How it works – Specialised commissioning in England

Andrew Monahan

11 June 2019


The NHS treats over 54 million people in England each year. For some, the care they need is more unique than that provided to the majority of NHS patients. In these circumstances specialised services are available.

In 2017/18 the expenditure on specialised services in England was £16.4 billion across 140 different services, representing 15% of expenditure and growing more rapidly than any other part of the NHS in England.

This briefing outlines the commissioning of specialised services – what they are, how they differ from other NHS services, how they are commissioned and the process for service development. It will be of interest to anyone wishing to gain an understanding of how specialised services operate within the NHS in England. 


How it works – Specialised commissioning in England

June 2019 (PDF 441KB)