Commentary on the NHS Digital review on the use of mesh implants for SUI and POP

Following reports of a number of adverse consequences from women who had urogynaecological mesh implants used to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP), NHS England established the Mesh Working Group. The Mesh Working Group Interim Report, published in 2015, set out a number of actions to address the issues that had been raised. These aimed to address the three major concerns expressed by the Working Group – clinical quality, data and information and informed consent.

Since publication of the Interim Report, there has been a continued effort to better understand the implications of using mesh implants, improve services and information for women with mesh implants for SUI and POP, increase the reporting of complications and take account of further published evidence. During 2016/17, the Mesh Oversight Group worked to ensure that the recommendations of the interim report were implemented.

As part of these ongoing efforts, at the request of NHS England, NHS Digital has produced a report summarising activity within Hospital Episode Statistics (HES) data for the NHS in England, of patients who have had a procedure for the treatment of urogynaecological prolapse or SUI. The report aims to provide a clearer national picture of patients who have had such procedures.

Nick Black from the Policy Innovation Research Unit (PIRU) has provided an independent view of NHS Digital’s report. The PIRU commentary is available here >>

The NHS Digital report is available here >>

How to commission evaluations of national policy pilots

To help policy makers who plan national pilot programmes and their evaluations, PIRU has developed a guidance document “Advice and how to commission national policy pilot evaluations”. The document is available here >>

Payment-for-performance: incentivising quality in public services

PIRU’s event on payment-for-performance (P4P) held in February 2013 reviewed the evidence for P4P and its evaluation. The event brought together research and policy experts for an evening of presentations and a panel discussion to explore the gains that may be made by applying P4P techniques, as well as an appraisal of the limitations.
Full details and a range of post-event outputs including downloadable slides, videos of the presentations and panel discussion, interviews, summaries and blogs are available here >>

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The recent Department of Health report, 'Innovation, Health and Wealth'* tells an intriguing story about the potential economic benefits of the NHS.


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Nick Mays, PIRU Director

Governments these days are less interested in simply supplying services and much more concerned to guarantee results, regardless of how services are provided. That’s true particularly for healthcare.


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