From 1 April 2025, responsibility for 70 specialised services will move from NHS England to Integrated Care Boards. The delegation of these services to ICBs is part of a wider shift towards a more strategic, whole population approach to commissioning that aligns with the government’s priorities for the NHS.
Taking on the responsibility for commissioning 70 specialised services across north central London brings great opportunities for us to increase investment in prevention of ill health and better manage future demand as well as support shifts in care from acute to community settings, improve integration and design services that better enable underserved communities to access care.
In north central London, to support this change, we are finalising a comprehensive Clinical Strategy to guide the ICB’s approach to prioritising and addressing inequalities in specialised services. Our approach is aligned with the NCL Population Health and Integrated Care Strategy with the initial focus on liver disease, renal services and sickle cell disease.
For renal services we now have a consistent NCL-wide service for people with chronic kidney disease and are investing more into expanding dialysis capacity. We are making sure people waiting for transplants are ready when one becomes available by using a programme called K-FiT which helps them manage their weight if necessary so that they are suitable to go on the waiting list. We are also investing in identifying those at risk of developing kidney problems.
For liver disease we have created a network to tackle the rising prevalence of disease that has already seen a 90% reduction un unnecessary referrals and developed a unified pathway for the early detection of liver disease. We have launched a seven day per week support service for people with alcohol issues across Royal Free, Barnet, and Chase Farm Hospitals, expanded diagnostic capacity, and implemented an early screening programme to protect people’s health as early as possible. This work has been picked up by NHSE who are working with NCL to shape the work we are doing into a national programme.
For sickle cell we have made great progress both to enhance community services and expand awareness of this life-long condition as well as developing new pathways to enable those in sickle cell crisis to bypass our Emergency Departments. We have also developed a peer mentoring programme for people with sickle cell disease which has received very positive feedback from participants.
Find out more: Specialised commissioning