The NHS is making changes to how some specialised health services are planned and delivered. From 1 April 2025, Integrated Care Boards (ICBs) will be directly responsible for commissioning 70 specialised services previously commissioned by NHS England.
Specialised services are generally accessed by comparatively smaller numbers of patients serving larger catchment populations than other ICB commissioned services. These services tend to be located in larger hospital trusts that can recruit a team of staff with the appropriate expertise and enable them to develop their skills.
If you, your baby or someone you know received care in a neonatal unit when they were born, or if you, your family or friends have experienced chemotherapy, radiotherapy or kidney dialysis for example, it is likely that you have used a specialised service
NHS England will continue to set consistent national standards, services specifications. and clinical commissioning policies; develop metrics and quality dashboards to support improvement, oversight and assurance; and provide national clinical leadership, expert advice and support to ICBs.
The role of Integrated Care Boards
North Central London Integrated Care Board (NCL ICB) is enthusiastic about the benefits to patients that taking on commissioning 70 specialised services across north central London brings. ICBs now have a significant opportunity to enable access to care closer to home, ensure everyone has fair access to high quality services, and integrate specialised and non-specialised pathways to improve the health and wellbeing of patients across London.
ICBs and providers will have the freedom to design services and to innovate, allowing a multi-disciplinary approach to planning patients’ care.
This transformation aligns service delivery with local needs while upholding national standards. ICBs are integrating these new commissioning duties into our corporate structure, ensuring accountability and a seamless continuation in service provision.
This isn’t just a shift in responsibilities; it’s an opportunity to embed specialised services into our wider commissioning portfolios, driving whole pathway improvement.
To support this change, NCL ICB is 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 where we have already made significant improvements.
What does this mean for patients?
Enabling ICBs to commission specialised services aims to improve patient care, reduce waiting times, and ensure people in London receive the best possible treatment when they need it.
For example, it will:
- enable the planning, commissioning and provision of better and more integrated services for patients across whole and linked pathways of care
- support key aims of the government’s forthcoming 10-year plan to bring about a shift from sickness to prevention, and from hospital to community
- strengthen the role of ICBs to act as strategic commissioners and lead on population health, with providers of specialised services increasingly reaching out and into neighbourhood health and care systems
North Central London ICB
Along with being one of the five London ICBs responsible for commissioning delegated specialised services in the London Region, NCL ICB is also taking the role of ‘host’ employer to ensure the safe and effective transfer of employment of staff from NHS England’s London region currently working on delegated specialised services.
Staff identified for transfer will TUPE to NCL ICB (the future host of the multi-ICB specialised commissioning team) on 1 July 2025. This will make sure that the ICBs have access to expertise and resources to support them in delivering their new responsibilities and to maximise the benefit to London’s patients.
Retained Services (South Region)
NHS England will retain responsibility for commissioning 84 specialised and highly specialised services which, although representing only a small percentage of the spend on specialised services, are too complex to delegate at this time particularly as they need to be commissioned on footprints larger than single ICBs. A new single national retained team is organised into three geographically focused units.
The South retained unit will hold commissioning responsibility for 84 specialised services covering London, South East and South West regions. The team will be accountable to the National Director of Specialised Commissioning in NHSE.
For more information on the delegation of specialised commissioning please visit: NHS England » Specialised Commissioning – update on specialised services for delegation