CINXE.COM

<!DOCTYPE HTML>     <html class="no-js" lang="en-US">  <head> <title>NHS commissioning » Specialised services</title> <meta name="title" property="og:title" content="NHS commissioning » Specialised services"> <script type="text/javascript"> var addthis_config = { ui_tabindex:0 } </script> <meta charset="utf-8"> <meta http-equiv="cleartype" content="on"> <meta name="description" property="og:description" content="What are specialised services? Specialised services support people with a range of rare and complex conditions. They often involve treatments provided to patients with rare cancers, genetic disorders or complex medical or surgical conditions. They deliver cutting-edge care and are a catalyst for innovation, supporting pioneering clinical practice in the NHS. For a quick overview […]"> <meta name="author" content="NHS commissioning"> <meta property="og:image" content="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/nhs-england-logo-export.png"> <meta property="og:url" content="https://www.england.nhs.uk/commissioning/spec-services/"> <link rel="alternate" type="application/rss+xml" title="RSS2.0" href="https://www.england.nhs.uk/commissioning/feed/" /> <meta name='robots' content='max-image-preview:large' /> <link rel='stylesheet' id='wp-block-library-css' href='https://www.england.nhs.uk/commissioning/wp-includes/css/dist/block-library/style.min.css?ver=6.7' type='text/css' media='all' /> <style id='co-authors-plus-coauthors-style-inline-css' type='text/css'> .wp-block-co-authors-plus-coauthors.is-layout-flow [class*=wp-block-co-authors-plus]{display:inline} </style> <style id='co-authors-plus-avatar-style-inline-css' type='text/css'> .wp-block-co-authors-plus-avatar :where(img){height:auto;max-width:100%;vertical-align:bottom}.wp-block-co-authors-plus-coauthors.is-layout-flow .wp-block-co-authors-plus-avatar :where(img){vertical-align:middle}.wp-block-co-authors-plus-avatar:is(.alignleft,.alignright){display:table}.wp-block-co-authors-plus-avatar.aligncenter{display:table;margin-inline:auto} </style> <style id='co-authors-plus-image-style-inline-css' type='text/css'> .wp-block-co-authors-plus-image{margin-bottom:0}.wp-block-co-authors-plus-image :where(img){height:auto;max-width:100%;vertical-align:bottom}.wp-block-co-authors-plus-coauthors.is-layout-flow .wp-block-co-authors-plus-image :where(img){vertical-align:middle}.wp-block-co-authors-plus-image:is(.alignfull,.alignwide) :where(img){width:100%}.wp-block-co-authors-plus-image:is(.alignleft,.alignright){display:table}.wp-block-co-authors-plus-image.aligncenter{display:table;margin-inline:auto} </style> <style id='classic-theme-styles-inline-css' type='text/css'> /*! This file is auto-generated */ .wp-block-button__link{color:#fff;background-color:#32373c;border-radius:9999px;box-shadow:none;text-decoration:none;padding:calc(.667em + 2px) calc(1.333em + 2px);font-size:1.125em}.wp-block-file__button{background:#32373c;color:#fff;text-decoration:none} </style> <style id='global-styles-inline-css' type='text/css'> :root{--wp--preset--aspect-ratio--square: 1;--wp--preset--aspect-ratio--4-3: 4/3;--wp--preset--aspect-ratio--3-4: 3/4;--wp--preset--aspect-ratio--3-2: 3/2;--wp--preset--aspect-ratio--2-3: 2/3;--wp--preset--aspect-ratio--16-9: 16/9;--wp--preset--aspect-ratio--9-16: 9/16;--wp--preset--color--black: #000000;--wp--preset--color--cyan-bluish-gray: #abb8c3;--wp--preset--color--white: #ffffff;--wp--preset--color--pale-pink: #f78da7;--wp--preset--color--vivid-red: #cf2e2e;--wp--preset--color--luminous-vivid-orange: #ff6900;--wp--preset--color--luminous-vivid-amber: #fcb900;--wp--preset--color--light-green-cyan: #7bdcb5;--wp--preset--color--vivid-green-cyan: #00d084;--wp--preset--color--pale-cyan-blue: #8ed1fc;--wp--preset--color--vivid-cyan-blue: #0693e3;--wp--preset--color--vivid-purple: #9b51e0;--wp--preset--gradient--vivid-cyan-blue-to-vivid-purple: linear-gradient(135deg,rgba(6,147,227,1) 0%,rgb(155,81,224) 100%);--wp--preset--gradient--light-green-cyan-to-vivid-green-cyan: linear-gradient(135deg,rgb(122,220,180) 0%,rgb(0,208,130) 100%);--wp--preset--gradient--luminous-vivid-amber-to-luminous-vivid-orange: linear-gradient(135deg,rgba(252,185,0,1) 0%,rgba(255,105,0,1) 100%);--wp--preset--gradient--luminous-vivid-orange-to-vivid-red: linear-gradient(135deg,rgba(255,105,0,1) 0%,rgb(207,46,46) 100%);--wp--preset--gradient--very-light-gray-to-cyan-bluish-gray: linear-gradient(135deg,rgb(238,238,238) 0%,rgb(169,184,195) 100%);--wp--preset--gradient--cool-to-warm-spectrum: linear-gradient(135deg,rgb(74,234,220) 0%,rgb(151,120,209) 20%,rgb(207,42,186) 40%,rgb(238,44,130) 60%,rgb(251,105,98) 80%,rgb(254,248,76) 100%);--wp--preset--gradient--blush-light-purple: linear-gradient(135deg,rgb(255,206,236) 0%,rgb(152,150,240) 100%);--wp--preset--gradient--blush-bordeaux: linear-gradient(135deg,rgb(254,205,165) 0%,rgb(254,45,45) 