The Local Health Boards (Functions) (Amendment) Regulations 2003

Regualtion 4

SCHEDULE Excepted functions of a relevant Health Authority

Commissioning of Specialised Services for adults and children in respect of:—	Description
Blood and bone marrow transplantation	Autografts and Allografts, all phases.
Assessment and provision of equipment for people with complex physical disability	Prosthetics and complex orthotics;Wheelchair provision including complex postural seating and powered wheelchair controls; Communication aids (excluding all forms of hearing aids and cochlear implants); Environmental controls and other electronic assistive technology; Telecare. All services provided by the Artificial Limbs and Appliances Service.
Haemophilia and other bleeding disorders	All activity including genetic support.
Spinal services	Spinal injuries (with damage or threat to spinal cord function) —all activity in designated centres; Complex spinal deformity surgery and reconstructive spinal surgery (without threat to spinal cord function).
Burns services	The treatment of complex burns including acute surgical care, intensive care, rehabilitation and multiple in-patient and out patient interventions for re-constructive surgery.
Cystic fibrosis	All services including outreach and shared care.
Cleft lip and palate services	Services provided by all relevant specialites
Allergy	Treatment of allergic disease requiring special facilities for investigation and management normally available only in national specialist centres.
Medical genetics	Clinical genetics; Laboratory genetics; Cytogenetics; Molecular genetics; Metabolic biochemistry; Planning for population screening
Clinical Immunology	Laboratory investigation for the diagnosis, clinical assessment and treatment of patients with suspected and established primary and humoral immunodeficiences and the monitoring of complex therapies.
Commissioning of Specialised Services for Adults in respect of:—
Cancer Services	Specialised services including Continuous Hyperfractionated Accelerated Radiotherapy (for lung cancer), Stereotactic radiosurgery, total skin electon beam radiotherapy cutaneous lymphoma only, micrographic surgery for skin cancer, thoracic surgery for the treatment of cancer, exenterative surgery for gynaecological cancer, brachytherapy, hyperthermia, radionuclide therapy, specialised palliative care services for common cancers: stents, laser and cryotherapy, photodynamic therapy, conformal radiotherapy, photopheresis, Position Emmission Tomography scanning, testing people for cancers that have genetic or familial associations including familial polyposis, hereditary non-polyposis, colon, breast.Specialised conditions including brain/central nervous system/spinal cancers, endrocrine, sarcoma (soft tissue and bone), skin cancer (melanoma (any site)), cutaneous lymphoma, Human Immunodeficiency Virus related malignancies, mesthelioma, specialised gynaecological cancers — vulval, vaginal and germ cell cancers, head & neck cancers, haematological malignancies such as leukaemia, lymphoma and myeloma, urological cancers —complex bladder, retro-peritoneal surgery, testes, lymphnode section, complex penile; pituitary tumours and teenage & young adult cancer (up to age 25).
Complex rehabilitation for brain injury and complex disability	Centres providing a significant proportion of complex rehabilitation — excluding local aftercare and rehabilitation.
Neurosciences	Neurosurgery; Neurology (excluding in-patient stroke and cerebral haemorrhage); Neurorehabilitation; Neuropathology; Neurophysiology; Neuroradiology; Neuroophthalmology; Neurootology.
Renal services	Treatment for End Stage Renal Failure; Treatment for acute renal failure; General nephrology (provided in a main nephrology unit); Renal related surgery including dialysis.
Home parental nutrition	Home care packages and support provided by hospital team.
Cardiology and cardiac surgery	Cardiothoracic transplantation (including implantable ventricular assist devices); Pulmonary hypertension; Cardiac electrophysiology; Congenital heart disease; Invasive cardiology; Angiography and cardiac surgery.
Infectious diseases	Inpatient infectious disease activity.
Hepatology, hepatobiliary and pancreatic surgery	Services for the treatment of patients with viral hepatitis; Services for patients with acute liver failure and advanced complications of cirrhosis; Services for patients with benign and malignant liver tumours and cancer of the intra and extrahepatic biliary tree (including pancreas); Hepatobiliary and pancreatic surgery.
Mental Health	Tertiary Eating Disorder services; Neuropsychiatry; Forensic Services excluding low secure; Mental health services for deaf people; Gender Identity disorder; Perinatal psychiatric services (Mother and Baby) units;Complex and/or treatment resistant disorders.
Plastic Surgery	Surgery on the skin and/or appendages including microsurgery.
Thoracic surgery	Surgery on the lungs and thoracic cavity and walls excluding cardiac surgery
Women’s health	Foetal medicine including prenatal diagnosis and foetal therapy; Congenital abnormalities of the genital tract.Infertility Services involving in-vitro techniques
Pathology
Dermatology
Cochlear Implants
Commissioning of Specialised Services for Children in respect of:—
	Cardiology and cardiothoracic surgery; Nephrology, including renal replacement therapy; Gastroenterology/ Hepatology/ Nutritional support; Respiratory; Oncology; Malignant haematology; Non-malignant haematology; Neonatal intensive care; Paediatric intensive care; Immunological disorder/infectious disease/allergy; Paediatric pathology; Paediatric Neurosciences (Including complex disability and rehabilitation); Metabolic disorders; Paediatric endocrinology and diabetes; Rheumatology; Specialised child and adolescent mental health services; Specialised dermatology; Paediatric surgery; Paediatric orthopaedic surgery; Paediatric ophthalmology; Paediatric ear, nose and throat surgery; Paediatric oral and maxillofacial surgery; Paediatric plastic surgery; Paediatric urology; Complex child and adolescent gynaecology, congenital anomalies and intersex.
Other Services
	Rheumatology; Endocrinology; Hyperbaric treatment; Respiratory services; Vascular services; Pain management services; Bone Anchored Hearing Aids; Colorectal services; Orthopaedic services; Morbid obesity services.
Highly specialised services which are commissioned on a UK basis by the National Specialist Commissioning Advisory Group
National Poisons Information Service	Advisory service for the identification, treatment and management of poisoning.
NHS Direct
National Population Screening Programmes	Programmes of population screening including NHS Breast Screening Programme, Cervical Screening Wales and New Born Hearing Screening Wales.
Emergency Ambulance Services	Emergency transport services for the sick and injured.
Blood Transfusion and Tissue Typing Services	The collection, testing and distribution of blood and blood products in Wales, including autologous transfusion, storage and distribution of blood products, tertiary reference service for transfusion serology, a medical advisory service and support to the transfusion medicine teaching curriculum; Maintaining the Welsh Bone Marrow Donor Registry and a tissue typing service for transplantation.
Regional Pharmaceutical Services	Clinical Support Services; Quality and Technical Services;Surgical Materials Testing Service.
Dental Service Increment Training	Service Increment for Training
Functions under section 87 of the Water Industry Act 1991(1)
Emergency Planning services.
Medical SIFT	Service Increment for Training
Diabetic Retinopathy Screening
Functions of a local supervising authority (LSA) pursuant to article 42(1)(b) and article 43 of the Nursing and Midwifery Order 2001.(2)

(1)

1991 c. 56.

(2)

S.I. 2002/253.