NHS England has launched a new consultation about how it should prioritise which specialised services and treatments to invest in.

The agency directly commissions around 145 specialised services, costing around £14 billion a year. Year-on-year, the service comes under pressure for substantial growth in activity and costs, and in order to ensure the maximum number of patients benefit from new innovative treatments coming on stream, choices need to be made about which of these to fund, it says. The consultation follows requests from patient groups for it to consult on changes to the principles and process by which it makes these decisions.

‘We want to ensure patients have access to the very best innovative, evidence-based treatments and services that are being developed all the time. We need to get the most out of every pound for the benefit of patients,” said Richard Jeavons, director of commissioning specialised services at NHS England.

The proposed principles underpinning decision-making on which it is consulting emphasise transparency, involvement of diverse stakeholders and the importance of funding only treatments and interventions for which there is good evidence, and whose provision is fair and equitable and represents a reasonable cost to the public. 

“NHS England will not confer higher priority to a treatment or intervention solely on the basis it is the only one available,” the consultation document states. It also notes that the Cancer Drugs Fund currently remains outside these arrangements.

The process is looking at the specialist treatments and services that will be routinely available for groups of patients on the NHS. Clinicians will continue to be able to make an Individual Funding Request to NHS England, on behalf of their patients, for treatment that is not routinely available.

The agency is also undertaking an engagement exercise to seek views on which specialised services should be prioritised for service reviews, as part of a rolling programme of reviewing how each specialised service is delivered. It is writing to all providers of specialised services, clinical reference groups and associated patient bodies to ask their views on where to concentrate efforts over the next 12-24 months.

The consultation runs from January 27 to April 27.