The Department is strengthening commissioning arrangements for specialised services following an independent review led by Sir David Carter. To support this direction of travel, we worked with specialised commissioning groups to refine the targeting of specialist top-ups, which are paid in addition to the tariff, for 2008-09. All providers of specialist orthopaedic services are eligible for specialist top-ups.
Arrangements for the reimbursement of specialist orthopaedic treatments were published as part of the tariff package, and alongside the NHS Operating Framework for 2008-09, in December 2007.
We continue to work with interested parties to monitor and review these arrangements.