50%,rgb(107,0,62) 100%);--wp--preset--gradient--luminous-dusk: linear-gradient(135deg,rgb(255,203,112) 0%,rgb(199,81,192) 50%,rgb(65,88,208) 100%);--wp--preset--gradient--pale-ocean: linear-gradient(135deg,rgb(255,245,203) 0%,rgb(182,227,212) 50%,rgb(51,167,181) 100%);--wp--preset--gradient--electric-grass: linear-gradient(135deg,rgb(202,248,128) 0%,rgb(113,206,126) 100%);--wp--preset--gradient--midnight: linear-gradient(135deg,rgb(2,3,129) 0%,rgb(40,116,252) 100%);--wp--preset--font-size--small: 13px;--wp--preset--font-size--medium: 20px;--wp--preset--font-size--large: 36px;--wp--preset--font-size--x-large: 42px;--wp--preset--spacing--20: 0.44rem;--wp--preset--spacing--30: 0.67rem;--wp--preset--spacing--40: 1rem;--wp--preset--spacing--50: 1.5rem;--wp--preset--spacing--60: 2.25rem;--wp--preset--spacing--70: 3.38rem;--wp--preset--spacing--80: 5.06rem;--wp--preset--shadow--natural: 6px 6px 9px rgba(0, 0, 0, 0.2);--wp--preset--shadow--deep: 12px 12px 50px rgba(0, 0, 0, 0.4);--wp--preset--shadow--sharp: 6px 6px 0px rgba(0, 0, 0, 0.2);--wp--preset--shadow--outlined: 6px 6px 0px -3px rgba(255, 255, 255, 1), 6px 6px rgba(0, 0, 0, 1);--wp--preset--shadow--crisp: 6px 6px 0px rgba(0, 0, 0, 1);}:where(.is-layout-flex){gap: 0.5em;}:where(.is-layout-grid){gap: 0.5em;}body .is-layout-flex{display: flex;}.is-layout-flex{flex-wrap: wrap;align-items: center;}.is-layout-flex > :is(*, div){margin: 0;}body .is-layout-grid{display: grid;}.is-layout-grid > :is(*, div){margin: 0;}:where(.wp-block-columns.is-layout-flex){gap: 2em;}:where(.wp-block-columns.is-layout-grid){gap: 2em;}:where(.wp-block-post-template.is-layout-flex){gap: 1.25em;}:where(.wp-block-post-template.is-layout-grid){gap: 1.25em;}.has-black-color{color: var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-color{color: var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-color{color: var(--wp--preset--color--white) !important;}.has-pale-pink-color{color: var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-color{color: var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-color{color: var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-color{color: var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-color{color: var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-color{color: var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-color{color: var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-color{color: var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-color{color: var(--wp--preset--color--vivid-purple) !important;}.has-black-background-color{background-color: var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-background-color{background-color: var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-background-color{background-color: var(--wp--preset--color--white) !important;}.has-pale-pink-background-color{background-color: var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-background-color{background-color: var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-background-color{background-color: var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-background-color{background-color: var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-background-color{background-color: var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-background-color{background-color: var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-background-color{background-color: var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-background-color{background-color: var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-background-color{background-color: var(--wp--preset--color--vivid-purple) !important;}.has-black-border-color{border-color: var(--wp--preset--color--black) !important;}.has-cyan-bluish-gray-border-color{border-color: var(--wp--preset--color--cyan-bluish-gray) !important;}.has-white-border-color{border-color: var(--wp--preset--color--white) !important;}.has-pale-pink-border-color{border-color: var(--wp--preset--color--pale-pink) !important;}.has-vivid-red-border-color{border-color: var(--wp--preset--color--vivid-red) !important;}.has-luminous-vivid-orange-border-color{border-color: var(--wp--preset--color--luminous-vivid-orange) !important;}.has-luminous-vivid-amber-border-color{border-color: var(--wp--preset--color--luminous-vivid-amber) !important;}.has-light-green-cyan-border-color{border-color: var(--wp--preset--color--light-green-cyan) !important;}.has-vivid-green-cyan-border-color{border-color: var(--wp--preset--color--vivid-green-cyan) !important;}.has-pale-cyan-blue-border-color{border-color: var(--wp--preset--color--pale-cyan-blue) !important;}.has-vivid-cyan-blue-border-color{border-color: var(--wp--preset--color--vivid-cyan-blue) !important;}.has-vivid-purple-border-color{border-color: var(--wp--preset--color--vivid-purple) !important;}.has-vivid-cyan-blue-to-vivid-purple-gradient-background{background: