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All patients have access to a wide variety of treatments that are funded by the NHS. However, there are some that we do not routinely fund.

These include:

Your GP or consultant can approach the CCG on your behalf to request funding for treatment that is not routinely available. These individual funding requests (IFR) can be made, because;

Making an individual funding request

To make an individual funding request, you will need to discuss this with your GP or consultant. They will complete an application form on your behalf and send it to us, alongside any supporting information. This supporting information must demonstrate your exceptional clinical circumstances and how your condition affects daily life.

Each request is individually assessed and discussed at the individual funding request (IFR) panel. Urgent requests may be considered at a special panel. The IFR panel is made up of qualified and trained people who only have sight of your medical information. Any contact or additional information that may need to be supplied to the panel should be done via your doctor or consultant.

The panel carefully consider a number of factors before reaching a decision, including:

On occasion, the panel may go back to your GP or consultant for additional information to support your request.

Once the panel has made a decision, we will let your GP or consultant know the result of the decision and if your address has been provided, copy a decision letter to you. In some cases, where approval has been given, there may be conditions or restrictions on your treatment.

Appealing a decision

Your GP or consultant can appeal the outcome of an individual funding request if they think that the IFR panel:

An appeal cannot be made on the grounds that you disagree with the original decision. If your GP or consultant wishes to make an appeal, they will need to specify which part of the decision making process is being appealed against.

If an appeal is accepted, it will be returned to the IFR panel to be re-considered. If an appeal is unsuccessful, a clear explanation will be provided to you and your GP or consultant.

If you remain unhappy after making an appeal, you can raise your concern with our patient support line. Tel: 01274 237557.

If you remain unhappy after speaking to our patient support line, you have the right to refer your request to the Parliamentary and Health Service Ombudsman:

Email: phso.enquiries@ombudsman.org.uk

Telephone:  0345 015 4033, Monday to Friday, 8.30 am – 5.30 pm

Write to: The Parliamentary and Health Service Ombudsman, Millbank Tower, Millbank, London, SW1P 4Q

Evidence based interventions 

Clinical evidence shows some interventions are only appropriate when they are performed in specific circumstances. These are known as evidence based interventions. 

The Evidence-Based Interventions (EBI) programme is a partnership between NHSCC, NHS England & Improvement, the Academy of Medical Royal Colleges and NICE. It aims to reduce referrals for interventions that evidence shows should not be commissioned or only commissioned if certain clinical criteria are met.

There are 17 interventions included in the EBI programme: four that should not be routinely offered to patients unless there are exceptional circumstances and 13 interventions that should only be offered to patients when certain clinical criteria are met.

NHS England have created some resources to help health professionals, patients and the public understand the Evidence-Based Interventions Programme, you can find these here