Approval from NHS England board on delegation of specialised services

The NHS England Board has approved plans to fully delegate the commissioning of appropriate specialised services to Integrated Care Boards (ICBs) in the East of England, Midlands and the North West regions of England.

In the South West, South East, London and the North East and Yorkshire regions of England, these specialised services will continue to be jointly commissioned between NHS England and multi-ICB collaborations for a further year.

Integrated commissioning supports a focus on population health management across whole pathways of care, improving the quality of services, tackling health inequalities and ensuring best value.

These arrangements are part of a careful and considered approach to delegating full commissioning responsibility across England for appropriate services by April 2025.

These commissioning arrangements apply to 59 specialised services deemed suitable and ready for greater ICB leadership by the NHS England Board in February with others (deemed suitable but have not been ready) potentially to follow in April 2025. Commissioning responsibility for all other specialised services will be retained by NHS England and this includes all highly specialised services.


These plans, which were first set out in our Roadmap for Integrating Specialised Services within Integrated Care Systems, have been developed in close collaboration with NHS England’s regional teams, ICBs and specialised service providers.  They represent the outcome of a thorough assessment process of ICB system readiness, and a comprehensive analysis of services to determine their suitability and readiness for more integrated commissioning. 

To keep up to date on progress, please register as a stakeholder to receive more information.


If you have any questions about the plans or would like more information, you can email