var(--wp--preset--gradient--vivid-cyan-blue-to-vivid-purple) !important;}.has-light-green-cyan-to-vivid-green-cyan-gradient-background{background: var(--wp--preset--gradient--light-green-cyan-to-vivid-green-cyan) !important;}.has-luminous-vivid-amber-to-luminous-vivid-orange-gradient-background{background: var(--wp--preset--gradient--luminous-vivid-amber-to-luminous-vivid-orange) !important;}.has-luminous-vivid-orange-to-vivid-red-gradient-background{background: var(--wp--preset--gradient--luminous-vivid-orange-to-vivid-red) !important;}.has-very-light-gray-to-cyan-bluish-gray-gradient-background{background: var(--wp--preset--gradient--very-light-gray-to-cyan-bluish-gray) !important;}.has-cool-to-warm-spectrum-gradient-background{background: var(--wp--preset--gradient--cool-to-warm-spectrum) !important;}.has-blush-light-purple-gradient-background{background: var(--wp--preset--gradient--blush-light-purple) !important;}.has-blush-bordeaux-gradient-background{background: var(--wp--preset--gradient--blush-bordeaux) !important;}.has-luminous-dusk-gradient-background{background: var(--wp--preset--gradient--luminous-dusk) !important;}.has-pale-ocean-gradient-background{background: var(--wp--preset--gradient--pale-ocean) !important;}.has-electric-grass-gradient-background{background: var(--wp--preset--gradient--electric-grass) !important;}.has-midnight-gradient-background{background: var(--wp--preset--gradient--midnight) !important;}.has-small-font-size{font-size: var(--wp--preset--font-size--small) !important;}.has-medium-font-size{font-size: var(--wp--preset--font-size--medium) !important;}.has-large-font-size{font-size: var(--wp--preset--font-size--large) !important;}.has-x-large-font-size{font-size: var(--wp--preset--font-size--x-large) !important;} :where(.wp-block-post-template.is-layout-flex){gap: 1.25em;}:where(.wp-block-post-template.is-layout-grid){gap: 1.25em;} :where(.wp-block-columns.is-layout-flex){gap: 2em;}:where(.wp-block-columns.is-layout-grid){gap: 2em;} :root :where(.wp-block-pullquote){font-size: 1.5em;line-height: 1.6;} </style> <link rel='stylesheet' id='contact-form-7-css' href='https://www.england.nhs.uk/commissioning/wp-content/plugins/contact-form-7/includes/css/styles.css?ver=5.9.8' type='text/css' media='all' /> <link rel='stylesheet' id='jquery-ui-css' href='https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static//lib/jquery-ui/themes/smoothness/jquery-ui.css?ver=6.7' type='text/css' media='screen' /> <link rel='stylesheet' id='main-css' href='https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/main-1ce80937921c73ff41efd2f36eb817fdc2d34e1e.min.css?ver=6.7' type='text/css' media='screen' /> <link rel='stylesheet' id='print-css' href='https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/print-fe4e4682bcb96cc3674bd9e62072e3d81c0553ab.min.css?ver=6.7' type='text/css' media='print' /> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <link rel="dns-prefetch" href="//fast.fonts.com"> <link rel="dns-prefetch" href="//www.google-analytics.com"> <link rel="shortcut icon" href="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/favicon.ico" type="image/x-icon"> <link rel="apple-touch-icon-precomposed" sizes="180x180" href="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/apple-touch-icon-180x180.png"> <link rel="apple-touch-icon-precomposed" sizes="152x152" href="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/apple-touch-icon-152x152.png"> <link rel="apple-touch-icon-precomposed" sizes="120x120" href="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/apple-touch-icon-120x120.png"> <link rel="apple-touch-icon-precomposed" sizes="76x76" href="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/apple-touch-icon-76x76.png"> <link rel="apple-touch-icon-precomposed" href="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/apple-touch-icon.png"> <script type="text/javascript" src="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/lib/jquery.min.js?ver=6.7" id="jquery-js"></script> <script type="text/javascript" src="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/lib/modernizr.min.js?ver=6.7" id="modernizr-js"></script> <script type="text/javascript" src="https://cc.cdn.civiccomputing.com/8/cookieControl-8.x.min.js?ver=6.7" id="cookieControl-js"></script> <link rel="canonical" href="https://www.england.nhs.uk/commissioning/spec-services/" /> <style type="text/css"> .header.nhs-e { background: #005eb8; } .nhs-e.top-nav-container { background: #0072ce; } .nhs-e.navigation li > a:hover, .nhs-e.navigation li > a.open, .nhs-e.navigation li.current-menu-item > a, .nhs-e.navigation li.current-menu-parent > a, .nhs-e.navigation li.current_page_item > a, .nhs-e.navigation li.current-page-ancestor > a { background: #0072ce; } </style> </head> <body class="page-template-default page page-id-35395 page-parent group"> <div class="skip-link"> <a href="#main-content" tabindex="1">Skip to main content</a> </div> <div class="cookie-banner-container" style="display: none"> <div class="cookie-banner row"> <h1>Cookies on the NHS England website</h1> <div class="rich-text"> <p>We’ve put some small files called cookies on your device to make our site work.