Somerset Clinical Commissioning Group
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What We Do and Don't Fund

A Guide to Individual Funding Requests

The CCG is committed to improving the health of the residents of Somerset and ensuring that patients are treated at the right time, in the right place, by the right people to the right standard and for the best value. The CCG is responsible for making the best use of its resources to look after the needs of our local population. Our aim is to provide comprehensive, effective and accessible health services.

However, as the demand for health services is greater than the money available, we must carefully prioritise the use of funds. To help us do this, some unusual or uncommon treatments or treatments which provide only limited benefit will not be routinely funded. The highest priority for funding will be given to those treatments of proven benefit in meeting the health needs of the population.

-  IFR Process Chart

-  IFRP Terms of Reference November 2017

-  IFRP Commissioning Policy November 2017

 -  IFRP Appeals Policy


Why are some treatments not normally funded by the NHS?

The NHS does not normally pay for treatments or operations if:

-  they are clinically not effective or their effectiveness has yet to be determined

-  they are restricted in number due to capacity and resource constraints

-  only certain people will benefit from treatments or operations

-  they have a low clinical priority and offer little health gain

 

For those treatments not routinely funded, the individual funding request panel will look at each case individually and consider the following factors.

-  evidence of clinical effectiveness

-  evidence of cost effectiveness

-  evidence of clinical need

-  equity of healthcare exceptional need

-  clinical exceptionality

 

Applying to the CCG for Individual Funding approval

Please note that applications must be received from a GP or other healthcare professional such as a Hospital consultant on the appropriate funding application form.

A patient who wishes to access a specific treatment which is not routinely funded should initially discuss this with their doctor or consultant.  If there is full support from the doctor or consultant an appropriate IFR application form can be put forward for review and consideration. 

All application forms require the signature of the doctor or consultant requesting the treatment to progress.

In order to guide the panel in their decision making, the CCG has developed a number of polices which set out the criteria which allow the patient to access the treatment they wish to have.

It may also be necessary to gather additional information from any doctors or healthcare professionals involved in a patients care.

 

What happens next?

The individual funding request panel meets regularly and includes doctors - at least one will be a GP (not your own) - and a lay representative. Following a panel meeting the outcome will be forwarded to the doctor or consultant who has completed and signed the application form. This will be copied to you as the patient, if indicated as appropriate within the application form put forward, and if you wish to be copied in on correspondence concerning your case.


GENERAL PRACTITIONERS 

IFRP and PA policies and other information relating to IFR can be accessed on the GP Navigator

Individual Funding Request Application Form

To gain access to the IFR Application Form you will need to log-in as a health professional.

If you area a health professional from an NHS Trust and are unable to sign in please contact the IFR team:01935 384001 or ifrsomerset@nhs.net

If you are a health professional outside of the Somerset CCG area to ensure security please contact the IFR team by email: ifrsomerset@nhs.net

 

- To complete the IFR Application Form electronically (Word document), please click here. If prompted with a Security Warning, please select Options and Enable this content to allow you to complete the form electronically.

- To download and print the IFR Application Form for completion by hand, please click here.


Policies and Application Forms

Please click on the links below to access the relevant policy or application form:

-  Abdominoplasty-Apronectomy IFR Policy 1819.v1.3

Acupuncture Prior Approval Policy

Acupuncture for Migraine Prophylaxis Prior Approval Application Form 1718.v2

-  Adenoidectomy Secondary Care Prior Approval Policy 1516.v1b - IFR

-  Adeno-Tonsillectomy & Adenoidectomy + Grommet Insertion Prior Approval Application Form 1718.v3

-  Anal Skin Tag Removal Policy 1617.v1.1 - IFR

Benign Skin Lesion PA Policy 1819.v4

Benign Skin Lesion PA Application Form 1819.v1


-  Blepharoplasty and Ptosis Prior Approval Policy 1617.v3 PA

-  Blepharoplasty / Ptosis Prior Approval Application Form 1718.v3

-  Breast Asymmetry Policy IFR 1617.v2a

-  Breast Augmentation Policy IFR 1617.v2a

-  Breast Implant Policy IFR 1617.v2b

-  Breast Mastopexy and Correction of Inverted Nipples Policy IFR 1617.v2a 

-  Breast Reduction Policy IFR 1617.v2a

-  Breast Reduction for Gynaecomastia Policy IFR 1617.v2a

-  Bunion (and other painful toe condition) Surgical Treatment Policy PA 1718.v3

-  Bunion Prior Approval Application Form 1718.v2

-  Carpel Tunnel Surgery Policy CBA 1516.v2c

-  Cataract CBA Policy 1819.v2   

-  Circumcision CBA Policy CBA 1819.v1.1b

-  Complex Obesity Surgery Policy CBA

-  Congenital Ear Deformity Correction Surgery Policy IFR 1516.v1.3a

-  Continuous Glucose Monitoring Policy IFR 1718.v1

-  Dermabrasion IFR Policy 1819.v2   

DEXA Scan Policy 1718.v2 CBA

Dupuytren’s Contracture Surgery Prior Approval Policy 1718.v3

Dupuytren’s Contracture Surgery Prior Approval Application Form 1718.v2

-  Ear Wax Policy CBA 1516.v1a

-  External Ear Repair Policy IFR 1516.v1.1a

-  Extracorporeal Shockwave Therapy (ESWT) 1718.v1 IFR

-  Facial Blushing & Erythrophobia Policy 1516.v1a

-  Female Genitalia IFR Policy 1819.v4b

Fertility Assessment and Treatment Policy PA 1516.v5

-  Fertility Preservation Oncology - Notification of Referral Form

-  Fertility Treatment Prior Approval Application Form 1516.v6

-  Functional Electrical Stimulation (FES) Policy CBA 1516.v2b

-  Grommet Insertion 18 years & under with Effusion Prior Approval Policy 

-  Grommet Insertion 18 years & under with Effusion Prior Approval Application Form

