April Newsletter

18th April 2016

Dear Members
I am writing a writing a small update to inform the membership regards key issues that you need to be aware of. I will write a full newsletter after the next committee away day on 9th September prior to the AGM.

Consultant appointment committee: We have not had any members offering to sit on these appointment committees. If we are unable to give a list to RCOG then we will not be in a position to request representation on appointment panels for urogynaecology posts. Please let the secretariat know if you are happy to be considered and I will pass on a list of interested colleagues to the RCOG.

ACCEA: Please submit your application by 18th April should you wish to be considered for BSUG support. The panel will consist of me, Phil Toosz-Hobson, Jonathan Duckett and a lay representative. The forms to be submitted were sent out previously.

Committee membership: The following committees are short of members and we welcome applicants. It is only by working within these that the society remains vibrant and creates change for the future:
• Research Committee
• Meetings Committee
• Governance Committee need more members to help with accreditation.

Specialist commissioning: This has now been disbanded for complex gynaecology and will be reformed by DOH England. A new chair will be appointed and then the probable plan is for there to be 4 regional representatives which will represent each region and have a mixture of interests regards specialist gynaecology and 4 specialist societies. We are hopeful that BSUG will be one.

Specialist commissioning will probably be more specific and entail only those aspects that are unable to be offered in secondary care. It is envisaged a flow of patients between the different levels of care as occurs between primary and secondary care will happen. Thus the group will need to define those aspects that require a unit that covers (by way of example) a population in excess of 1 million. Thus it is possible that for some areas of care that it will be more procedure specific and hence will remove the risk of destabilising the excellent secondary care that currently exists.

In essence commissioning has 3 levels which could be considered as: • Commonly carried out (standard commissioning)
• Less commonly carried out (called specialist commissioning)
• Rarely carried out (called highly specialised)
• Database committee is looking for an interested trainee.

Accreditation of units
There has been a recent flurry and we are pleased that many units are now applying for accreditation. This will set the standards for good practice. Please note that as the criteria have changed in line with best practice, all currently accredited units will need to show evidence of working towards conforming to new criteria and be compliant within 2 years from 1st April 2016.

Mesh complications:
A meeting took place with NHS England, BSUG, BAUS and other organisations to discuss the implementation of previous work examining this concern. The final version of the patient information leaflets should hopefully be available soon. Once available it is probable that members will be asked to trial the leaflet and audit patient and clinician feedback. The plan is for the leaflets to be fully up and running by 2018.

NHS Improvement (an amalgamation of Monitor & the NHS Trust Development Authority) have written to chief executives and Medical directors informing them of the need for their clinicians to comply with appropriate training, adherence to clinical practice, reporting of complications to MHRA and compliance with national data requirements for all surgeons undertaking mesh procedures. Thus it is important that all procedures (especially tapes for incontinence and vaginal mesh for prolapse) are entered onto a national database. Together with BAUS we aim to collect all data on mesh implants for the current year (2016 to 2017).

Patient support groups have raised concern regards where they can access care regarding mesh complications. There is the impression that there are only 2 to 3 clinicians that offer this in the UK. The results of a recent survey on availability of services to remove mesh carried out by RCOG is currently being analysed and the data will be available soon. NHS England wishes to have units that offer advice regards mesh complications and determine those units that offer surgery. The results of the survey will help identify those units that have stated that they are able to offer this care. Presumably this will in time be taken on by the commissioners of healthcare who purchase treatment.
Alfred Cutner (Chair of BSUG)