</p> <p>We’d also like to use analytics cookies. These send information about how our site is used to a service called Google Analytics. We use this information to improve our site.</p> <p>Let us know if this is OK. We’ll use a cookie to save your choice. You can聽<a id="nhsuk-cookie-banner__link" tabindex="1" href="https://www.england.nhs.uk/privacy-policy/">read more about our cookies</a> before you choose.</p> <p> </p> </div> <p> <button class="preferences">Change my preferences</button> <button class="ok">I'm OK with analytics cookies</button> </p> </div> </div> <div class="nhs-e top-nav-container group"> <div class="row group"> <nav class="secondary-navigation" role="navigation"> <ul id="menu-top-header-navigation" class="nav-menu"><li id="menu-item-49701" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49701"><a href="https://www.england.nhs.uk/">Home</a></li> <li id="menu-item-49702" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49702"><a href="https://www.england.nhs.uk/news/">News</a></li> <li id="menu-item-49703" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49703"><a href="https://www.england.nhs.uk/publication/">Publications</a></li> <li id="menu-item-49704" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49704"><a href="https://www.england.nhs.uk/statistics/">Statistics</a></li> <li id="menu-item-50424" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-50424"><a href="https://www.england.nhs.uk/blogs/">Blogs</a></li> <li id="menu-item-49706" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49706"><a href="https://www.england.nhs.uk/events/">Events</a></li> <li id="menu-item-49707" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49707"><a href="https://www.england.nhs.uk/contact-us/">Contact us</a></li> </ul> </nav> </div> </div> <header class="nhs-e header group" role="banner"> <div class="row group"> <div class="nhs-e logo"> <a href="https://www.england.nhs.uk/ourwork/"> <img src="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/nhs-england-white.svg" alt="NHS commissioning" /> </a> </div> <div class="nhs-e header-search"> <form role="search" id="search-form" class="search-form" method="get" action="https://www.england.nhs.uk/commissioning"> <label class="hide" for="s" id="search-label">Search</label> <input type="search" name="s" aria-labelledby="search-label" class="search-input"> <label class="hide" for="search" id="search-button">Search</label> <input type="submit" id="search" aria-labelledby="search-button" value="Search" class="button"> </form> </div> </div> <div class="nhs-e nav-container group"> <button type="button" href="#" class="nav-toggle" id="js-nav-toggle"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 18 18"><path class="menu-icon" fill="#ffffff" d="M.1 3.6C0 2.7 0 1.7.1.7.1.3.5 0 1 0h16.1c.5 0 .9.3.9.7.1 1 .1 1.9 0 2.9 0 .4-.4.7-.9.7H1c-.5 0-.9-.3-.9-.7zm.9 7.6c-.5 0-.9-.3-.9-.7-.1-1-.1-2 0-2.9 0-.4.4-.7.9-.7h16.1c.5 0 .9.3.9.7.1 1 .1 1.9 0 2.9 0 .4-.4.7-.9.7H1zM1 18c-.5 0-.9-.3-.9-.7-.1-1-.1-1.9 0-2.9 0-.4.4-.7.9-.7h16.1c.5 0 .9.3.9.7.1 1 .1 1.9 0 2.9 0 .4-.4.7-.9.7H1z"/></svg> <span>Menu</span> </button> <nav class="nhs-e navigation group" role="navigation"> <ul id="menu-top-nav" class="nav-menu"><li id="menu-item-60" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-60"><a href="https://www.england.nhs.uk/about/">About us</a></li> <li id="menu-item-48046" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-48046"><a href="https://www.england.nhs.uk/ourwork" title="NHS England – our work">Our work</a></li> <li id="menu-item-49719" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-home menu-item-49719"><a href="https://www.england.nhs.uk/commissioning/">Commissioning</a></li> <li id="menu-item-49720" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49720"><a href="https://www.england.nhs.uk/participation/">Get involved</a></li> <li id="menu-item-55052" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-55052"><a href="https://www.england.nhs.uk/coronavirus/">Coronavirus</a></li> </ul> </nav> </div> </header> <main class="main group" role="main"> <div id="chat" class="intelecomchat"> </div> <div class="row"> <aside class="subnav group normal_nav desktop-only" role="complementary"><div class="sub-nav"><nav class="nav-collapse"><ul> <li class="top"><a href="https://www.england.nhs.uk/commissioning">NHS commissioning</a></li><li class="parent"><a href="https://www.england.nhs.uk/commissioning/spec-services/">Specialised services</a></li><li class="children-nav"><ul><li