Public accounts committee delivers tough but right message on specialised services budget

15 July 2016

Over the last three years, spending on specialised services has increased at a faster rate (6.4% a year) than the NHS as a whole (3.5%) and now accounts for about 14% of the total NHS budget.

In its new report following an inquiry into NHS specialised commissioning, the public accounts committee (PAC) raises concerns that, despite the large increase in the budget for specialised services, NHS England has not kept its spending within the budget it set itself. 

To remain within its budget for specialised commissioning, NHS England will need to make tough decisions

It highlights that to remain within its budget for specialised commissioning, NHS England will need to make tough decisions, which include taking action in three areas:

Commenting on the report, Siva Anandaciva, head of analysis at NHS Providers, said:

“Providers of specialised care services face ever-increasing costs related to the commissioning and payment for the new devices and medicines their patients need. The PAC is right that we need a deeper understanding of the costs of these services.

"The PAC delivers the tough, but honest, message that the sustainability of the NHS as a whole and our ability to deliver the transformation envisaged in the NHS Five year forward view will be at risk if we do not keep the specialised services budget under better control. This means making hard but important decisions.

“We welcome the PAC’s recommendations for greater transparency on costs and more consistency of information from all providers. Engaging providers in this process will be crucial to designing and delivering more effective services. It is only through genuine partnership working between NHS England, local commissioners and providers that we can reduce variation, increase efficiency and most importantly improve the health outcomes for patients living with the most complex and rare conditions.

The PAC delivers the tough, but honest, message that the sustainability of the NHS as a whole and our ability to deliver the transformation envisaged in the NHS Five year forward view will be at risk if we do not keep the specialised services budget under better control

“Finally, as the recent report from the commission on specialised services recommended, we need a national strategy that takes better account of which services should be designed and commissioned nationally, regionally in networks, and locally in communities. The strategic framework recently developed by NHS England is an important first step in building this strategy.”