NHS Specialised Services

Specialised Services National Definitions Set

Specialised services are defined in law as those services with a planning population of more than one million people. This means that a specialised service would not be provided by every hospital in England; generally, it would be provided by less than 50 hospitals.

The Specialised Services National Definitions Set (SSNDS) describe these services in more detail. The definitions provide a helpful basis for service reviews and strategic planning and enable commissioners to make comparisons on activity levels and spend. The definitions help with the identification of activity that should be regarded as specialised and therefore subject to collaborative commissioning arrangements. The 10 Specialised Commissioning Groups, acting on behalf of their member PCTs, are responsible for the commissioning arrangements for specialised services.

It should be noted that the definitions are not service specifications, descriptions of best/evidence based practice or service models and should not be used as a tool to change or inform clinical practice.

The second edition of the SSNDS, published in 2002, consisted of 35 definitions. Following the publication of the Carter Review of Commissioning Arrangements for Specialised Services in May 2006 it was agreed that the SSNDS would be updated. The third edition of the SSNDS was published in phases over 2009/10. The third edition of the SSNDS contains 34 definitions (4 definitions have been dropped and 3 new definitions have been added). Each definition has been updated/created by an inclusive process involving providers (clinicians, hospital managers, and information and coding staff), commissioners and patients’ groups. Every effort has been made to ensure that each definition contains all the relevant medical condition and treatment classification codes as well as referencing key policy and standards documents. The final version of each definition has been approved by the National Specialised Commissioning Group (NSCG) and endorsed by the relevant professional organisations.

Specialised services are constantly developing and changing; new specialised services will be provided by the NHS whilst other services will become more commonplace and cease to be specialised. At any moment there will be new specialised services that are not included in the SSNDS. The production of the SSNDS has to be seen as an ongoing process with new editions being produced from time to time.

Improving the SSNDS very much depends on the adequacy of diagnosis and intervention classification systems. The current classification systems used in the third edition are the International Classification of Diseases, version 10, and the OPCS Classification of Interventions and Procedures, version 4.5.

Queries and suggestions for possible improvements should be sent to: enquiries@nsct.nhs.uk

Below is a list of the Specialised Services National Definitions Set documents. These can also be accessed in the Specialised Services National Definitions Set category in the document library.

Definition No. 1: Specialised cancer services (adult)

Definition No. 2: Specialised services for blood and marrow transplantation (all ages)

Definition No. 3: Specialised services for haemophilia and other related bleeding disorders (all ages)

Definition No. 4: Specialised services for women's health

Definition No. 5: Assessment and provision of equipment for people with complex physical disability

Definition No. 6: Specialised spinal services (all ages)

Definition No. 7: Specialised rehabilitation services for brain injury and complex disability (adult)

Definition No. 8: Specialised neurosciences services (adult)

Definition No. 9: Specialised burn care services (all ages)

Definition No. 10: Cystic fibrosis services (all ages)

Definition No. 11: Specialised renal services (adult)

Definition No. 12: Specialised intestinal failure and home parenteral nutrition services (adult)