NHS England responds to patient feedback and consults on prioritising specialised services

NHS England today launches a new consultation about how it will prioritise which specialised services and treatments to invest in. Patient groups asked it to consult on changes to the principles and process by which it makes these decisions.

NHS England directly commissions around 145 specialised services. In order to ensure the maximum number of patients benefit from new innovative treatments coming on stream, choices need to be made about which of these to fund.

In carrying out a public consultation, NHS England will ensure the principles and process for making these decisions are well informed, evidence-led and in line with the expectations of patients and the public. The consultation will last for 90 days from 27 January 2015.

Richard Jeavons, Director of Commissioning Specialised Services at NHS England, said: “We want to ensure patients have access to the very best innovative, evidence-based treatments and services that are being developed all the time. We need to get the most out of every pound for the benefit of patients. They asked us to consult on the principles and process behind making these decisions, which is exactly what we are doing.”

This process is looking at the specialist treatments and services that will be routinely available for groups of patients on the NHS. Clinicians, on behalf of their patients, will continue to be able to make a request (an Individual Funding Request) to NHS England for treatment that is not routinely available.

NHS England is also undertaking an engagement exercise to seek views on which specialised services should be prioritised for ‘service reviews’ as part of a rolling programme of reviewing how each specialised service is delivered. NHS England is writing to all providers of specialised services, Clinical Reference Groups and associated patient groups seeking their views on where to concentrate efforts over next 12 – 24 months.  A number of engagement events and workshops are also being planned. Views on which areas to prioritise for service reviews can also be emailed to us.

NHS England also said today that it has listened to patients and clinicians and would continue national commissioning of specialist renal and morbid obesity services in 2015/16. It said it will keep under review whether to transfer responsibility to clinical commissioning groups, but any changes would not happen before April 2016.

Commenting on the decision to continue commissioning specialist renal and morbid obesity services at a national level, Richard Jeavons added: “We all want what is best for patients, and we have listened extremely carefully to their views and those of CCGs. For the time being we will continue to directly commission these services, which will give us head room to work through the proposals in more detail and address the issues that have been raised with us.”


  1. Tony Lincoln says:

    My grandson aged 11 has the “nonsense mutation” of Duchenne Muscukar Dyxtrophy and I have been keenly following the situation regarding the funding of Translarna.
    NHS England in deferring a decision on providing funding for translarna has again demonstrated its breathtaking inability to listen to patients needs or consider the merits of providing a drug to children who are in desperate need. The condition of children suffering Duchenne Muscular Dystrophy will continue to deteriorate to a point whereby a number of children will be unable to walk and, thus, not qualify to receive treatment with translarna. A terrible disgrace and it makes me wonder how in GB we cannot look after our youngsters in a way to give them a chance. Please explain to me how Germany, France, Italy, Spain and, believe it or not, Greece(where there is no money) are all prescribing translarna to patients. NHS Englznd has failed and those at the top should be ashamed of themselves.
    Tony Lincoln
    Kent TN16 1BD

  2. Ken Sharp says:

    Thanks for sharing the article. Prioritizing services is good but it must be very useful to patients in all means. Ours is a Medical Call Center offering quality services and are always available to receive the patients.


      Dear Sir/Madam,

      I am Laith Algharagholy from Iraq, my close reletive (7 years old) is in need for the Translarna medicine as many doctors said in Iraq, and as it is well-known we can not find this medicine in Iraq, it is very urgent case, please Sir could you help me with this, if so I would be very grateful.
      I look forward to hearing from you as sson as possible


      Laith Algharagholy
      Dhi-Qar/south of Iraq

  3. Dr and Mrs John Baker says:

    Re: Draft Clinical Commissioning Policy on the use of Translarna for the treatment of Duchenne Muscular Dystrophy (DMD).
    Our two young grandsons both have DMD. The eldest who is 5 yrs 4 mths, was diagnosed with the condition in December 2013, followed by the same diagnosis for his younger brother, who is 2 yrs 11 mths, last February.
    Neither my wife nor I are medically qualified (although I was a former special school headteacher and have a doctorate in education) or do we have any direct connections with any pharmaceutical company, however we believe strongly that the recent delay in the decision-making process regarding NHS England moving forward on licensing the drug Translarna for the treatment of a small percentage of children who have DMD is very worrying. Our son and his wife have been informed by Great Ormond Street Hospital, where their children are outpatients, that both boys have the strain of DMD that would be amenable to treatment with Translarna, and that our eldest grandson could commence the treatment immediately as his age, medication and physical development all meet the prescribing criteria.
    There may be much that already is being done by the National Health Service in terms of conducting trials with this new drug and undertaking research, and we are aware that Translarna has already been approved (subject to certain conditions) and is being used within the European Union
    Our reason for submitting this personal statement is that any delays in the introduction of such an important drug in the treatment of this life-limiting condition could have very long-term ramifications for any child with DMD, including – of course – our two dear grandsons, and we hardly need to tell you how extremely grateful our son and his wife would be if the decision is made to introduce and fund this drug here in the UK.
    John and Patricia Baker (grandparents)

    • Mark Silverman says:

      Translarna is available in other European countries including France, Germany, Italy and Spain. There is no excuse to hide behind processes and reviews when the drug has been given conditional approval by the EMA for what is the most common, fatal genetic condition affecting children. The Prime Minister has stated that he wants this resolved and there is absolutely no excuse for any further delay in making this drug available to treat those living with serious and life-limiting condition.

  4. DG says:

    You mustn’t continue to neglect sufferers of Duchenne muscular dystrophy, both in terms of care and drug approval. And the issues with this neglect aren’t only important for Translarna, but for all the drugs that will follow for Duchenne sufferers that can’t be helped by Translarna.
    I realise you’re consulting on how to prioritise, rather than what to prioritise, but children are dying from DMD while you delay this. I honestly couldn’t look myself in the mirror if I was responsible for this.

    [link removed]

  5. Clive Woodard says:

    I understand that NICE Technology Appraisals will be deemed “First Order” but where do NICE Interventional Procedure Guidelines (IPG’s) fit?

    Best wishes

    CW Healthcare Consultancy Ltd

  6. paul taylor says:

    Whilst commissioning has to be looked at periodically the way in which services are delivered must be part of that.
    Take dialysis as an example, there are many companies which can deliver the service but do not care about the patient pathway, all they want to do is get them in, put them on the machine, take them off utilising their own company products which can be no good to the patient themselves. Any complications that arise due to their dialysis means they have to visit A&E or struggle to get the appropriate intervention thorugh their renal specialst

  7. Karen Coupe says:

    The decision was made last year to remove dialysis and obesity from NHS. The so called consultation process was a farce as no one knew about it. The online questionnaire looked like it had been trown together by someone who’d been told to throw something together in half an hour. Of the 36 questions, 12 asked about ethnicity and much of the rest asked questions I’d expect a Chief Executive to answer which were who should take the blame when it all goes wrong. The whole idea is absurd. Only someone wanting to save money would think that an organisation can take over services that experienced people have worked for decades to get processes as right as possible after just a few months.

  8. Isabel leggett says:

    All this is better news that we have recently but I do not understand why morbid obesity is classed in the same way as renal is classed?