class="page_item page-item-55555"><a href="https://www.england.nhs.uk/commissioning/spec-services/clinical-networks/">Specialised services clinical networks</a></li> <li class="page_item page-item-55109"><a href="https://www.england.nhs.uk/commissioning/spec-services/advanced-therapy-medicinal-products/">Advanced therapy medicinal products</a></li> <li class="page_item page-item-35454"><a href="https://www.england.nhs.uk/commissioning/spec-services/npc-crg/">National Programmes of Care and Clinical Reference Groups</a></li> <li class="page_item page-item-43942"><a href="https://www.england.nhs.uk/commissioning/spec-services/highly-spec-services/">Highly specialised services</a></li> <li class="page_item page-item-43887"><a href="https://www.england.nhs.uk/commissioning/spec-services/key-docs/">Key documents</a></li> <li class="page_item page-item-35458"><a href="https://www.england.nhs.uk/commissioning/spec-services/get-involved/">Get involved</a></li> <li class="page_item page-item-38883"><a href="https://www.england.nhs.uk/commissioning/spec-services/consultations/">Consultations</a></li> <li class="page_item page-item-55399"><a href="https://www.england.nhs.uk/commissioning/spec-services/november-2023-prioritisation-decisions/">November 2023 prioritisation decisions</a></li> <li class="page_item page-item-54610"><a href="https://www.england.nhs.uk/commissioning/spec-services/october-2022-prioritisation-decisions/">October 2022 prioritisation decisions</a></li> <li class="page_item page-item-51717"><a href="https://www.england.nhs.uk/commissioning/spec-services/improving-value/">Improving Value</a></li> </ul></li><li class="page_item page-item-51600"><a href="https://www.england.nhs.uk/commissioning/what-is-commissioning/">What is commissioning?</a></li> <li class="page_item page-item-51602"><a href="https://www.england.nhs.uk/commissioning/who-commissions-nhs-services/">Who commissions NHS services?</a></li> <li class="page_item page-item-51636"><a href="https://www.england.nhs.uk/commissioning/commissioned-services/">Commissioned services</a></li> <li class="page_item page-item-51616"><a href="https://www.england.nhs.uk/commissioning/regulation/">Commissioning Oversight</a></li> <li class="page_item page-item-51618"><a href="https://www.england.nhs.uk/commissioning/how-commissioning-is-changing/">How commissioning is changing</a></li> <li class="page_item page-item-50638"><a href="https://www.england.nhs.uk/commissioning/primary-care/">Primary care</a></li> <li class="page_item page-item-47903"><a href="https://www.england.nhs.uk/commissioning/continence/">Continence</a></li> <li class="page_item page-item-47926"><a href="https://www.england.nhs.uk/commissioning/orthotic-services/">Orthotic services</a></li> <li class="page_item page-item-47674"><a href="https://www.england.nhs.uk/commissioning/nut-hyd/">Nutrition and hydration</a></li> <li class="page_item page-item-28704"><a href="https://www.england.nhs.uk/commissioning/cpag/">Clinical Priorities Advisory Group (CPAG)</a></li> <li class="page_item page-item-45981"><a href="https://www.england.nhs.uk/commissioning/comm-carers/">Commissioning for carers</a></li> <li class="page_item page-item-21612"><a href="https://www.england.nhs.uk/commissioning/armed-forces/">Armed Forces healthcare commissioning</a></li> <li class="page_item page-item-28701"><a href="https://www.england.nhs.uk/commissioning/rdag/">Rare Diseases Advisory Group (RDAG)</a></li> <li class="page_item page-item-24307"><a href="https://www.england.nhs.uk/commissioning/policies/">Commissioning policies</a></li> <li class="page_item page-item-21076"><a href="https://www.england.nhs.uk/commissioning/health-just/">Health and justice</a></li> <li class="page_item page-item-33722"><a href="https://www.england.nhs.uk/commissioning/ccs/">Critical care services</a></li> <li class="page_item page-item-51528"><a href="https://www.england.nhs.uk/commissioning/sexual-assault-and-abuse/">Sexual assault and abuse</a></li> <li class="page_item page-item-26665"><a href="https://www.england.nhs.uk/commissioning/pub-hlth-res/">Public health commissioning</a></li> <li class="page_item page-item-48153"><a href="https://www.england.nhs.uk/commissioning/ccg-engagement/">CCG engagement</a></li> </ul></nav> </div></aside> <div class="page-content" id="main-content"> <nav class="breadcrumbs"> <ul> <li><a href="/">Home</a></li><li><a href="https://www.england.nhs.uk/commissioning">NHS commissioning</a></li><li>Specialised services</li> </ul> </nav> <header> <h1>Specialised services</h1> </header> <article class="rich-text"> <h3>What are specialised services?</h3> <p>Specialised services support people with a range of rare and complex conditions. They often involve treatments provided to patients with rare cancers, genetic disorders or complex medical or surgical conditions. They deliver cutting-edge care and are a catalyst for innovation, supporting pioneering clinical practice in the NHS. For a quick overview of specialised services watch our animation.