Individual Funding

Bucks CCGs statement on IFR data and policy – 5 July 2017

NHS Aylesbury Vale and NHS Chiltern CCGs adopt the same priority statements as the rest of the Thames Valley CCGs, in order to provide assurance that patients have equitable access to health care.

The Individual Funding Request (IFR) data for Aylesbury Vale and Chiltern Clinical Commissioning Groups is a count of all the referrals that the IFR team process on our behalf, however they also provide us with a referral triage service and these referrals have been included in error.

This wide variation in data across CCGs is a result of differences in what is actually being counted by individual IFR teams, some of whom, as in Bucks, are delivering a wider service than typical IFR management.

Our use of wording on our website is not helpful; on reflection we can see this is misleading and will take immediate steps to ensure the process is more accurately described. In addition, we will work with our Thames Valley CCGs to ensure we all apply the IFR terminology in a more standardised way in the future, which should better reflect correct IFR levels.

The actual clinical policies implemented by Bucks are the same as those implemented across the Thames Valley, based on clinical evidence available and with legal and ethical support. They are not unique to Bucks and are commonly used by other CCGs.

 

Individual Funding

AVCCG commits to ensuring that the care patients receive is evidence based and safe.

Some treatments cannot be justified as there is little evidence to say they improve health, or the benefit measured against the possible risk to patients is not strong.

This means that on occasion we may have to make some hard choices between funding something of possible benefit for one patient or funding something of proven benefit for many,

This is why doctors and other health professionals have produced a list of treatments which the NHS won’t provide, and others which will only be done in certain circumstances. The policy statements are held on a separate website. You can visit them using the links below:

It is important to remember that even for treatment which the NHS will not normally provide; there are sometimes exceptional circumstances where there may be overwhelming health benefits for an individual patient. In these cases, a doctor, on behalf of a patient, can explain the exceptional circumstances to the Clinical Commissioning Groups and a special panel will decide if the NHS will carry out the operation.

The following Operational Policy and its Annexes describe the Individual Case Review Panel (ICRP), the context in which it makes decisions and how it operates. It is written for residents of Buckinghamshire and for their clinicians (General/Dental Practitioners and Medical Consultants), in order to help decide whether it is appropriate to apply to the Panel and to help ensure any IFR meets the guidelines and operational policies of the PCT.

Individual Case Review Panel – Operational Policy

Please click on each of the following PDF document links to find out more.

Panel meetings

These occur twice a month on the Third Wednesday of the month and the fourth Thursday of the month. The deadline for these meetings is the Third Monday of each month. Please note that a case will only be considered if the information is provided in full. Missing information will delay the process.

Terms of Reference

Please click on the following PDF document to find out more.

Case-Review-Panel-ToR-final

Reconsideration of Cases

Cases can be reconsidered when ‘new’ additional clinical information is provided. More details can be found in the Operational Policy.

Appealing a decision

If you wish to appeal against a decision then the process that the case has been through will be reviewed and not the decision made. More details can be found in the Operational Policy.

If you have any additional questions

Please contact the  Individual Funding Request (Priorities) Team on 01494 555588 or email bucks.ifrrequests@nhs.net for all enquiries about the policy statements or the process for considering Individual Funding Requests.

Postal Address: Central Southern Commissioning Support Unit (CSCSU), 3rd Floor, 40 Oxford Road, High Wycombe, Bucks, HP11 2EE

Referral Threshold Criteria

Additionally, the Buckinghamshire Clinical Commissioning Groups, with the advice of local doctors, from time to time agrees ‘thresholds’ for clinical services. These thresholds are designed to ensure that patients are treated by the right clinical service according to their needs, based on the best available evidence.

The referral thresholds below have been agreed between primary and secondary care to assist GPs in making referrals in the most effective way to meet their patient’s needs.

NTERVENTION REFERRAL CRITERIA
Cardiology  Cardiology
Dermatology  Dermatology
ENT  ENT
Gastroenterology  Gastroenterology
General Surgery  General Surgery
Headache Migraine  Headache & Migraine
Ophthalmology  Ophthalmology
Orthopaedic  Orthopaedic
Paediatric  Paediatric
Plastics  Plastics
Urology  Urology

Below is a document with a list of questions you may like to consider prior to referral

Referral Policy – Considerations