What is an individual funding request?
An individual funding request can be made by your doctor, if they believe that a particular treatment or service that is not routinely offered by the NHS is the best treatment for you, given your individual clinical circumstances.
Why are some treatments not routinely offered by the NHS?
The vast majority of treatments and services that patients need are offered routinely by the NHS. There may be some cases however where a decision has been taken not to offer the treatment to groups of patients with a particular clinical need. This may be because there is limited evidence for how well the treatment works in those patients or because the treatment is very expensive and doesn’t offer good value for money for the NHS.
There will also be some circumstances where a treatment is still very new and a decision hasn’t been taken yet on whether it should be offered routinely on the NHS.
Is there a list of procedures subject to IFR's?
A list (last updated October 2017) can be downloaded here.
When can an individual funding request be made?
An individual funding request can be made for a treatment that is not routinely offered by the NHS when the doctor believes that their patient is clearly different to other patients with the same condition or where their patient might benefit from the treatment in a different way to other patients. This is known as “clinical exceptionality”.
As an example, dental implants are not routinely offered by the NHS, however if a patient could not use their arms due to a disability and needed dental implants to hold a pen so they could write, this might be considered an exceptional case.
Doctors can also make a request for funding where a decision hasn’t yet been taken on whether a treatment should be offered in the NHS and where their patient’s condition is likely to get a lot worse very quickly and without any prospect of recovery, unless they receive the treatment. This is known as “critical clinical urgency”.
Where a request is made on grounds of clinical urgency, the doctor will need to show that the evidence for use of the treatment is strong and that the treatment is likely to represent good value for money compared with other treatments provided routinely by the NHS.
Your doctor should explain to you why they believe that a treatment that is not routinely offered by the NHS is the best treatment option for you.
Who can make an individual funding request?
Your doctor will make the funding request on your behalf and will inform you of the outcome. Individual funding requests cannot be made directly from patients.
Who considers the application?
Applications will first go through a screening process by to make sure all relevant information has been submitted. The doctor will be contacted if further information is needed. In most cases, the application will then be considered by an expert independent panel of clinicians who will not have been involved in your treatment. The panel also contains an independent lay (public) representative. All panel members have received training to enable them to assess individual funding requests fairly and thoroughly. Your personal details will be kept confidential. The decision will be made known to your doctor and you will also be sent a copy of the letter. If the application is unsuccessful then the letter will explain the reasons. When you next see your doctor, they will discuss with you what other treatment options might be available.
How long will an application take?
In urgent cases, applications will be considered within two weeks, and often much sooner. In other cases, applications will usually be considered within four weeks.
Where can I find more information?
Further information on NHS England can be found on our website at www.england.nhs.uk and more detailed information on individual funding requests can be found at http://www.england.nhs.uk/commissioning/policies/gp/