Commissioning

On 2 March 2026, NHS England and the Department of Health and Social Care (DHSC) announced the next phase in the transfer of national commissioning functions, subject to parliamentary approval. From April 2027, integrated care boards (ICBs) will assume responsibility for a broader set of services, including selected specialised services (in addition to those already delegated), most components of screening programs, and public health functions. Following the expected abolition of NHS England in 2027, DHSC will take on the remaining national commissioning responsibilities, including highly specialised services and High Cost devices, as well as maintaining national service specifications and clinical commissioning policies.

On November 4, 2025, NHS England published the strategic commissioning framework to support the 10 Year Health Plan ambitions. The document outlines that strategic commissioning will be the key role of integrated care boards (ICBs) in the future. It is expected that all ICBs will begin to adopt this approach as part of the NHS planning process for the financial year 2026/27.

On November 4, 2025, NHS England published an updated work plan for the development of Clinical Commissioning Policies for specialised services. One new MedTech-related policy concerning cochlear implantation in single-sided deafness was added to the work program, and none have been published since the previous update. The status of ongoing policies has also been updated.

On August 19, 2025, NHS England announced that most integrated care boards (ICBs, local commissioners) will coordinate their work by gathering in clusters. Thirteen clusters, each comprising two to three ICBs, will be established by the end of 2025, while thirteen ICBs will continue to operate independently.

On August 21, 2025, NHS England published an updated work plan for the development of Clinical Commissioning Policies for specialised services. One new MedTech-related policy concerning renal denervation for resistant hypertension was added to the work program, and none have been published since the previous update. The status of ongoing policies has also been updated.

On June 6, 2025, NHS England published an updated work plan for the development of Clinical Commissioning Policies for specialised services. Two new MedTech-related policies concerning interventional radiology were added to the work program, and none have been published since the previous update. The status of ongoing policies has also been updated.

On January 16, 2025, NHS England published an updated work plan for specialized clinical commissioning policies production. One Med Tech-related policy in the neuromodulation field was added to the work plan. No policies have been published since the previous update.

On December 5, 2024, NHS England announced the next steps in delegating commissioning responsibilities for prescribed specialized services to local commissioners - integrated care boards (ICBs). These include the final list of 70 specialized services delegated to all ICBs starting from April 2025

On October 3, 2024, NHS England published an updated work plan for specialized clinical commissioning policies development. One Med Tech-related policy in the orthopedic field was added to the work plan. No policies have been published since the previous update. The status of ongoing policies was updated.

On September 11, 2024, NHS England published an updated work plan for specialized clinical commissioning policies development. One MedTech-related policy was added to the program on long-term left ventricular assist devices (LVAD) for destination therapy in adults with heart failure. No new policies were published.

On December 7, 2023, NHS England confirmed the next steps in delegating commissioning responsibilities for specialised services to local commissioners - integrated care boards (ICBs). In the first step, selected specialised services have been delegated to Joint Committees of ICBs and NHS England Regions since April 2023. The next steps include the full delegation of suitable services to certain ICBs from April 2024. Regardless of delegation status, NHS England will remain the accountable commissioner for specialised services and responsible for developing national service specifications and clinical commissioning policies.

On October 10, 2023, NHS England published an updated work plan for specialized clinical commissioning policies development (as of October 2, 2023). Two MedTech-related policies were added to the program: Gamma Knife stereotactic radiosurgery for essential tremor in adults; Stereotactic Ablative Radiotherapy for the treatment of primary kidney cancer. The status of ongoing policies was updated.