National Assembly for Wales

With regard to highly specialised services, the Welsh Health Specialised Services Committee will develop a service specification based on professional guidance, expert opinion and existing clinical practice in other health systems. The service specification will then determine what can be commissioned either regionally or nationally. Some highly specialised services are based on professional guidance regarding a minimum population or number of cases per annum but this will depend on the nature of the specific service.

For specialist services that are not commissioned by WHSSC, health boards are expected to commission and deliver services in line with the clinical standards set by recognised organisations such as the National Institute for Health and Care Excellence, the Royal Colleges or specialist associations and societies. It is routine for health boards to collaborate in this manner where there are advantages in greater scale or normal limitations in expertise and infrastructure. The optimal population footprint for these services may be determined by a combination of professional guidance, clinical consensus and planning assumptions.

The Welsh Government does not maintain a list of health services that are provided by individual local health boards on a Wales-wide basis. Many of these services are likely to be highly specialised services and are listed on the website of the Welsh Health Specialised Services Committee at:

http://www.whssc.wales.nhs.uk/policies-and-procedures-1

Commissioners are responsible for monitoring the quality of the service being offered by another provider. In a number of areas there is an enhanced level of oversight through national clinical audit or peer reviews. These are powerful tools for looking at the delivery of services delivered across health board boundaries.