Genetics services are commissioned by Specialised Services commissioners. Specialised services are provided by a relatively small number of centres which serve populations of over a million.

In England dedicated commissioning teams, known as Specialised Commissioning Groups (SCGs), commission the services on behalf of their member Primary Care Trusts. Following the publication in May 2006 of the Review of Commissioning Arrangements for Specialised Services (Chaired by Sir David Carter) in which 32 recommendations were made, the organisation of specialised services commissioning was restructured. All SCGs report to the National Specialised Services Commissioning Group (referred to as the NSCG) in order to co-ordinate specialised services commissioning across all SCGs where appropriate. Highly specialised services are commissioned by a national organisation called the National Commissioning Group (this work had previously been the role of the National Specialised Commissioning Advisory Group – NSCAG). The NCG is a sub group of the NSCG. Both organisations have transferred from the Department of Health to the NHS and are hosted by the London SHA.

Scotland, Northern Ireland and Wales have different arrangements to England. In Scotland there is a consortium arrangement, in Wales the Health Commission commissions genetic services and in Northern Ireland the Regional Medical Services Consortium informs the Health and Social Services Boards who commission genetic services.