Specialised care

Our vision

Improved patient experience through more joined up services; improved health outcomes; and equitable access to high quality sustainable specialised services. Providers will be incentivised through improved financial incentives over the longer term, reducing demand, where appropriate, and reducing unwarranted variation.


Our challenges

Over the past 18 months, NHS England has listened to many patients’ experiences of specialised services. Feedback tells us that current care pathways can be disjointed, particularly where the commissioning responsibility for services changes. This can lead to gaps in provision and poor sharing of data, which is simply not acceptable and cannot possibly produce the best outcomes for patients. We know we can do better by patients and improve outcomes for local populations.


We have a duty as commissioners to reduce inequalities and work collaboratively to improve outcomes for populations.


Patients often receive specialised care following treatment within primary and secondary care. NHS England and CCGs together commission all of these services and should work closely with their local authority and public health partners, to ensure an integrated patient and population centred approach. We therefore need to develop a more collaborative approach to specialised commissioning and make it easier for commissioners to work together to better align pathways, and service models across the system.


We know that many CCGs are keen to have a greater say over the commissioning of specialised services, to develop a more holistic and integrated approach to improving healthcare for their diverse local populations. If we get this right, we believe there are significant opportunities to enhance the commissioning system, reduce inequalities and secure health gains within local health economies – from aligning priorities for services and patient pathways, to securing transformation savings. The intention is to move towards a more differentiated approach to specialised commissioning from 1 April 2015, within a commissioning framework that identifies the optimal population, service model and pathways required for key service groups, as we believe this will deliver the best outcomes for patients.


About the programme

The specialised commissioning programme through a joint committee will focus on two key areas:

1. Collaborative commissioning with CCGs – to ensure CCGs to have a greater say over  the commissioning of the majority of specialised services.

2. Devolving services to CCGs – inform recommendations to Ministers to devolve commissioning responsibility for services to CCGs where it is considered appropriate.