Introduction
Specialised services are generally provided in relatively few hospitals and accessed by small numbers of patients. These services are usually for patients who have rare conditions or who need a specialised team working together at a centre. There are currently 146 specialised services, covering a diverse range of disparate and complex services, from services for long-term conditions, such as renal (kidney) and mental health problems, to services for uncommon conditions such as rare cancers. Some specialised services, such as those for cystic fibrosis, cover the majority of care for patients with these conditions. However, most specialised services only form a part of a patient’s care and treatment pathway. Some highly specialised services, including those for very rare diseases, are only provided at a very small number of centres across the country. Others, such as chemotherapy services, are provided by most acute hospitals.
In April 2013, NHS England took on responsibility for commissioning specialised services. The Secretary of State for Health is responsible for deciding which services should be commissioned as specialised services by NHS England. Through its commissioning of these services NHS England aims to: improve outcomes for patients; ensure patients have equal access to services regardless of location; and improve productivity and efficiency. Between 2013–14 and 2015–16, the budget for specialised services increased from £13 billion to £14.6 billion, an increase of 6.3% a year on average. Over this period the budget for the NHS as a whole increased by 3.5% a year on average. By 2020–21, the budget for these services is expected to rise to £18.8 billion, 16% of the total NHS budget.
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12 July 2016