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National Services Division Commissioning for Scotland's Health

Risk Share

NSD manages four risk-sharing arrangements on behalf of NHS Boards:

Recombinant coagulate factor concentrates

This risk share scheme provides pooled funding for the provision of blood clotting conentrates for people with haemophilia and thrombophilia through the six haemophilia centres in Aberdeen, Dundee, Edinburgh, Glasgow, Inverness and the Royal Hospital for Sick Children, Glasgow.

National Protocols and Guidelines for Haemophilia Centres

In Scotland factor concentrates for haemophiliacs who use prophylaxis and /or home treatment can be delivered directly to the patient. The principal aim of the service is to provide a sensitive and personal home delivery service to haemophilia patients and their families. To improve the quality of care to patients at home who require to administer clotting factor on a regular basis thus enabling these patients and their families to lead as normal and active lives as possible.

The aim of the protocols are:

  • To set national agreed terms of reference in relation to home delivery within all haemophilia centres.
  • To be used as a tool to enhance home delivery service within a haemophilia centre

The National Protocols and Guidelines can be accessed through the following link

Haemophilia Protocols and Guidelines [51 Pages, 296Kb]

The spend in 2015/16 on recombinant coagulate factor concentrates and orphan drugs is reported below.

NHS Board Orphan Drug Usage 2015/16 (£) Recombinant & Commercial Factor Concentrates Usage 2015/16 (£)
Ayrshire & Arran  780,929 943,841
Borders  234,721 517,514
Dumfries & Galloway  186,693 454,437
Fife  740,217 1,412,736
Forth Valley  150,268 1,875,052
Grampian  1,546,963 2,118,314
Greater Glasgow & Clyde  2,904,154 6,834,071
Highland  362,240 971,988
Lanarkshire  881,743 1,205,821
Lothian  1,162,355 5,773,024
Orkney  0 0
Shetland  0 389,303
Tayside  465,166 1,705,568
Western Isles  0 344,934
9,415,449 24,546,604

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Orphan drug risk share

NHS Boards pool funding nationally to meet the costs of selected very high cost drugs for patients in Scotland.

General principles of risk share [2 pages, 135Kb]

List of drugs included (2 pages, 82KB)


Forensic medium-secure care for patients with learning difficulties

NHS Boards pool funding nationally to meet the costs of care and treatment for patients with learning disability who need medium secure care.

General principles of risk share scheme for forensic medium-secure services for patients with learning disabilities [3 pages, 162Kb]

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Specialised services from UK

Further information on specialised services in the UK is available in the following section of the NSD website:

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