The below Parliamentary question was asked by Tessa Munt on 2014-04-30.
To ask the Secretary of State for Health, pursuant to the Answer of 24 March 2014, Official Report, column 132W, on radiotherapy and with reference to section three of the guidance issued by Monitor on the Commissioning of Radiosurgery Services on 4 April 2014, for what reasons NHS England is not funding patients to be treated with the Gamma Knife at University College London Hospital.
Jane Ellison
The business case for the gamma-knife centre at Oxford was originally agreed with the primary care trust (PCT) prior to April 2013, with an assumption that the PCT would stop sending patients to other centres elsewhere, and start sending them to the new centre once it was completed.
As of April 2013, commissioning of these services transferred to the specialist commissioning team in NHS England.
NHS England is currently undertaking a review of stereotactic radiosurgery (SRS) (e.g. Gamma Knife) and stereotactic ablative radiotherapy (SABR, e.g. Cyber-knife) for intracranial conditions to establish what the national demand is in line with its national clinical commissioning policies on SRS and SABR, and what the national capacity requirements are for this specialised treatment.
Until the capacity requirements are clear, NHS England has said that it would be inappropriate to encourage new market entrants to provide this service as it cannot be clear what the potential consequential impacts on service quality, sustainability (financial and clinical) and potential unintended changes to patient pathways will be. Until the review is complete NHS England has said no substantive changes will be made to the current provision.
As part of the transition of this service to NHS England, it developed, consulted upon and published a series of national clinical commissioning policies for intracranial SRS and SRT treatment.
A report setting out the emerging findings of this review has been shared with clinical reference groups to seek their views and help NHS England develop a final draft. Once the views of stakeholders have been gathered, this will then go to Specialised Commissioning Oversight Group (SCOG) to agree a preferred option. Once the SCOG has a preferred option, NHS England will consult with patients and professionals and take account of those views when taking a final decision. If it is concluded there are to be significant changes in the provision of services, there will be a full public consultation before any changes are made.
NHS England is expecting that the draft report will be ready for consideration at SCOG in June and then it would commence a public consultation on the draft report and preferred option during July to September. The report and recommendations will then be finalised after taking account of the views expressed during the consultation stage and a final decision taken by SCOG in September 2014.
NHS England inherited the range of gamma knife providers currently in place, of which University College London Hospitals (UCLH) was not one. NHS England is currently undertaking a review of stereotactic radiosurgery provision and will consult widely with stakeholders and providers prior to making changes to service provision. There are two long established providers of gamma knife surgery commissioned by NHS England located in central London to whom patients from all six London specialist neurosurgical centres have been referred for gamma knife treatment for a number of years, including patients from UCLH.
Finally, there was no contract in place with UCLH to provide gamma knife surgery for any PCT prior to 1 April 2013. Any activity that may have been undertaken there would have been done on an ad-hoc, non-contracted basis and NHS England does not hold this information.
