NHS England has announced the decisions made by its Directly Commissioned Services Committee (DCSC) in relation to specialised services.

The decisions of the committee, which met in May, will, in future, be communicated via a new stakeholder newsletter, which is currently being developed, and which will be accessible both via direct mail, and through the NHS England website.

The DCSC is a decision-making committee which considers recommendations made by the Clinical Priorities Advisory Group (CPAG).

At its May meeting, members considered recommendations made at CPAG meetings in March and April.

The DCSC agreed to the revision of a number of existing specialised service specifications and commissioning policies, which have been amended either to include additional information, or to provide clarity about certain points. In all cases, the revisions were tested with stakeholders who did not consider that the suggested amendments required formal consultation.

The amended documents have been added to the relevant Clinical Reference Group (CRG) pages on the NHS England website. The relevant web links can be seen below. Amended specifications and policies are:

• Clinical commissioning policy: Disease modifying therapies for patients with multiple sclerosis (Gateway ref: 01719)
• Clinical commissioning policy: Targeted therapies in the treatment of pulmonary hypertension in adults (Gateway ref: 01720)
• Service specification: specialised pain (Gateway ref: 01722)
• Service specification: paediatric medicine – allergy (Gateway ref: 01723)
• Service specification: paediatric neurosciences – neurodisability (Gateway ref: 01721)

The DCSC also agreed a number of policies for public consultation. They are:

• Clinical commissioning policy: Bortezomib for the treatment of refractory antibody mediated rejection post kidney transplant;
• Clinical commissioning policy: Eculizumab for the treatment of refractory antibody mediated rejection post kidney transplant;
• Clinical commissioning policy: non-invasively lengthened spinal rods;
• Clinical commissioning policy: Dolutegravir for treatment of HIV-1 in adults and adolescents.

Consultation launched on 25 June 2014 and will be open for a period of 12 weeks, after which the DCSC will consider feedback received and make a decision about future commissioning arrangements. The consultation can be found at: Consultation on specialised services clinical commissioning policies

There were two clinical commissioning policies where CPAG recommended that the services should not be routinely commissioned by NHS England at this time. The DCSC endorsed this recommendation and agreed that both services should be considered through NHS England’s prioritisation process later this year. In both cases, NHS England will publish a commissioning policy statement, setting out the agreed commissioning position, in due course. The services which were not agreed for routine commissioning are:

• Levodopa-Carbidopa intestinal gel for advanced Parkinson’s Disease;
• Oncotype DX, a gene profiling test which is used in the treatment of breast cancer

In addition, the DCSC agreed that the revised service specification for osteo-ordonto-keratoprosthesis for corneal blindness, which is a highly specialised service, should be referred to NHS England’s Rare Diseases Advisory Group in order to obtain additional information for consideration by CPAG at a future meeting.

It was agreed that the existing policy be revised, but it will be considered again at the July CPAG meeting, in order to take into account further NICE guidance and definition, which needs to be incorporated before a revised policy can be published.