Update on delegation of Specialised Services

08/04/2025

Information shared Specialised Commissioning, NHS England

Following the Government’s announcement that it is to bring the functions of NHS England into the Department of Health and Social Care we wanted to provide a brief update on what this means for the specialised commissioning function and the delegation of some specialised services to ICBs.

NHS England has now announced the incoming team who will help lead the organisation’s transition. The team – called the NHS Transformation Executive Team – will replace the current NHS England Executive Group and will support ongoing business priorities, statutory functions and day to day delivery.

Specialised commissioning is a key statutory responsibility of NHS England so these functions will need to continue going forward and we do not expect any immediate changes to how services are commissioned for patients as a result of this month’s announcement.

For now, the full range of functions delivered by specialised commissioning will continue as planned. You should therefore continue to liaise with NHS England on all operational and policy matters including attending any scheduled meetings relating to specialised commissioning (where relevant to you).

However we recognise that the announcement could be unsettling to some, and we want to assure you that we will keep you updated as plans develop and become clearer.

Delegation

We can confirm that plans to delegate commissioning responsibility for 70 specialised services to all ICBs in the North East and Yorkshire, London, South East and South West regions from April 2025 as well as to delegate an additional 11 services to those ICBs in the Midlands, North West and East of England regions that took on full delegated commissioning responsibilities this year, will continue as planned and agreed by the NHS England Board in December 2024, on 1 April 2025.

Delegation of these suitable and ready specialised services will :

enable the planning, commissioning and provision of better and more integrated services for patients across whole and linked pathways of care;
support key aims of the government’s forthcoming ten-year plan to bring about a shift from sickness to prevention; and from hospital to community;
strengthen the hand of ICBs to act as strategic commissioners and lead on population health, with providers of specialised services increasingly reaching out and into neighbourhood health and care systems.

Plans to delegate suitable specialised services were first set out in the May 2022 Roadmap for Integrating Specialised Services within Integrated Care Systems and enabled by the legislative provisions in the Health and Social Care Act 2022.They have been developed in close collaboration with NHS England’s regional teams, ICBs, specialised service providers clinicians and patient groups. They represent the outcome of a thorough assessment of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning.

Although commissioning responsibility for 70 services is being delegated to ICBs, commissioning accountability will continue to rest with NHS England for the time being. In this role, NHS England will continue to set consistent national standards, services specifications and clinical commissioning policies; develop metrics and quality dashboards to support improvement, oversight and assurance; and, provide national clinical leadership, expert advice and support to ICBs through our Clinical Reference Group infrastructure.

Approximately 100 specialised services, including all highly specialised services, will not be delegated to ICBs and will continue to be the direct commissioning responsibility and accountability of NHS England.

If you have any questions on any of the above you can email us at england.scengagement@nhs.net

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