Updates on Clinical Commissioning Work Programs in England

On May 17, 2021, NHS England published an update of the Specialized Services Policy Pipeline (covering the period January 20, 2021 - April 20, 2021).

Two types of Work Programmes exist:

• Clinical commissioning policy work program;
• Specialized commissioning service specification work program.

Updates were only made in the clinical commissioning policy work program.

One new med-tech related Clinical Commissioning Policy was added to the work program: Ultra-hypofractionated radiotherapy using five treatments for men with low or intermediate-risk localized prostate cancer.

Four new med-tech related policies were published:

• Stereotactic ablative radiotherapy (SABR) for patients with previously irradiated, locally recurrent primary pelvic tumors (all ages) (published on February 18, 2021) - recommended as a treatment option through routine commissioning;
• Stereotactic ablative radiotherapy (SABR) for patients with previously irradiated, locally recurrent para-aortic tumors (all ages) (published on February 18, 2021) - is not recommended as a treatment option;
• Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) to the surgical cavity following resection of cerebral metastases (all ages) (published on February 18, 2021) – is not recommended as a treatment option;
• Proton Beam Therapy for lung cancer in adults (published on February 11, 2021) - is not recommended as a treatment option.

The development of two med-tech related policies was discontinued:

• TAVI and surgical valve replacement for aortic stenosis - the commissioning position with Shared Decision Making Tool was proposed instead;
• Extracorporeal photopheresis (ECP) for treatment of chronic lung allograft dysfunction (CLAD). The following reasons were provided: a grant from the National Institute of Health Research (NIHR) has been awarded to evaluate ECP in NHS CLAD populations in a randomized control trial (ECLAD); the Internal Medicine Programme of Care (POC) supports the decision for the policy work to be stopped at this point without not-for-routine commissioning (NRC) position; this follows the broader discussion with the Clinical Director for the policy team, clinical lead, and key stakeholders; the rationale was that ECP is an existing service across a wider patient group. It could potentially destabilize existing services to take forward an NRC policy in advance of the findings from the ECLAD trial.

The status of ongoing policies was updated as well.

See the full details here.

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