Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, which hospitals in England are allowed to use stereotactic radiosurgery to treat cerebral arteriovenous malformations and trigeminal neuralgia.

A procurement process was completed in 2016 that resulted in 17 services being commissioned in England to deliver Stereotactic Radiosurgery/Radiotherapy (SRS/RT) treatments to patients with less complex clinical indications.

Two of these services were also commissioned to deliver SRS/RT to rarer and more complex conditions, including cerebral arteriovenous malformations (AVMs) and trigeminal neuralgia. The two providers are Sheffield Teaching Hospitals NHS Foundation Trust, which takes referrals from neurosurgical centres in the north of England, and University College London Hospitals NHS Foundation Trust, which takes referrals from neurosurgical centres in the south of England.

These conditions constitute a very small number of patients and the treatment requires specialist clinical expertise. Prior to 2016, although the majority of patients were receiving their SRS treatments in Sheffield, some individual centres were also treating very small numbers of these types of patients. The national review of this service was undertaken in order to ensure delivery of high-quality services.This resulted in the commissioning of two national centres, protecting and concentrating clinical expertise in the management of these rarer cases.

In 2013-14 the contracted NHS England providers of SRS/RT were:

- Addenbrookes Hospital, Cambridge;

- Bupa Cromwell, London;

- Derriford Hospital, Plymouth;

- Mount Vernon Hospital, Middlesex;

- Nova Healthcare/ Leeds Teaching Hospitals;

- Sheffield Teaching Hospitals;

- Royal Preston Hospital, Lancashire;

- Salford Royal Hospital, Salford/ The Christie, Manchester;

- St Bartholomew’s Hospital, London;

- Thornbury Gamma Knife Centre, Sheffield;

- The Walton Centre, Liverpool/Clatterbridge Centre for Oncology, Wirral;

- University Hospital Birmingham;

- University Hospital Bristol.

Some of these centres would have provided treatments for AVMs and trigeminal neuralgia.