Open Fetal Surgery to treat fetuses with Open Spina Bifida - Two Centres

NHS AGEM CSU on behalf of NHS England Highly Specialised Services invited suitably qualified and experienced providers to deliver the Open Fetal Surgery to treat fetuses with Open Spina Bifida service across England. Objectives of the Procurement The key objectives of the Procurement were to commission the Service for open fetal surgery to treat fetuses with open spina bifida which will provide: diagnosis including fetal magnetic resonance imaging (MRI); open fetal surgery; and adult HDU and ante natal ward care for women carrying a fetus with congenital open spina bifida. This is provided that the woman and her fetus meet the criteria. NHS England sought to appoint two Fetal Surgery Centres (FSC's). Scope of services The Service(s) will be required to meet the following needs: • The population covered is all women carrying a fetus which is suspected of having open spina bifida who meet the access criteria and who are defined as the commissioning responsibility of NHS England. • Approximately 700 women per year in the UK have an ultrasound scan performed in the first half of pregnancy that results in a diagnosis of the fetus having a major form of open spina bifida (myelomeningocoele or myeloschisis), which is where the spinal column and cord are not properly formed. • Babies born with this condition are often unable to walk, incontinent of urine and faeces, may develop hydrocephalus due to incomplete closure of the spinal canal and may require a series of operations to drain fluid from the brain later in life (shunt placement). Many women in the UK opt for a termination of pregnancy on the basis of medical grounds, although some choose to continue with the pregnancy. One hundred babies are born in England each calendar year with spina bifida, not all of whom would meet the NHS England access criteria for open fetal surgery. Data from current European Open Fetal Surgery Centres suggests that only 20% of women with an affected fetus choose to undergo open fetal surgery, meaning that these centres might operate on around 10 to 20 women per year from across the UK, including up to 10 from England.