UK Government

Recommendation 9a-9c: Peer review of UK comprehensive care centres has been an essential part of haemophilia services for many years. The triennial audit was replaced in 2019 with a more formal peer review process on a five year cycle.

The existing NHS England specialist services for haemophilia and related bleeding disorders (adults and children) service specification has been updated to ensure a contractual requirement for providers to participate in, and act upon peer review findings. NHS England will also write to Integrated Care Boards and Trust Boards to emphasise the valuable role of peer review and ask for their commitment to review and implement findings. The revised service specification is intended to proceed to public consultation in summer 2025.

Scottish Government

These recommendations have largely been implemented in Scotland. Regular peer reviews are already taking place for the larger Comprehensive Care Centres (in Glasgow and Edinburgh), but, given limits in the UK Haemophilia Centre Doctors’ Organisation’s (UKHCDO’s) capacity to schedule peer reviews for the Haemophilia Treatment Centres, arrangements are being made to do Scottish-led peer reviews of these smaller centres (in Inverness, Aberdeen and Dundee). The Scottish Oversight and Assurance Group Chair has written to the relevant Health Boards to ask them to implement any future findings and recommendations from these peer reviews.

Welsh Government

The Welsh Government is currently working with the Haemophilia Centres on their peer review findings to take forward any recommendations and implement changes as necessary.

Northern Ireland Executive

In Northern Ireland, Recommendations 9a) to 9d) are carried out as standard practice. The Belfast Health and Social Care Trust is is commissioned by the Department (through the Strategic Planning and Performance Group) to carry out this work and houses the Haemophilia Comprehensive Care Centre (CCC), which is the only centre in Northern Ireland; there are not any Haemophilia Treatment Centres (HTCs).

There is no Regional Network in Northern Ireland, and this is taken into consideration by Peer Review Teams while Peer Review Audits are carried out within both the Haemophilia Adult and Paediatric Services within the Trust.

Next Steps

NHS England are reviewing the wording in the draft national service specification to consider if further edits are required to align the wording with the recommendations of the IBI report. NHS England will also formally write to the Chair of each NHS Trust with a Comprehensive Care Centre (CCC) or Haemophilia Treatment Centre (HTC) designation asking for their commitment as a board to consider and implement the findings of peer reviews. The outcomes of the peer review process will be reviewed at NHS England’s Specialised Commissioning National Quality Governance Group for assurance that recommendations are being acted on.

The definitions for CCCs and HTCs will be reviewed to ensure that the criteria to be designated as a CCC or HTC remain relevant.