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Complex mesh surgical service

Published on 22 April 2021

Complex Mesh Surgical Service

The Complex Mesh Surgical Service hosted by NHS Greater Glasgow and Clyde (GG&C) is the nationally designated centre in Scotland for women with mesh complications. The GG&C service forms part of the UK network of centres and is recognised for its clinical expertise in this field.

The service is for women who are considering specialist surgical mesh removal.

Alliance report - My Path, My Health, My Life

As Commissioners of the National Mesh Centre, NHS National Services Scotland (NSS) welcomes the release of the ALLIANCE report. We will work with all relevant partners to ensure the swift implementation of its recommendations.
A number of actions identified in the report have already been put in place or are being carefully considered. We are grateful for the work of ALLIANCE in helping us ensure the needs of mesh-injured women are at the heart of this new service for them. As Commissioners of the National Mesh Centre, NSS is working in partnership with our NHS Greater Glasgow and Clyde (GG&C) colleagues to:

*Provide clear treatment pathways and ensure continuity. We are working closely with local gynaecology teams to agree a national pathway that covers referral to the national service and follow-up arrangements after discharge

  • Ensure signposting will be supported through the national service by nurses and therapists to improve care co-ordination
  • Engage mesh-injured women with the service via user stakeholder events and feedback surveys. Together we will ensure their voice continues to shape their service
  • Offer facilitated support and ensure clear communication, with NSS and GG&C providing accessible, up-to-date information and signposting, including website content.
  • Help mesh-injured women access the support they need. We encourage eligible mesh-injured women to apply for funding from the £1million fund made available by Scottish Government that can provide a one-off payment of up to £1,000 to help towards the costs associated with emotional or practical support.

What is the Complex Mesh Surgical Service?

From the late 1990s to 2018 women in Scotland were treated with polypropylene mesh implants for stress urinary incontinence and pelvic organ prolapse.

Unfortunately, some women develop complications from vaginal mesh surgery including:

  • vaginal exposure of the mesh
  • erosion (perforation) of the mesh into the urinary tract or bowel
  • infection
  • chronic pain
  • fistulae
  • mesh shrinkage
  • nerve or vascular injury
  • sexual difficulties such as pain during intercourse

The service provides:

  • multidisciplinary team (MDT) assessment
  • surgical intervention
  • post-operative care
  • post-surgery follow-up

Local health boards provide ongoing management with support from the specialist surgical centre.

The aim of the specialist service is:

  • to build on Baroness Cumberlege’s First Do No Harm (2020) report to provide holistic care
  • to support women through MDT assessment and decisions on surgical management for complications from mesh insertion (vaginally or abdominally) for urinary incontinence and prolapse

The Clinical Lead for the National Service is Dr Ros Jamieson, Clinical Director and Consultant in Obstetrics & Gynaecology. She will establish a new National Multidisciplinary Team (MDT) to review all clinical referrals and determine the appropriate pathway of care for each individual.

The new MDT will include the following:

  • Dr Karen Guerrero, Dr Vaibhav Tyagi, Dr Stewart Pringle and Dr Vladamir Revicky as part of the Urogynaecology Service providing the Complex Mesh Surgical Service.
  • Mr David Wright and Miss Lisa Moyes providing dedicated Consultant Colorectal surgery input.
  • Mr Lorenzo Dutto as the designated Urology Consultant.
  • Dr J McNeil as the designated Radiology Consultant.

Recruitment is underway to appoint a designated consultant for Anaesthesia and Pain Management.

The Complex Mesh Surgical Service will benefit from additional dedicated staff including Specialist Nursing, Physiotherapy, Pharmacy, Clinical Psychology and Administration Support.

Address

Queen Elizabeth University Hospital 1345 Govan Road Glasgow G51 4TF

Financial support fund

The Scottish Government has set up a £1million fund to support women affected by mesh complications.

Further details, guidance and application form can be found at nhsnss.org/services/practitioner/medical/scottish-government-mesh-fund/ The fund closes on 1 July 2021 and applications must be completed by 31 May 2021.

For all enquiries, please email: NSS.MESH-Fund@nhs.scot

NHS National Services Scotland (NSS) If you have a query regarding our National Services Division, you can contact the team by email: Nss.nsd-enquiries@nhs.scot

Please note that NSD does not directly provide medical services and we won't be able to answer queries about your own care or appointments. If you would like to discuss any aspects of your care, please contact your primary healthcare provider. This might be your GP, Consultant, Nurse or other healthcare professional. They will be best placed to give you the right advice.