National Services Division Commissioning for Scotland's Health
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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 [58 Pages, 568Kb]


The spend in 2009/10 on recombinant coagulate factor concentrates and orphan drugs is reported below.

Risk Share spend 2009/10
NHS Board Recombinant and Commercial Factor Concentrates Usage 2009/10 (£s) Orphan Drug Usage 2009/10 (£s)
Ayrshire & Arran 1,183,956 414,208
Borders 891,217 240,021
Dumfries & Galloway 408,506 -
Fife 1,562,869 491,281
Forth Valley 1,155,990 135,179
Grampian 2,719,525 626,447
Greater Glasgow & Clyde 5,590,389 2,059,852
Highland 2,402,132 373,393
Lanarkshire 2,107,482 269,179
Lothian 6,302,870 365,586
Orkney 1,132 -
Shetland 453,813 -
Tayside 2,167,951 236,482
Western Isles 80,698 -

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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 [1 page, 107Kb]


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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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