose schedules.
• The addition of WBRT to radiosurgery improved local and distant brain control (i.e. absence of new intracranial lesions at the site or outside of treated lesions after treatment) among selected people with brain metastases, but investigators reported worse cognitive outcomes and no differences in overall survival.
• Selected people with multiple brain metastases from non-small-cell lung cancer may show no difference in overall survival when optimal supportive care is given and WBRT is omitted.
• Use of other treatments (radiosensitisers, chemotherapy, or molecular targeted agents) in conjunction with WBRT remains experimental.