Regulations 7, 10 and 11
SCHEDULE 4E+WServices for rare and very rare conditions
InterpretationE+W
1. For the purposes of this Schedule—
(a)an individual is a child if they have not yet attained the age of 18 years old;
(b)an individual is a young person if they are aged 13 years old or over but have not yet attained the age of 21 years old; and
(c)an individual is an adult if they are aged 18 years old or over,
unless, for the purposes of a service specified in this Schedule, the Board, or the person providing such a service pursuant to a commissioning contract with the Board, considers on clinical grounds that an individual should otherwise be treated as a child, a young person or an adult.
The servicesE+W
2. Adult ataxia telangiectasia services.
3. Adult congenital heart disease services.E+W
[F13A. Adult highly specialist oesophageal gastric services in the form of gastro-electrical stimulation for patients with intractable gastroparesis.]E+W
Textual Amendments
4. Adult highly specialist pain management services.E+W
5. Adult highly specialist respiratory services.E+W
6. Adult highly specialist rheumatology services.E+W
7. Adult secure mental health services.E+W
8. Adult specialist cardiac services.E+W
9. Adult specialist eating disorder services.E+W
10. Adult specialist endocrinology services.E+W
F211. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E+W
Textual Amendments
F2Sch. 4 para. 11 omitted (1.4.2015) by virtue of The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 2(4)
12. Adult specialist neurosciences services.E+W
13. Adult specialist ophthalmology services.E+W
14. Adult specialist orthopaedic services.E+W
15. Adult specialist pulmonary hypertension services.E+W
16. Adult specialist renal services.E+W
17. Adult specialist services for patients infected with HIV.E+W
18. Adult specialist vascular services.E+W
19. Adult thoracic surgery services.E+W
20. Alkaptonuria service.E+W
21. Alström syndrome service.E+W
22. Ataxia telangiectasia service for children.E+W
[F322A. Atypical haemolytic uraemic syndrome services.]E+W
Textual Amendments
23. Autoimmune paediatric gut syndromes service.E+W
24. Autologous intestinal reconstruction service for adults.E+W
25. Bardet-Biedl syndrome service.E+W
26. Barth syndrome service.E+W
27. Beckwith-Wiedemann syndrome with macroglossia service.E+W
28. Behcet's syndrome service.E+W
29. Bladder exstrophy service.E+W
30. Blood and marrow transplantation services.E+W
[F431. Bone conduction hearing implant services.]E+W
Textual Amendments
F4Sch. 4 para. 31 substituted (1.4.2015) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 2(5)
32. Breast radiotherapy injury rehabilitation service.E+W
33. Child and adolescent mental health services – Tier 4.E+W
34. Choriocarcinoma service.E+W
35. Chronic pulmonary aspergillosis service.E+W
36. Cleft lip and palate services.E+W
37. Cochlear implantation services.E+W
38. Complex childhood osteogenesis imperfecta service.E+W
39. Complex Ehlers Danlos syndrome service.E+W
40. Complex neurofibromatosis type 1 service.E+W
41. Complex spinal surgery services.E+W
42. Complex tracheal disease service.E+W
43. Congenital hyperinsulinism service.E+W
44. Craniofacial service.E+W
45. Cryopyrin associated periodic syndrome service.E+W
46. Cystic fibrosis services.E+W
47. Diagnostic service for amyloidosis.E+W
48. Diagnostic service for primary ciliary dyskinesia.E+W
49. Diagnostic service for rare neuromuscular disorders.E+W
50. Encapsulating peritoneal sclerosis treatment service.E+W
51. Epidermolysis bullosa service.E+W
52. Extra corporeal membrane oxygenation service for adults.E+W
53. Extra corporeal membrane oxygenation service for neonates, infants and children with respiratory failure.E+W
54. Ex-vivo partial nephrectomy service.E+W
55. Fetal medicine services.E+W
56. Gender identity development service for children and adolescents.E+W
57. Gender identity disorder services.E+W
[F557A. Hand transplantation for adults.]E+W
Textual Amendments
58. Heart and lung transplantation service [F6(including mechanical circulatory support)].E+W
Textual Amendments
F6Words in Sch. 4 para. 58 substituted (1.4.2016) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2016 (S.I. 2016/293), regs. 1(1), 4(2)(a) (with reg. 5)
[F759. Highly specialist adult gynaecological surgery and urinary surgery services for women.]E+W
Textual Amendments
F7 Sch. 4 paras. 59, 59A substituted for Sch. 4 para. 59 (1.4.2015) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 2(6)
[F759A. Highly specialist adult urological surgery services for men.]E+W
Textual Amendments
F7 Sch. 4 paras. 59, 59A substituted for Sch. 4 para. 59 (1.4.2015) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 2(6)
60. Highly specialist allergy services.E+W
F861. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E+W
Textual Amendments
F8Sch. 4 para. 61 omitted (1.4.2015) by virtue of The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 2(7)
62. Highly specialist dermatology services.E+W
63. Highly specialist metabolic disorder services.E+W
64. Highly specialist pain management services for children and young people.E+W
65. Highly specialist palliative care services for children and young people.E+W
66. Highly specialist services for adults with infectious diseases.E+W
67. Hyperbaric oxygen treatment services.E+W
68. Insulin-resistant diabetes service.E+W
69. Islet transplantation service.E+W
70. Liver transplantation service.E+W
71. Lymphangioleiomyomatosis service.E+W
72. Lysosomal storage disorder service.E+W
73. Major trauma services.E+W
74. McArdle's disease service.E+W
75. Mental health service for deaf children and adolescents.E+W
[F976. Mitochondrial donation service.]E+W