</p> <p><iframe width="500" height="281" src="//www.youtube.com/embed/4FZeqtmYXno?rel=0" frameborder="0" allowfullscreen></iframe></p> <p>These services include a range of treatments, from interventions that most of us have heard of, such as chemotherapy, radiotherapy and kidney dialysis, through to pioneering procedures that are currently only carried out in small numbers, such as using a patient鈥檚 own tooth to restore their sight, and hand transplants. We also support trials of treatments, such as PrEP (Pre-exposure prophylaxis, a drug to prevent HIV), and an evaluation of mitochondrial donation, a form of IVF in which the future baby鈥檚 mitochondrial DNA comes from a donor egg to avoid passing on inherited diseases.</p> <p>Specialised services are not available in every local hospital because they have to be delivered by specialist teams of doctors, nurses and other health professionals who have the necessary skills and experience. Unlike most healthcare, which is planned and arranged locally, specialised services are planned nationally and regionally by NHS England.</p> <p>In total, there are 149 specialised services currently directly commissioned by NHS England. Three factors determine whether NHS England commissions a service as a prescribed specialised service. These are:</p> <ul> <li>The number of individuals who require the service;</li> <li>The cost of providing the service or facility;</li> <li>The number of people able to provide the service or facility</li> </ul> <p>In 2022/23 the planned spend for specialised services is 拢22.9 billion. The level of funding for these services has risen more rapidly compared to other parts of the NHS, but it is still under pressure. The number of patients needing specialised services is rising due to an ageing population and advances in medical technology.</p> <p>Although NHS England currently directly commissions all specialised services, we have set out in our <a href="https://www.england.nhs.uk/publication/nhs-england-commissioning-functions-for-delegation-to-integrated-care-systems/">Roadmap for integrating specialised services</a> how integrated care boards will be given a bigger role in commissioning some specialised services from April 2023.</p> <h3>Making decisions about new treatments</h3> <p>We have a legal duty to fund certain new medicines and devices recommended by the National Institute for Health and Care Excellence (NICE), but we also make available additional funding each year for other new treatments.聽 For these new treatments, we have to make complex decisions about which represent the best value for patients and taxpayers. We have a duty to ensure that new treatments are supported by convincing evidence of safety and effectiveness, that they are affordable and offer value for money, and that decisions about them are fair and transparent. Doctors, other healthcare professionals, and patient and public representatives are involved at every stage of this decision-making process.</p> <h3>Prioritisation</h3> <p>For proposed new treatments which require additional investment, NHS England carries out a relative prioritisation process to determine which services will be routinely commissioned. The video聽below explains how all the proposed new treatments are independently assessed by the聽<a href="https://www.england.nhs.uk/commissioning/cpag/">Clinical Priorities Advisory Group (CPAG)</a>聽on their likely relative clinical benefit and relative cost.</p> <p><iframe width="500" height="281" src="//www.youtube.com/embed/b1exxrBDUEU?rel=0" frameborder="0" allowfullscreen></iframe></p> <p>CPAG then makes its recommendations to NHS England who review these recommendations against the budget available and considers which new treatments to recommend for funding.</p> <p>For more information on how we make decisions聽<a href="https://www.england.nhs.uk/publication/infographic-specialised-commissioning-service-development-process/">see our infographic</a>. Our聽<a href="https://www.england.nhs.uk/commissioning/spec-services/service-development-policy-and-methods/">service development policy</a>聽sets out how this works in more detail.</p> <h3>Prioritisation decisions</h3> <p>A summary of the outcome of the most recent relative prioritisation round can be found here:</p> <ul> <li><a href="https://www.england.nhs.uk/commissioning/spec-services/november-2023-prioritisation-decisions/" target="_blank" rel="noopener">November 2023 prioritisation decisions</a></li> <li><a href="https://www.england.nhs.uk/commissioning/spec-services/october-2022-prioritisation-decisions/">October 2022 prioritisation decisions</a></li> <li><a href="https://www.england.nhs.uk/publication/may-2021-prioritisation-decisions/">May 2021 prioritisation decisions</a></li> </ul> <h3>Contact us</h3> <p>For any general enquiries about specialised commissioning, please <a href="mailto:england.boffice_speccom@nhs.net">email the specialised commissioning team</a>聽(please do not send urgent correspondence to this address).