NHS England has confirmed an additional 25 specialised services that all ICBs will take commissioning responsibility for from April 2025.
Three regions of England have already taken over in responsibility for the commissioning of special services as of 1 April, according to an NHS board meeting held on 28 March. These include ICBs across the East of England, Midlands and the North West of England.
However, ICBs in the South West, South East, London and the North East will not take on this responsibility until 1 April 2025. Instead, there will be ‘one more year’ of statutory joint commissioning arrangements between NHS England and the ICBs in these areas.
Julian Kelly, chief financial officer at NHS England, said at the board meeting that they have divided up the final number of services that will be delegated and those that will be retained by NHS England.
He said there were a total of 174 services to be divided up between NHS England and ICBs. However, there were 57 services within that number that had previously not been decided upon.
He confirmed that this final decision added 25 services that were now suitable and ready for delegation from April 2025 (see below), representing a total expenditure of £2,732m. These include several CAMHS services, haematology services and some mental health services.
The board also heard that the remaining 32 services, worth £863.1m, would remain with NHS England, including gender dysphoria services and genomic services.
While ICBs will take on the funding and commissioning of 70 specialised services altogether, the specifications will remain in NHS England’s remit.
He said: ‘The two things to note are, number one we have done some further work to complete our view and recommendation on those services which we are going to delegate and those services we are going to retain and broadly there are 70 services [that will be delegated]. There are 104 we will retain.
‘The second thing to note is as of the 1 April, responsibility for commissioning the delegated services in the East of England, the Midlands and the North West will pass to the ICBs.
‘Those regions are largely operating under single joint commissioning arrangements, but it will pass to them with the clear plan that all regions and all ICBs will take on responsibility for commissioning as of 1 April 2025.’
Services suitable and ready for delegation from April 2025
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Service line description |
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Complex home ventilation (adults) |
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Secure and specialised mental health services (Adult) (Medium and low) – excluding LD/ASD/WEMS/ABI/DEAF |
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Secure and specialised mental health services (adult) (Medium and low) – ASD MHLDA PC |
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Secure and specialised mental health services (adult) (Medium and low) – LD MHLDA PC |
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Adult specialist eating disorder services MHLDA PC |
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Renal transplantation |
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Haematopoietic stem cell transplantation services (adults and children) |
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Extracorporeal photopheresis service (adults and children) |
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Tier 4 CAMHS (general adolescent inc eating disorders) MHLDA PC |
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Tier 4 CAMHS (low secure) MHLDA PC |
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Tier 4 CAMHS (PICU) MHLDA PC |
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Tier 4 CAMHS (LD) MHLDA PC |
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Tier 4 CAMHS (ASD) MHLDA PC |
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Cystic fibrosis services (adults and children) |
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FCAMHS MHLDA PC |
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Castleman disease |
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Penile cancer (adults) |
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Management of central airway obstruction (adults) |
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Sickle cell anaemia (adults and children) |
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Thalassemia (adults and children) |
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Specialist immunology services for adults with deficient immune systems |
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Specialist immunology services for children with deficient immune systems |
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Specialist perinatal mental health services (adults and adolescents) MHLDA PC |
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Specialist augmentative and alternative communication aids (adults and children) |
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Specialist environmental controls (adults and children) |
