Specialist Services (UK) and Specialised Services
The links below will take you to the relevant section of the page.
- Services provided in England for residents of Scotland
- UK and English designated specialist services
- Other specialised services in England
Services provided in England for residents of Scotland
NSD funds services provided in England through two distinct funding streams:
- a contribution to the National Specialised Commissioning Team (NSCT) for Scottish access to designated highly specialist services which are provided on a UK basis
- by managing a pool of funds (risk share scheme) on behalf of NHS Boards for specialised services in England which are not nationally designated.
A full list of nationally funded servcies is available in the document below:
List of nationally funded services [8 pages, 341Kb]
UK and English designated specialist services
The National Specialised Commissioning Team is responsible for commissioning nationally designated clinical services which are either very low volume or require rare skills. In some circumstances, the portfolio of NSCT overlaps with Scottish nationally-designated services, e.g. adult liver transplantation or ophthalmic oncology and pathology. Some services for very rare conditions are only available at one or two sites in the UK.
NSD funds Scottish access to these services, although some are funded entirely by NSCT on a UK basis. Further information is available from the following external website:
National Specialised Commissioning Team website
Other specialised services in England
Since 1 April 2002, NSD has also administered a risk share scheme for NHS Boards to fund specialised services provided to residents of Scotland by NHS Trusts in England. NSD funds 35 sets of services at around 80 different NHS Trusts in England. The range of services is diverse. A list of these services, and further information is available from the following external website:
Specialised Services National Definition Set website
The clinical performance of these services is not monitored by NSD in the same way as designated national specialist services, instead the service is primarily a financial arrangement through which NSD meets the costs on behalf of NHS Boards from pooled funds. All decisions on appropriate treatment for any individual referred to England remain the responsibility of the NHS Board of the patient's residence.
NSD only funds treatment in England using the pooled funds from the risk share scheme if:
- The treatment is specialised and is included within the UK National Specialised Services Definition Set
- The treatment is provided in the NHS (not private) in England (not abroad)
- The service is not provided in Scotland
- The referral is from an appropriate tertiary specialist consultant in Scotland; and
- The service is not covered by a designated national specialist service funded through the NSD/NSCT service agreement
Decisions on funding are made on an individual referral basis by a virtual panel at NSD comprising the Medical Director, Nursing and Quality Adviser, and NSD Director.
Costs in 2010/11 were approximately £8m.
The specialised services definitions are broad headings and do not cover all care within these specialities. Non-specialised elements of care continue to be funded by NHS Boards. NSD is only responsible for commissioning these services within England. These definitions do not extend to funding of services in Scotland, Wales or Northern Ireland.
National Services Division works with the National Specialised Commissioning Group to foster collaborative working at a pan-Specialised Commissioning Group level. For more information, please visit the external National Specialised Commissioning Group website.
For further information on the commissioning of specialised services, please visit the external introduction to commissioning and specialised services commissioning website.
National Services Division contact:
Jean Travers, Commissioning Analyst
To contact members of NSD staff, please visit our staff contacts page.
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