Tier 4 personality disorders

This Clinical Reference Group (CRG) covers mental health services for tier 4 personality disorders

Respond and Advise CRGs are established where a service does not currently have a formal national work programme or national transformation programme, but where NHSE requires expert clinical advice.

This form of CRG will operate in a very responsive and flexible way, responding to requests for advice and input from national and regional teams alongside Integrated Care Systems.


The CRG may at times inform commissioning policy or national standards, provide advice to support the provision of ministerial, parliamentary or media briefings, and advise on prioritisation and innovation.




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.

Get involved

If you are interested in the work of the CRG or its NPOC, you can register as stakeholder.

For details on our latest consultations please visit the NHS England consultation hub.

Get in contact

For any questions or queries relating to the work of the xx CRG or its NPOC, please contact: england.specmh@nhs.net