An IFR is only regarded as such when a case can be set out by a patient’s clinicians that they have exceptional clinical circumstances. Below is the definition of exceptionality as detailed in the Individual Funding Requests Decision Making Policy. Defining Exceptionality
Source: Dr Henrietta Ewart The following information explains how NHS St Helens CCG makes decisions about providing treatments that are not normally available through the National Health Service (NHS).
Like any other organisation, the NHS has limited resources and we have a duty to manage them to a robust process.
This means we have to:
There are a set of recognised principles which are used in the NHS to guide commissioning decisions on individual treatments. There are some treatments that are not routinely funded and as such we have policies on particular drugs or treatments. These clinical commissioning policies are agreed with other Clinical Commissioning Groups in Cheshire and Merseyside, are reviewed regularly and are available on our website shortly.
The IFR Team will validate requests in line with NHS St Helen CCG’s commissioning policies.
Information we receive about you will be treated in the strictest confidence and used according to the data-protection laws.
The IFR Team will consider whether your case meets our policy criteria and will make a decision. However, your case may need to be discussed by NHS St Helens CCG’s Individual Funding Panel who meet regularly. The panel consists of representatives from the IFR Team who will present your case as well as clinicians and senior managers.
There are times when an IFR may be refused and this is always a difficult situation. A detailed response on the reason for the decision will be provided including the criteria considered by the NHS St Helens CCG.
We receive a letter from your clinician requesting treatment for you
If you think we have not followed the correct process to reach our decision, or you feel we did not consider everything relevant when we made our decision, your referring clinician can appeal by writing to say why.
NHS St Helens CCG Individual Funding Panel makes its decision on whether to fund new technologies and medicines by assessing the clinical effectiveness of treatments (do they work and what are the benefits when compared with existing treatments?) and their cost effectiveness. Where there are significant financial implications for the CCG but proven health benefits, the final decision rests with the Governing Body of the CCG. The panel also receives requests from health professionals to fund a treatment that is not normally commissioned by the CCG. If the request could apply to a number of patients, the decision is referred to NHS St Helens CCG to consider the development of a relevant policy. Otherwise, the decision the panel needs to make is whether the patient is clinically exceptional to our policy (as defined above) and whether it is fair and equitable to offer this treatment to one individual when it is not routinely available to others.
IFRs are dealt with by Midlands and Lancashire Commissioning Support Unit who provide the service on behalf of NHS St Helens CCG.
Patients are unable to submit IFRs. However, if your clinician believes that your case is clinically exceptional then they can submit a request (and all relevant clinical information to support your application) using the relevant IFR form which can be accessed on the links below.
This should be submitted to the IFR Team whose contact details are as follows: Individual Funding Request Team NHS St Helens CCG Midlands and Lancashire Commissioning Support Unit 1829 Building Countess of Chester Health Park Liverpool Road Chester CH2 1HJ
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