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

A Guide to Individual Funding Requests

The Somerset CCG Individual Funding Request team is currently in the process of updating all the documents with reference 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.

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

 

Applying to the CCG for 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. 

If you are a patient who wishes to access a specific treatment which is not routinely funded, please discuss this with your doctor or consultant and, if appropriate, an IFR application form can be put forward for review and consideration. You can also put forward with the application correspondence on how your condition affects you and how the treatment will benefit you.

In order to guide the panel in their decision making, the CCG has developed a number of policies which set out the criteria which allow patients 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 your 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 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 Policy

Acupuncture Prior Approval Policy

Acupuncture (Migraine) Secondary Care Prior Approval Application Form

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

-  Adenoidectomy Secondary Care Prior Approval Application Form 1516.v2 - IFR

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

-  Benign Skin Lesions Policy 1516.v3 - IFR

-  Blepharoplasty and Ptosis Prior Approval Policy 1617.v3 - IFR

-  Blepharoplasty / Ptosis Prior Approval Application Form 1718.v2a - IFR

-  Botulinum Toxin (Botox) Treatment Policy 1516.v2c - IFR

-  Botulinum Toxin (Botox) Prior Approval Application Form 1617.v2b - IFR

-  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 Policy PA 1718.v2 

-  Bunion Prior Approval Application Form 1718.v1

-  Carpel Tunnel Surgery Policy CBA 1516.v2c

-  Cataract Policy CBA 1516.v1a

-  Circumcision Policy CBA 1516.v1.1a

-  Complex Obesity Surgery Policy

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

-  Continuous Glucose Monitoring Policy IFR 1718.v1

-  Dermabrasion Policy IFR 1516.v1.1a

Dupuytren’s Contracture Surgery Prior Approval Policy

Dupuytren’s Contracture Surgery Prior Approval Application Form

-  Ear Wax Policy CBA 1516.v1a

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

-  Facial Blushing & Erythrophobia Policy 1516.v1a

-  Female Genitalia Policy 1516.v4a  

Fertility Assessment and Treatment Policy PA 1516.v5

-  Fertility Preservation Referral Form

-  Fertility Treatment Prior Approval Application Form

-  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 - IFR

-  Hip Replacement Surgery Policy CBA 1617.v6

-  Homeopathy Prior Approval Application form

-  Hysterectomy for Menorrhagia Policy 1617.v1a - IFR

IFR Process Chart

IFRP Terms of Reference April 2016 V2e

IFRP Commissioning Policy

IFRP Appeals Policy

-  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 - IFR

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

-  Laparoscopic Ventral Rectopexy and STARR Application Form PA 1516.v1a

-  Laser Surgery to Correct Visual Acuity Policy 1516.v1.1a - IFR

-  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 1516.v1.2a - IFR

-  Open/Upright MRI Prior Approval Application Form

-  Penile Implants Prosthesis Policy
  
As of September 2016, Penile Prosthesis surgery is routinely commissioned by NHS England:  
   https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/08/clinical-com-pol-16059p.pdf  
   This surgery was previously 'not routinely funded' by the CCG.

-  Percutaneous Tibial Nerve Stimulation (PTNS) Policy1617.v2a - IFR

-  Percutaneous Tibial Nerve Stimulation (PTNS) Prior Approval Form

-  Removal of Port Wine Stains & Birthmarks Policy 1516.v3a - IFR 

-  Reversal of Sterilisation Policy 1516.v1.1a - IFR

-  Scar Revision Policy 1516.v1.1a - IFR

-  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

-  Surgical Intervention for Simple Snoring Policy 1516.v1a - IFR

-  Tattoo Removal Policy 1516.v1.1a - IFR

-  Tonsillectomy Policy PA 1516.v2a

-  Tonsillectomy Secondary Care Application Form 

-  Trigger Finger Policy CBA 1617.v1b - IFR

Varicose Veins Prior Approval Policy

-  Varicose Veins Secondary Care Application Form

-  Vasectomy Policy CBA & IFR Secondary Care 1718.v1a


Contact Details - Individual Funding

Karen Mills - IFR Manager Somerset CCG.  Tel: 01935 384103

Amy Lucas - IFRP Administrator Somerset CCG.  Tel: 01935 384001

Somerset CCG area email address for IFRP Application Forms and supporting information.

 

IFRP Panel Meeting Dates 

Somerset CCG IFRP Panel Meeting Dates 2017

  

CONTACT US

Contact Somerset CCG by phone or email:

01935 384000

enquiries@somersetccg.nhs.uk

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