Commissioning and adoption - Specialised commissioning

Specialised commissioning supports technologies and treatments for patients with rare and complex healthcare needs. These technologies and treatments require specialist staff and centres, so not every hospital is able to provide these services.

Specialised commissioning covers conditions such as rare genetic disorders, cancers and some surgical needs. They are grouped in into 6 national programmes of care:

• Cancer
• Mental health
• Blood and infection – infection, immunity, and haematology
• Internal medicine – digestion, renal, hepatobiliary and circulatory system
• Trauma – traumatic injury, orthopaedics, head and neck and rehabilitation
• Women and children – women and children, congenital and inherited diseases

The 6 programmes are formed from 149 specialist commissioning areas, split between NHSE and ICSs. There is an ongoing transition to move a greater proportion of specialised commissioning services into the remit of ICSs. Currently a minority of these areas are delegated to ICSs, however, this number is due to rise in the future.

Applications for an innovation to be supported by specialised commissioning are reviewed by Clinical Priorities Advisory Group (CPAG). It ranks all submitted applications for the benefits that each technology will provide to patients. The cost impact of these innovations is reviewed separately. Once both assessments have been carried out, the innovations which provide the most benefit to patients are funded within the specialised commissioning budget available.