A01. Specialised Respiratory

Respiratory services deal with patients with breathing difficulties. Respiratory disease services are usually provided by respiratory physicians in local hospitals. However, some diseases are very rare while other more common ones can lead to complex problems.


This Clinical Reference Group (CRG) covers:

  • services for people with severe and difficult-to-control asthma
  • services for people with interstitial lung disease
  • services for people requiring management of complex respiratory disease who will need complex assisted ventilation at home
  • services for people with pulmonary hypertension, including complex surgery
  • services for people with cystic fibrosis.


Professor Andrew Menzies-Gow, Director of the Lung Division, Royal Brompton Hospital, Professor of Practice (Respiratory Medicine) Imperial College, National Clinical Director for Respiratory Services NHS England and Improvement.

  • Prof David Kiely, clinical member
  • Prof Andrew Jones, clinical member
  • Dr Robina Coker, clinical member
  • Dr  Hitasha Rupani, clinical member
  • Dr Luke Howard, clinical member
  • Dr Ian Balfour-Lynn, clinical member
  • Dr Michael Davies, clinical member
  • Dr Lisa Spencer, clinical member
  • Kathy Blacker, lead commissioner
  • Prof Anna Murphy, pharmacy lead
  • Dr Neil Hamilton, pharmacy lead
  • Dr Amanda Bevan, pharmacy lead
  • Helen Potter, commissioning pharmacist
  • Dr Martin Allen, GIRFT lead
  • Dr Annette Wood, Public Health England lead
  • Rebecca Cosgriff, Patient and Public Voice representative
  • Steve Jones, Patient and Public Voice representative
  • Lottie Renwick, Patient and Public Voice representative


A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 Hub Commissioning Teams to contract services on an annual basis.

Service Specifications

Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care. The specifications have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe both core and developmental service standards. Core standards are those that all funded providers should be able to demonstrate, with developmental standards being those which may require further changes in practice over time to provide excellence in the field.

The following service specifications fall within the scope of this CRG:


A commissioning policy is a document that defines access to a service for a particular group of patients. A NICE Technology Appraisal Guideline on the same topic will replace, or be incorporated into, a commissioning policy as appropriate. These are important documents that are developed to ensure consistency in access to treatments nationwide.

The following policies fall within the scope of this CRG:


Not routinely commissioned: