Referral in Scotland

The procedure  for Scotland is as follows. In sum, you have to be referred to one of the Centres of Excellence of your choice by your GP and a tertiary specialist consultant, and their referral submitted via the National Services Division (NSD).


The NSD (who are responsible for commissioning and performance managing National Screening Programmes, Specialist Clinical Services and National Managed Clinical Networks on behalf of NHS Scotland) funds a number of Specialist and Specialised Services in England on behalf of NHS Boards (Scotland has 14 Health Boards) and manages Risk-sharing Arrangements in areas of very high cost for individual patients. See Accessed 14 Jul 18.


Additional background for your GP – to help save them time looking – is as follows.


Services in England


NSD funds services provided in England for residents in Scotland through two distinct funding streams:

  • a contribution to the NHS England for Scottish access to highly specialist services which are provided on a UK basis.  Access is ensured through a service agreement
  • by managing a pool of funds (risk share scheme) on behalf of NHS Boards to pay for individual patient referrals for a “prescribed” list  of specialised services in England which are not included in the service agreement with NHS England.

The service provided by NSD is primarily a financial arrangement through which NSD meets the costs of specialist patient treatment in England on behalf of NHS Boards from pooled funds.  All decisions on appropriate treatment for any individual referred to England remain the responsibility of the NHS Board of the patient’s residence.


NSD only funds treatment in England if:

  • The treatment is specialised and is included within the UK Prescribed List of specialised services
  • The treatment is provided in the NHS (not private) in England (not abroad)
  • The service is not provided in Scotland; and
  • The referral is from an appropriate tertiary specialist consultant in Scotland.


Decisions on funding are made on an individual referral basis by a virtual panel at NSD comprising the Medical Director, Nursing and Quality Adviser, and NSD Director.

Reference: Accessed 14 Jul 18.


The List of Nationally Funded Services can be found here – Behcet’s is listed on page 6

The UK Prescribed List of specialised services is found here