Public Accounts Committee

NHS Specialised Services inquiry

Inquiry status: Concluded

Report published 15 July 2016. Government response published 7 November 2016.

Report published

Specialised services in the NHS are those provided in relatively few hospitals, accessed by comparatively small numbers of patients but with catchment populations of more than one million. These services tend to be located in specialised hospital trusts that can recruit a team of staff with the appropriate expertise and enable them to develop their skills Specialised services account for approximately 13% of the total NHS budget, spending circa £14.7 billion per annum (2015–16).

The commissioning of specialised services is a prescribed direct commissioning responsibility of NHS England Four factors determine whether NHS England commissions a service as a prescribed specialised service. These are:

  • The number of individuals who require the service;
  • The cost of providing the service or facility;
  • The number of people able to provide the service or facility
  • The financial implications for Clinical Commissioning Groups (CCGs) if they were required to arrange for provision of the service or facility themselves.

There are over 140 specialised services, covering a diverse range of disparate and complex services from long-term conditions, such as renal services, specific mental health problems, to rarer conditions such as uncommon cancers, burn care, medical genetics, and paediatric cardiac surgery.

The National Audit Office (NAO) are currently examining whether NHS is delivering value for money in the commissioning of specialised services. It will examine whether NHS England has a delivery plan to implement its strategy for the commissioning of these services; whether NHS England is commissioning these services effectively; and whether NHS England is able to gain assurance that these services are being delivered efficiently and effectively in line with its objectives for patient outcomes and access to services.

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