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: