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

Somerset Clinical Commissioning Group (SCCG)

Evidence Based Interventions (EBI)

(Previously known as Individual Funding Requests (IFR))

We are 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. 

We are responsible for making the best use of our 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 these funds.  

Some unusual or uncommon treatments, or treatments which provide limited benefit, will not be routinely funded or commissioned. The highest priority for funding will be given to those treatments of proven benefit in meeting the health needs of the population.

Why some treatments are not routinely commissioned or funded by the NHS?

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

  • they are not clinically effective or their effectiveness has yet to be determined
  • theyare restricted in number due to capacity and resource constraints
  • only certain people will benefit from treatments or operation
  • offer little health gain

Information on the pathways for treatments not routinely commissioned or funded can be accessed by clicking here

Evidence Based Interventions Panel (EBIP) 

The Somerset Clinical Commissioning Group (SCCG) Evidenced Based Interventions Panel (EBIP) may review and consider applications put forward by clinicians and will use the following factors;

  • evidence of clinical effectiveness 
  • evidence of cost effectiveness 
  • evidence of clinical need equity of healthcare 
  • exceptional need 
  • clinical exceptionality

Applying for funding authorisation for a treatment not routinely funded/commissioned

Applications must be received from a GP or other healthcare professional such as a hospital Consultant and on the appropriate funding application form.

A patient who wishes to access a specific treatment which is not routinely funded or commissioned by Somerset CCG should initially discuss this with their GP or Consultant. 

If there is full support from the GP or Consultant an appropriate Evidenced Based Interventions (EBI) application form can be put forward for review and consideration of funding. All application should be completed and signed by the GP or Consultant requesting the treatment to progress through the Somerset CCG Evidenced Based Interventions pathway.

In order to guide the Evidenced Based Interventions Panel in any decision making, the Somerset CCG has developed a number of Evidenced Based Intervention Polices which set out the criteria for treatments.

The Evidence Based Interventions Panel includes doctors, a lay representative, and Public Health representative and other health professionals.

It may be necessary to request and gather additional clinical information from healthcare professionals involved in a patient's care to support the funding application that has been put forward.  

When an application has been reviewed and considered at a meeting by the Evidence Based Interventions Panel the Panel’s decision will be forwarded to the GP or Consultant who has completed and signed the application form, in writing.  The correspondence will be copied to the patient, if indicated as appropriate within the application form, and  put forward.

Evidenced Based Interventions Application Process Flowchart 

Evidenced Based Interventions Panel Terms of Reference 

Evidenced Based Interventions Panel Commissioning Policy

Evidenced Based Interventions Panel Appeals Policy

Evidence Based Interventions Panel Meeting Dates

Somerset Clinical Commissioning Group Individual Funding Request (IFR) Panel Meeting Dates 2018  

Somerset Clinical Commissioning Group Evidenced Based Interventions (EBI) Panel meeting dates 2019

The Evidence Based Interventions Generic Application Form

If a clinician would like to apply for a treatment which is not routinely commissioned or funded by Somerset Clinical Commissioning Group (SCCG) the clinician should  complete the Generic Evidence Based Interventions (EBI) Application Form electronically (Word document).  The application form can be accessed by clicking here. If you are prompted with a Security Warning, please select Options and Enable this content to allow completion of the form electronically.

Please note all Evidence Based Interventions application forms (generic and prior approval) should be emailed to ebisomerset@nhs.net

Evidence Based Interventions application forms (generic and prior approval) will not be accepted through the post. In order not to delay the process please email applications to ebisomerset@nhs.net.

Evidence Based Interventions Policies and Prior Approval Application Forms

Please click on the links below to access the adopted Somerset Clinical Commissioning Group Evidence Based Interventions Policies and/or Prior Approval Application form:

-  Abdominoplasty-Apronectomy IFR Policy 1819.v1.3

Acupuncture Policy 1819.v1a 

Acupuncture for Migraine Prophylaxis Prior Approval Application Form 1718.v2

-  Adenoidectomy Secondary Care Policy 1516.v1b - IFR

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

-  Anal Skin Tag Removal IFR Policy 1819.v1.1a

Benign Skin Lesion PA/EBI Policy 1819.v4a

Benign Skin Lesion Prior Approval Application Form 1920.v1a

-  Blepharoplasty and Ptosis Prior Approval Policy 1819.v3a

-  Blepharoplasty and Ptosis Prior Approval Application Form 1920.v3a

-  Breast Asymmetry IFR Policy 1819.v2b

-  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 1920.v3a

-  Bunion Prior Approval Application Form 1920.v2a

Caesarean CBA Policy 1819.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

Dilation and Curettage HMB IFR Policy 1819.v1a

Dupuytren’s Contracture Surgery Prior Approval Policy 1819.v3a

Dupuytren’s Contracture Surgery Prior Approval Application Form 1920.v3a

-  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 1617.v2

-  Fertility Treatment Prior Approval Application Form 1920.6a

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

-  Grommet Insertion 18 years & under with Effusion PA Policy 1718.v3 

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

-  Grommet Insertion AOM without Effusion PA Policy 1718.v1

-  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 CBA Policy 1617.v2

-  Hair Depilation Policy 1516.v1a - IFR

-  Hernia (Adults) CBA Policy 1819.v2b

-  Hip Replacement Surgery Policy CBA 1819.v7a     

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 WITH Osteoarthritis EBI Policy 1819.v3

-  Knee Arthroscopy without Osteoarthritis PA Policy 1819.v3

-  Knee Arthroscopy without Osteoarthritis Prior Approval Form 1819.v1b

-  Knee Replacement CBA Policy 1819.v3     

-  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 & STARR Secondary Care Application Form PA 1617.v2

-  Liposuction (Cosmetic) Policy 1617.v2a - IFR

-  Low Back Pain With and Without Sciatica Interventions Policy CBA & IFR 1819.v3

-  Nasal Surgery IFR Policy 1516.v2b

-  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 CBA Policy 1819.v2a 

-  Skin Contouring Policy 1617.v1b - IFR

-  Surgery of the Face Policy 1617.v1c - IFR

-  Snoring - surgical Intervention IFR Policy 1819.v2

-  Tattoo Removal IFR Policy 1819.v1.2 

-  Tonsillectomy Prior Approval Policy v4a   

-  Tonsillectomy Surgery Prior Approval Form 1920.v5   

-  Trigger Finger Policy CBA 1617.v1b - IFR

Varicose Veins Prior Approval 1920.v3a

-  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

Evidence Based Interventions Team Contact Details

Amy Lucas       - Team Administrator    Tel: 01935 384001   Email: amy.lucas6@nhs.net

Marion Square -  Assistant Officer         Tel: 01935 384007   Email:  marion.square1@nhs.net

Karen Mills       -  Deputy Lead               Tel: 01935 384103   Email: karen.mills14@nhs.net

Sherrie Wild     -  Head                           Tel: 07717 631231   Email: sherrie.wild@nhs.net

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

 


CONTACT US

Contact Somerset CCG by phone or email:

01935 384000

somccg.enquiries@nhs.net 

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