The CTP has a responsibility to commission medicines and care for their population within available resources and as such is required to make difficult decisions about which treatments are routinely provided. Decisions on which treatments should not be routinely provided have been carefully considered and are listed in a Prior Approval Policy. The CTP has worked closely with a range of organisations and people to develop decision making policies and processes.
The Prior Approval Policy provides a list of drugs and treatment which are considered to have a low priority for NHS resources in certain or all circumstances and are therefore considered 'not to be routinely funded'. A process is established for a clinician to submit an Individual Funding Request (IFR) in order to seek prior approval for such drugs and treatment.
The CTP policies and processes have been carefully developed in accordance with core national guidance such as the NHS Constitution. The NHS Constitution is a declaration of rights that are underpinned in law. It confirms a number of Rights that patients and service users have, in particular:
- Patients have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if their doctor says they are clinically appropriate for them.
- Patients have the right to expect local decisions on funding of other drugs and treatments to be made rationally following a proper consultation of the evidence. If the local NHS decides not to fund a drug or treatment the patient or the doctor feels would be right for the patient, the CTP will explain the decision made.
The below links give access to key documents that explains the rationale around IFRs, what treatments are low priority and why, and what processes need to be followed to apply for funding on behalf of a patient:
IFR Documents
- IFR Application Form - An IFR form or detailed letter needs to be completed by the referring clinician for each IFR and sent to the contact point below.
- Prior Approval Policy v6 - This document contains a list of treatments and drugs that require prior approval through the IFR process. It also contains a copy of individual Commissioning Policies such as Bariatric Surgery and Fertility - This Policy was Implemented on 1st October 2011.
- Prior Approval Policy (July 2011 - 30th September 2011) - This Policy only applies to requests received before 1st October 2011.
- NELCTP IFR Operational Process Framework - This document details the process to be followed for an IFR, the Appeals process and the relevant contact points.
- Patient Information Leaflet - under development
- Frequently Asked Questions - under development
- Good Practice Example of completed IFR Form - to follow
- Good Practice Example of completed IFR Letter - to follow
Contacting the IFR Team
Further support on the process and policies can be obtained by contacting one of the IFR Service Support Officers.
North East Lincolnshire Care Trust Plus
Tel: 0300 3000 438 / 439
E-mail: nel.ifr@nhs.net
Useful Links
