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National Services Division Commissioning for Scotland's Health

The national designation process

Strengthening National Commissioning

Introducing the new framework for making recommendations on national commissioning: National Specialist Services Committee

The new decision-making framework for making recommendations on national commissioning was developed over the last year by a sub group of the Scottish Government Health and Social Care Directorates National Planning Forum and will come into use during the 2013/14 national commissioning cycle. It involves a full and systematic approach to decision making, centred around patients’ need and based on clearly defined evaluation criteria. The framework is designed to ensure a fair, transparent and structured process to produce high-quality, consistent and well-documented commissioning decisions on specialist services.

A new committee – the National Specialist Services Committee (NSSC) - has now replaced the previous National Services Advisory Group and met for the first time on 12 November 2012. Further details are included in the document National Specialist Services Committee (NSSC) - Remit, Membership, Criteria and Ways of Working.

NSSC is chaired by an NHS Board Chief Executive and comprises representatives of each territorial NHS Board in Scotland from a variety of disciplines - Medical Directors, Directors of Public Health, Planning, Finance, Workforce, a Chief Operating Officer - and the Chair of its National Professional Patient and Public Reference Group (NPPPRG).

NSSC’s decisions are informed through a robust advisory structure, co-ordinated by NPPPRG, which draws on expertise from existing professional, patient and public groups such as:

  • Scottish Academy of Royal Colleges and Faculties
  • National Planning Forum
  • NSD Public Reference Group
  • Patient Groups for specialist services
  • Scottish Government Speciality advisers
  • Public Health Network (Scotland)
  • General Practitioner representatives including SGPC and RCGP (Scotland)
  • Regional Planning Groups
  • Special NHS Boards, including Scottish Ambulance Service, NHS 24 and NHS Education Scotland
  • Healthcare Improvement Scotland: Scottish Health Technologies Group (SHTG), Scottish Medicines Consortium (SMC), Scottish Intercollegiate Guidelines Network (SIGN)
  • NHS Commissioning Board specialist commissioning team
  • English Advisory Group on National Specialist Services
  • UK Genetic Testing Network

NSSC meets quarterly and considers proposals for national commissioning of highly specialist health services, and services for people with rare disease and /or complex needs. It provides oversight of existing nationally commissioned services, and reviews these every 3-5 years.

Proposals for new national designated / commissioned specialist services may be submitted by clinicians and/or hospitals, supported by their NHS Board; by NHS Boards, Regional Planning Groups, or national groups. They could be, for example:

  • existing services provided for only part of Scotland which proposers wish to extend to provide treatment for all residents of Scotland with similar needs; or
  • new developments involving recently proven techniques; or
  • services not currently provided in Scotland for which patients have to travel to England or abroad; or
  • gaps in current provision for which there is an established patient need.

National specialist funding is not available for research – only for proven techniques.

Submitting Proposals

NSSC applies a three stage process to the consideration of proposals. Separate guidance is available for proposals for full national specialist patient services; and for national managed clinical or diagnostic networks.

National Specialist Patient Services application process

A “full national specialist patient service” attracts national funding for the actual costs incurred in the provision of clinical care and treatment (i.e costs of skilled staff time, theatre, ward, consumables, imaging, diagnostics, drugs used for inpatients). Guidance notes and application for submitting a proposal can be downloaded from the following the links below.

Stage 1

2015-16 Guidance on a full national specialist patient service [6 pages, 106Kb]

Appendix A - Application Process [1 page, 14kb]

Appendix B - Stage 1 Proforma Proposal [1 page, 77Kb]

Stage 2

Appendix C - Stage 2 Outline Proposal Guidance [6 pages, 122Kb]

Appendix Ci - Stage 2 Outline Proposal Evaluation [2 pages, 86Kb]

Appendix Cii - Stage 2 Outline Proposal Chief Executive Support [1 page, 62Kb]

Appendix Ciii - Stage 2 Outline Proposal Centre Information Proforma [1 page, 74Kb]

Appendix Civ - Stage 2 Outline Proposal Finance Worksheet [1 worksheet, 40kb]

Stage 3

Appendix D - Stage 3 Full Proposal Proforma [3 pages, 89Kb]

Appendix Di - Stage 3 Director of Finance Centre Support [1 pages, 62Kb]

Appendix Dii - Stage 3 Lead Director of Finance Support [1 pages, 62Kb]

Appendix Diii - Stage 3 Chief Executive Whole Proposal Support [1 pages, 62Kb]

Appendix Div - Stage 3 Completion Notes [2 pages, 150Kb]

Appendix Dv - Stage 3 Centre Information Proforma [1 pages, 74Kb]

Appendix E - Stage 3 Individual Provider Full Application Process [11 worksheets, 182Kb]

Appendix E - Stage 3 Summary of Full Application process [3 worksheets, 30Kb]

National Managed Clinical/Diagnostic Network Application Process

A “national managed clinical or diagnostic network” attracts only limited resource to support the management and administration of the network; and funding to recompense an NHS Board for backfill to provide some protected time for the Lead Clinician. There are existing network support offices in Glasgow, Lothian and Tayside and it is expected that any new national managed clinical or diagnostic network will be supported from within the current network support structure. Network support offices provide network management and administrative support to over 20 national networks at present. Guidance notes on the application process for NMCNs, and the pro forma for applicants is available from the document below:

2015-16 - Guidance on designation of NMCNs and editable pro forma for applicants [11 pages, 287Kb]

Proposals may be submitted throughout the year, and will be considered at the next meeting of NPPPRG and NSSC following submission of an outline or full proposal. NPPPRG considers proposals first, and provides professional, patient and public advice on the proposals to NSSC.

The final dates for submission for meetings are:

Submission timescales for proposals
Date for submission of proposals NPPPRG meeting NSSC meeting
Monday 10 October 2016 Thursday 3 November 2016 Wednesday 7 December 2016
Monday 23 January 2017 Monday 13 February 2017 Monday 20 March 2017
Monday 17 April 2017 Monday 8 May 2017 Monday 12 June 2017
Monday 31 July 2017 Monday 21 August 2017 Thursday 28 September 2017
Monday 9 October 2017 Wednesday 1 November 2017 Wednesday 6 December 2017

Further information on the NSSC can be found at the links below:

NSSC Decision Making [2 pages, 36Kb]

NSSC Frequently Asked Questions [1 page, 76Kb]