On 3 October, NHS England published "Prescribed Specialised Services Commissioning Intentions", a paper setting out its intended approach to dealing with the commissioning of specialised services.

Broadly speaking, NHS England is adopting a six-stranded strategic approach:

  1. ensuring consistent access to effective treatments for patients, in line with evidence based clinical policies, underpinned by clinical practice audit;
  2. a clinical sustainability programme with all providers focused on quality and value;
  3. a financial stability programme with all providers, focusing on better value;
  4. a systematic market review for all services to ensure the right capacity is available, consolidating services where appropriate to address clinical or financial sustainability issues;
  5. adopting new approaches to commissioning care, where it promotes integrated case and clinical oversight for patients in particular services and care pathways;
  6. a systemic, rules-based approach to management of contractual service delivery.

These principals are fleshed out in more detail in the paper, and are likely to be developed further in NHS England’s proposed five-year plan for specialised services, to be published as part of its overarching "Call to Action" strategy document in April next year.

NHS England also takes the opportunity to set out its intended approach in respect of a number of specific areas, including dialysis services, individual funding requests, the Cancer Drugs Fund, "at scale" procurement of drugs and devices not covered by the tariff (which, it is estimated, will result in a saving of £400m over five years), commissioning of post-transplant immunosuppressants, mental health, innovative radiotherapy, paediatric cardiology, genetics and haemophilia tendering.

The paper can be accessed via this link.