Textual Amendments
F9Sch. 4 para. 76 inserted (1.4.2016) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2016 (S.I. 2016/293), regs. 1(1), 4(2)(b) (with reg. 5)
77. Neurofibromatosis type 2 service.E+W
78. Neuromyelitis optica service.E+W
79. Neuropsychiatry services.E+W
80. Ocular oncology service.E+W
81. Ophthalmic pathology service.E+W
82. Osteo-odonto-keratoprosthesis service for corneal blindness.E+W
83. Paediatric and perinatal post mortem services.E+W
84. Paediatric cardiac services.E+W
85. Paediatric intestinal pseudo-obstructive disorders service.E+W
86. Pancreas transplantation service.E+W
87. Paroxysmal nocturnal haemoglobinuria service.E+W
88. Positron Emission Tomography – Computed Tomography services.E+W
89. Primary ciliary dyskinesia management service.E+W
90. Primary malignant bone tumours service.E+W
91. Proton beam therapy service.E+W
92. Pseudomyxoma peritonei service.E+W
93. Pulmonary hypertension service for children.E+W
94. Pulmonary thromboendarterectomy service.E+W
95. Radiotherapy services.E+W
96. Rare mitochondrial disorders service.E+W
97. Reconstructive surgery service for adolescents with congenital malformation of the female genital tract.E+W
98. Retinoblastoma service.E+W
99. Secure forensic mental health service for young people.E+W
100. Severe acute porphyria service.E+W
101. Severe combined immunodeficiency and related disorders service.E+W
102. Severe intestinal failure service.E+W
103. Severe obsessive compulsive disorder and body dysmorphic disorder service.E+W
104. Small bowel transplantation service.E+W
105. Specialist burn care services.E+W
106. Specialist cancer services.E+W
107. Specialist cancer services for children and young people.E+W
[F10107A. Specialist colorectal surgery services.]E+W
Textual Amendments
108. Specialist dentistry services for children and young people.E+W
109. Specialist ear, nose and throat services for children and young people.E+W
110. Specialist endocrinology and diabetes services for children and young people.E+W
111. Specialist gastroenterology, hepatology and nutritional support services for children and young people.E+W
112. Specialist genetic services.E+W
113. Specialist gynaecology services for children and young people.E+W
114. Specialist haematology services for children and young people.E+W
115. Specialist haemoglobinopathy services.E+W
[F11116. Specialist immunology services for adults with deficient immune systems.]E+W
Textual Amendments
F11Sch. 4 paras. 116, 116A substituted for Sch. 4 para. 116 (1.4.2015) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 2(10)
[F11116A. Specialist immunology services for children with deficient immune systems.]E+W
Textual Amendments
F11Sch. 4 paras. 116, 116A substituted for Sch. 4 para. 116 (1.4.2015) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 2(10)
[F12116B. Specialist maternity care for women diagnosed with abnormally invasive placenta.]E+W
Textual Amendments
F12Sch. 4 para. 116B inserted (1.4.2016) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2016 (S.I. 2016/293), regs. 1(1), 4(2)(c) (with reg. 5)
117. Specialist mental health services for deaf adults.E+W
F13118. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E+W
Textual Amendments
F13Sch. 4 para. 118 omitted (1.4.2016) by virtue of The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2016 (S.I. 2016/293), regs. 1(1), 4(2)(d) (with reg. 5)
119. Specialist neonatal care services.E+W
120. Specialist neuroscience services for children and young people.E+W
121. Specialist ophthalmology services for children and young people.E+W
122. Specialist orthopaedic surgery services for children and young people.E+W
123. Specialist paediatric intensive care services.E+W
124. Specialist paediatric liver disease service.E+W
125. Specialist perinatal mental health services.E+W
126. Specialist plastic surgery services for children and young people.E+W
127. Specialist rehabilitation services for patients with highly complex needs.E+W
128. Specialist renal services for children and young people.E+W
129. Specialist respiratory services for children and young people.E+W
130. Specialist rheumatology services for children and young people.E+W
131. Specialist services for children and young people with infectious diseases.E+W
132. Specialist services for complex liver, biliary and pancreatic diseases in adults.E+W
133. Specialist services for haemophilia and other related bleeding disorders.E+W
134. Specialist services for severe personality disorder in adults.E+W
135. Specialist services to support patients with complex physical disabilities [F14excluding wheelchair services].E+W
Textual Amendments
F14Words in Sch. 4 para. 135 inserted (1.4.2015) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2015 (S.I. 2015/415), regs. 1(1), 2(11)
136. Specialist surgery for children and young people.E+W
137. Specialist urology services for children and young people.E+W
138. Spinal cord injury services.E+W
139. Stem cell transplantation service for juvenile idiopathic arthritis and related connective tissue disorders.E+W
140. Stickler syndrome diagnostic service.E+W
[F15140A. Surgery for complex obesity in children.]E+W
Textual Amendments
F15Sch. 4 para. 140A inserted (1.4.2016) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2016 (S.I. 2016/293), regs. 1(1), 4(2)(e) (with reg. 5)
[F16140B. Uterine transplantation services.]E+W
Textual Amendments
F16Sch. 4 para. 140B inserted (1.4.2017) by The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2017 (S.I. 2017/296), regs. 1, 2(2)
141. Vein of Galen malformation service.E+W
142. Veterans' post traumatic stress disorder programme.E+W
143. Wolfram syndrome service.E+W
144. Xeroderma pigmentosum service.E+W