</p> <p>If your query relates to a Clinical Reference Group, please email <a href="mailto:England.voice-crg@nhs.net">england.voice-crg@nhs.net</a>.</p> <h3>Latest news and updates</h3> <p>If you would like to keep up to date with the latest news and developments in specialised commissioning then you can聽<a href="https://www.england.nhs.uk/commissioning/spec-services/get-involved/crg-stake-reg/">register as a stakeholder</a>.</p> <p>For up to the minute latest news please also check out our <a href="https://www.england.nhs.uk/commissioning/spec-services/latest-news/">news section</a>.</p> </article> <div class="comment-area"> </div> </div> <aside class="subnav group normal_nav mobile-only" role="complementary"><div class="sub-nav"><nav class="nav-collapse"><ul> <li class="top"><a href="https://www.england.nhs.uk/commissioning">NHS commissioning</a></li><li class="parent"><a href="https://www.england.nhs.uk/commissioning/spec-services/">Specialised services</a></li><li class="children-nav"><ul><li class="page_item page-item-55555"><a href="https://www.england.nhs.uk/commissioning/spec-services/clinical-networks/">Specialised services clinical networks</a></li> <li class="page_item page-item-55109"><a href="https://www.england.nhs.uk/commissioning/spec-services/advanced-therapy-medicinal-products/">Advanced therapy medicinal products</a></li> <li class="page_item page-item-35454"><a href="https://www.england.nhs.uk/commissioning/spec-services/npc-crg/">National Programmes of Care and Clinical Reference Groups</a></li> <li class="page_item page-item-43942"><a href="https://www.england.nhs.uk/commissioning/spec-services/highly-spec-services/">Highly specialised services</a></li> <li class="page_item page-item-43887"><a href="https://www.england.nhs.uk/commissioning/spec-services/key-docs/">Key documents</a></li> <li class="page_item page-item-35458"><a href="https://www.england.nhs.uk/commissioning/spec-services/get-involved/">Get involved</a></li> <li class="page_item page-item-38883"><a href="https://www.england.nhs.uk/commissioning/spec-services/consultations/">Consultations</a></li> <li class="page_item page-item-55399"><a href="https://www.england.nhs.uk/commissioning/spec-services/november-2023-prioritisation-decisions/">November 2023 prioritisation decisions</a></li> <li class="page_item page-item-54610"><a href="https://www.england.nhs.uk/commissioning/spec-services/october-2022-prioritisation-decisions/">October 2022 prioritisation decisions</a></li> <li class="page_item page-item-51717"><a href="https://www.england.nhs.uk/commissioning/spec-services/improving-value/">Improving Value</a></li> </ul></li><li class="page_item page-item-51600"><a href="https://www.england.nhs.uk/commissioning/what-is-commissioning/">What is commissioning?</a></li> <li class="page_item page-item-51602"><a href="https://www.england.nhs.uk/commissioning/who-commissions-nhs-services/">Who commissions NHS services?</a></li> <li class="page_item page-item-51636"><a href="https://www.england.nhs.uk/commissioning/commissioned-services/">Commissioned services</a></li> <li class="page_item page-item-51616"><a href="https://www.england.nhs.uk/commissioning/regulation/">Commissioning Oversight</a></li> <li class="page_item page-item-51618"><a href="https://www.england.nhs.uk/commissioning/how-commissioning-is-changing/">How commissioning is changing</a></li> <li class="page_item page-item-50638"><a href="https://www.england.nhs.uk/commissioning/primary-care/">Primary care</a></li> <li class="page_item page-item-47903"><a href="https://www.england.nhs.uk/commissioning/continence/">Continence</a></li> <li class="page_item page-item-47926"><a href="https://www.england.nhs.uk/commissioning/orthotic-services/">Orthotic services</a></li> <li class="page_item page-item-47674"><a href="https://www.england.nhs.uk/commissioning/nut-hyd/">Nutrition and hydration</a></li> <li class="page_item page-item-28704"><a href="https://www.england.nhs.uk/commissioning/cpag/">Clinical Priorities Advisory Group (CPAG)</a></li> <li class="page_item page-item-45981"><a href="https://www.england.nhs.uk/commissioning/comm-carers/">Commissioning for carers</a></li> <li class="page_item page-item-21612"><a href="https://www.england.nhs.uk/commissioning/armed-forces/">Armed Forces healthcare commissioning</a></li> <li class="page_item page-item-28701"><a href="https://www.england.nhs.uk/commissioning/rdag/">Rare Diseases Advisory Group (RDAG)</a></li> <li class="page_item page-item-24307"><a href="https://www.england.nhs.uk/commissioning/policies/">Commissioning