Status: As per delegation arrangements
Effective date: 1 April 2026
Next review date: 1 April 2031
Specialised services are those provided in relatively few hospitals, accessed by comparatively small numbers of patients but with catchment populations of usually more than one million. These services tend to be located in specialised hospital trusts that can recruit a team of staff with the appropriate expertise and enable them to develop their skills.
NHS England is the accountable commissioner for a portfolio of ~150 specialised services. These include a range of services from renal dialysis and secure inpatient mental health services, through to treatments for rare cancers and life-threatening genetic disorders. A list of all specialised services commissioned by NHS England can be found here.
Commissioning responsibility for 59 specialised services has been delegated, since April 2023, to nine statutory joint committees formed between integrated care boards (ICBs) and NHS England Regions. The ICB has responsibility for implementing agreed policies for delegated specialised services. A list of the delegated services can be found here.
All services will continue to be prescribed specialised services regardless of whether they are retained for commissioning by NHSE or delegated to ICBs.
All prescribed specialised services will continue to need to adhere to national standards, service specifications and clinical access policies. NHS England policies for routinely commissioned treatments.
ICBs and NHSE will ensure that all prescribed specialised services meet the needs of local populations (regardless of where they live in England) and that inequalities in access are reduced to create high quality care and outcomes for all.
Exceptional funding requests for specialised services must be directed to NHS England and will not be considered by Essex ICB
Essex ICB will not fund any activity (or associated drugs/devices) for these specialised services outside specialist commissioning arrangements. Patients must be referred to specialised centres commissioned by NHS England. Key documents can be found on the NHS England website (opens in a new tab)
The following are commonly requested treatments / procedure that at the time of publication are the responsibility of NHS England. The list is not exhaustive, and providers must check the NHS England website (opens in a new tab) for the current commissioning position.
- Autologous chondrocyte implantation (ACI) of the knee
- Bone Anchored Hearing Aids
- Cochlear Implants
- Gender Dysphoria
- Gastro-electrical stimulation for gastroparesis
- Penile Prosthesis/Implants
- Sacral nerve modulation for faecal or urinary incontinence