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About specialist services

Published on 12 February 2024

National Services Directorate (NSD) currently commission more than 60 national designated specialist services on behalf of Scottish Government and NHSScotland’s health boards.

Specialist and highly specialist healthcare services treat patients living with a rare condition or who have highly specialist needs. These services are therefore not available in every hospital because they can only be delivered by teams of doctors, nurses and other health professionals who have the necessary training, skills and experience. However rare the condition, we strive to create fair and effective care pathways that offer the best support to patients.

Each commissioned specialist service is provided by one or two NHS boards for the whole population of Scotland. This means that while a service maybe based in Edinburgh, patients from other regions in Scotland have equitable access to it.

We work with provider boards to maximise available resources, ensuring that patients have access to high-quality services and standards of care that can be measured against appropriate standards.

Each designated service is subject to strict governance and performance reviews. We do this by:

  • developing service agreements with provider boards, detailing the service specification, performance and quality standards, finance and activity expectations
  • conducting regular meetings between clinicians and managers to continually review auditing processes, measure clinical outcomes and identify service improvements

To learn more about how about the oversight arrangements for nationally designated services and how NHSScotland makes decisions about setting up new services please visit Assessing and triaging requests | National Services Scotland (

NSD contact

Please note that NSD does not directly provide medical services and we won't be able to answer queries about your own care or appointments. If you would like to discuss any aspects of your care, please contact your primary healthcare provider. This might be your GP, Consultant, Nurse or other healthcare professional. They will be best placed to give you the right advice.