England Mesh Complication Centres Announced5th February 2021
NHS England and NHS Improvement are responsible for commissioning specialised services for women with complications of mesh inserted for urinary incontinence and vaginal prolapse. Following the initial public consultation of the new service specification in 2018, we have undertaken a provider selection exercise and can now share which hospitals will be leading the multidisciplinary teams (MDTs) providing this specialist service.
From 1 April 2021, the following Trusts will be working with NHS England and NHS Improvement, and each other, to provide this service:
- Newcastle Upon Tyne Hospitals NHS FT
- Sheffield Teaching Hospitals NHS FT
- Manchester University NHS FT
- Cambridge University Hospital NHS FT
- University College London Hospitals NHS FT
- University Hospitals of Leicester NHS Trust
- Nottingham University Hospitals NHS Trust
No bids were initially received from the South East and South West which NHS England believed was an unacceptable situation for patients. However, following subsequent discussions, we are encouraged that some providers have now come forward and we are looking to establish a service in each of these regions as swiftly as possible.
Regional MDTs will also work together to a national MDT arrangement to ensure that women who have complex needs, that may require specific expertise, can be referred to the centre best placed to manage their care.
NHS England and NHS Improvement will continue to work closely with the new mesh centres to develop nationally agreed clinical guidelines and patient pathway protocols. The next few months will be an opportunity for these Trusts to build relationships with the hospitals in their patch and agree how these patient pathways will work locally. No-one should be concerned that their care will change immediately, as any patient transfers will be carefully managed over the next few months.
NHS staff are working hard to continue delivering NHS services across the country despite the Covid-19 pandemic. The new specialist service will hope to see patients as quickly as possible while managing the impact of the current Covid-19 pandemic on waiting times for services and ensuring patients can be seen safely.
The National Institute of Health and Care Excellence (NICE) has been working with women who have been affected by pelvic mesh complications and healthcare professionals who treat and support them, to produce two patient decision aids.
Both patient decision aids will be released for review by key stakeholders later this month before final versions are passed to NHS England and NHS Improvement for field testing, once the specialist services are up and running.
NICE has also carried out an exceptional surveillance review on its guideline on the management of urinary incontinence and pelvic organ prolapse in women (NG123). Given the limited evidence identified on partial and full removals for managing mesh-related complications, it was considered that there is insufficient evidence to trigger an update to the guideline at this time. NICE will monitor the situation and update the guideline if required.