-  Grommet Insertion AOM without Effusion Prior Approval Policy

-  Grommet Insertion AOM without Effusion Prior Approval Application Form

-  Grommet Insertion in Adults with Otitis Media with Effusion (OME) Policy PA 1617.v3a

-  Grommets in Adults Prior Approval Application Form

-  Haemorrhoids Surgical Treament Criteria Based Access Policy

-  Hair Depilation Policy 1516.v1a - IFR

-  Hernia (Adults) Policy 1516.v2a CBA

-  Hip Replacement Surgery Policy CBA 1617.v6

Homeopathy Services Policy 1718.v1 - IFR

Hyperhidrosis Treatment Policy 1718.v3 IFR 

-  Hysterectomy for Menorrhagia CBA Policy 1718.v2

-  Ingrown Toenail Policy 1718.v1.1 CBA

-  Knee Arthroscopy Surgery Policy CBA 1718.v2

-  Knee Replacement Policy CBA 1617.v2a 

-  Laparoscopic Cholecystectomy for Asymptomatic Gall Stones Criteria Based Access Policy 1617.v1b CBA

-  Laparoscopic Ventral Rectopexy and STARR Prior Approval Policy 1516.v1b

-  Laparoscopic Ventral Rectopexy and Stapled Transanal Resection of the Rectum (STARR) Secondary Care  Application Form PA 1617.v2

-  Liposuction (Cosmetic) Policy 1617.v2a - IFR

-  Low Back Pain & Siatica Interventions Policy CBA 1718.v2b

-  Nasal Surgery Policy

-  Open and Upright MRI Prior Approval Policy 1819.1.3

-  Open/Upright MRI Prior Approval Application Form 1617.v3

-  Percutaneous Tibial Nerve Stimulation (PTNS) Prior Approval Policy1617.v2a

-  Percutaneous Tibial Nerve Stimulation (PTNS) Secondary Care Prior Approval Form 1617.v2

-  Portwine Stains - Birthmarks - Removal IFR Policy 1819.v4

-  Reversal of Sterilisation -Vasectomy IFR Policy 1819.v2

-  Scar Revision Policy IFR Policy 1819.v2

-  Shoulder Impingement Surgery Policy CBA 1718.v2 

-  Skin Contouring Policy 1617.v1b - IFR

-  Somerset Clinical Consensus on Specialist Injections 

-  Surgery of the Face Policy 1617.v1c - IFR

-  Snoring - surgical Intervention IFR Policy 1819.v2

-  Tattoo Removal IFR Policy 1819.v1.2

-  Tonsillectomy Policy PA 1516.v3a

-  Tonsillectomy Surgery Prior Approval Form Secondary Care only 1718.v3

-  Trigger Finger Policy CBA 1617.v1b - IFR

Varicose Veins Prior Approval Policy

-  Varicose Veins Secondary Care Application Form 1718.v2

-  Vasectomy Policy CBA & IFR Secondary Care 1718.v1a

-  Visual Acuity - Laser Surgery to Correct IFR Policy 1819.v1.2


Contact Details - Individual Funding Team

Amy Lucas       - IFRP Administrator Somerset CCG   Tel: 01935 384001 Email: amy.lucas6@nhs.net

Marion Square - IFR Coordinator Somerset CCG        Tel: 01935 384007 Email:  marion.square1@nhs.net

Karen Mills       - IFR Manager Somerset CCG             Tel: 01935 384103 Email: karen.mills14@nhs.net

 

IFRP Panel Meeting Dates 

Somerset Clinical Commissioning Group Individual Funding Request Panel Meeting Dates 2018 

  

NHS England Information

1.    NHS England Health and Justice  and Armed Forces Service Specific Policies:          

https://www.england.nhs.uk/commissioning/policies/ssp/

 

2.    NHS England The Manual

This is a technical document describing the 146 prescribed specialised services. It describes the rationale and which elements of specialised services are directly commissioned by NHS England and which are commissioned by Clinical Commissioning Groups (CCGs).

https://www.england.nhs.uk/commissioning/spec-services/key-docs/#manual

 

3.    NHS England IFR Polices: https://www.england.nhs.uk/commissioning/spec-services/key-docs/#ifr

  • NHS England IFR Commissioning Policy
  • NHS England IFR Standard Operating Procedure Policy
  • NHS England IFR Application From

 


CONTACT US

Contact Somerset CCG by phone or email:

01935 384000

somccg.enquiries@nhs.net 

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