• Spending on specialised services due to rise by 5.6 per cent each year
  • Share of budget also set to grow more steeply

Spending on specialised services is due to rise by around 5.6 per cent per year under new commissioning plans – significantly more than spend on local mental health and community services.

The share of NHS England’s budget allocated to specialised services is also set to grow more steeply than it did in the previous five years.

The NHS long-term plan has made high profile spending commitments for mental health and community services, which have historically suffered from a lack of investment relative to physical health and acute and specialist services.

But HSJ analysis of commissioning allocations published last week by NHS England shows its specialised services budget would benefit from the highest average annual growth rate over the next five years, of 5.6 per cent in real terms.

Budgets for specialised services are used to pay for highly specialised drugs and equipment, which are often subject to higher rates of inflation than services, in which the workforce represents a higher proportion of spend. In recent years, it has seen high profile cost pressures from very expensive new treatments, resulting in NHS England working to limit their introduction to the NHS and access.

Mental health spending is expected to rise by 3.6 per cent, while spending on “primary medical and community services” would rise 3.8 per cent. There is no specific commitment on funding growth for acute services.

Specialised services have received higher growth rates in previous years, but the new allocations show the rate of growth is also rising.

In 2013-14, 14.1 per cent of total NHS commissioner spending went on specialised services, which has grown to a forecast of 15.4 per cent in 2018-19.

Over the next five years, specialised services are proposed to rise to a 17 per cent share – a slightly faster growth rate than the preceding period.

The specialist budget includes specialist mental healthcare as well as physical services, all of which is allocated to and overseen by national and regional teams in NHS England. 

NHS England said in a statement: “We expect the majority of spending on new drugs and treatments to be in specialised services, resulting in a higher growth rate.

“The NHS long-term plan set out ambitious plans to save thousands of lives and take advantage of the best new treatments including genomic tests for every child with cancer and revolutionary new therapies like CAR-T.”