policies</a></li> <li class="page_item page-item-21076"><a href="https://www.england.nhs.uk/commissioning/health-just/">Health and justice</a></li> <li class="page_item page-item-33722"><a href="https://www.england.nhs.uk/commissioning/ccs/">Critical care services</a></li> <li class="page_item page-item-51528"><a href="https://www.england.nhs.uk/commissioning/sexual-assault-and-abuse/">Sexual assault and abuse</a></li> <li class="page_item page-item-26665"><a href="https://www.england.nhs.uk/commissioning/pub-hlth-res/">Public health commissioning</a></li> <li class="page_item page-item-48153"><a href="https://www.england.nhs.uk/commissioning/ccg-engagement/">CCG engagement</a></li> </ul></nav> </div></aside> </div> </main> <footer class="footer group" role="contentinfo"> <div class="row"> <div class="footer-links"> <nav class="footer-navigation"> <ul id="menu-footer-links" class="menu"><li id="menu-item-28" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-28"><a href="https://www.england.nhs.uk/terms-and-conditions/">Terms and conditions</a></li> <li id="menu-item-54" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-54"><a href="https://www.england.nhs.uk/privacy-policy/">Privacy and cookies</a></li> <li id="menu-item-56" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-56"><a href="https://www.england.nhs.uk/comment-policy/">Social media and comment moderation</a></li> <li id="menu-item-57" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-57"><a href="https://www.england.nhs.uk/accessibility/">Accessibility</a></li> <li id="menu-item-49328" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49328"><a href="https://www.engage.england.nhs.uk/survey/website-satisfaction-survey/consultation/subpage.2016-06-20.7559111318/view">Website satisfaction survey</a></li> <li id="menu-item-49717" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-49717"><a href="https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/">Open Government Licence v3.0</a></li> </ul> </nav> <div class="social-networks"> <ul> <li> <a href="https://twitter.com/NHSEngland" title="Follow us on Twitter" target="_blank"> <span class="hide">Follow us on Twitter</span> </a> </li> <li> <a href="https://www.linkedin.com/company/nhsengland" title="Visit us on LinkedIn" target="_blank"> <span class="hide">Visit us on LinkedIn</span> </a> </li> <li> <a href="http://www.youtube.com/user/TheNHSEngland" title="Watch videos on YouTube" target="_blank"> <span class="hide">Watch videos on YouTube</span> </a> </li> <li> <a href="https://www.flickr.com/photos/nhsengland" title="View photos on Flickr" target="_blank"> <span class="hide">View photos on Flickr</span> </a> </li> <li> <a href="http://feeds.feedburner.com/NHSCBoard" title="All RSS" target="_blank"> <span class="hide">All RSS</span> </a> </li> </ul> </div> </div> <div class="footer-logo"> <a href="https://www.nhs.uk/" title="NHS website"> <img src="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/img/nhs-uk-logo.svg" alt="NHS website"> </a> </div> </div> <div id="__ba_panel"></div> </footer> <script type="text/javascript" src="https://www.england.nhs.uk/commissioning/wp-includes/js/dist/hooks.min.js?ver=4d63a3d491d11ffd8ac6" id="wp-hooks-js"></script> <script type="text/javascript" src="https://www.england.nhs.uk/commissioning/wp-includes/js/dist/i18n.min.js?ver=5e580eb46a90c2b997e6" id="wp-i18n-js"></script> <script type="text/javascript" id="wp-i18n-js-after"> /* <![CDATA[ */ wp.i18n.setLocaleData( { 'text direction\u0004ltr': [ 'ltr' ] } ); /* ]]> */ </script> <script type="text/javascript" src="https://www.england.nhs.uk/commissioning/wp-content/plugins/contact-form-7/includes/swv/js/index.js?ver=5.9.8" id="swv-js"></script> <script type="text/javascript" id="contact-form-7-js-extra"> /* <![CDATA[ */ var wpcf7 = {"api":{"root":"https:\/\/www.england.nhs.uk\/commissioning\/wp-json\/","namespace":"contact-form-7\/v1"}}; /* ]]> */ </script> <script type="text/javascript" src="https://www.england.nhs.uk/commissioning/wp-content/plugins/contact-form-7/includes/js/index.js?ver=5.9.8" id="contact-form-7-js"></script> <script type="text/javascript" id="main-js-extra"> /* <![CDATA[ */ var cookieControlSettings = {"apiKey":"90adfdad163e4c52a4794c7aa4ea95a84732ae3f","product":"PRO_MULTISITE"}; /* ]]> */ </script> <script type="text/javascript" src="https://www.england.nhs.uk/commissioning/wp-content/themes/nhsengland/static/main-b952ae9fc371b7f02c44521aacc475379c82b1ca.min.js?ver=6.7" id="main-js"></script> <script type="text/javascript" src="https://www.england.nhs.uk/commissioning/wp-content/plugins/page-links-to/dist/new-tab.js?ver=3.3.7" id="page-links-to-js"></script> <script> // nhs england markExternalLinks(); showDownloadableFileIcons(); // Browsealoud var _baTheme=0, _baUseCookies=true, _baHideOnLoad=true; </script> </body> </html>