Referral

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Abdominal hernia in adults Adult Snoring Surgery (in the absence of Obstructive Sleep Apnoea) Arthroscopic shoulder decompression for subacromial shoulder pain Arthroscopic surgery for meniscal tears Artificial urinary sphincters for post-prostatectomy incontinence Assisted Conception Benign Skin and Subcutaneous Lesions Commissioning Policy Blepharoplasty (upper and lower lid) including brow lift Botulinum Toxin A for the management of focal hyperhidrosis commissioning policy Breast implants - removal and replacement Breast reduction surgery Carpal tunnel syndrome (surgery) Cataract Surgery Chronic rhinosinusitis with or without polyps Circumcision Cosmetic Treatments Cryopreservation to Preserve Fertility Dilatation and curettage for heavy menstrual bleeding in women Dupuytren's contracture treatment Ear Wax Removal Femoro–Acetabular Impingement, open or arthroscopic surgery Fusion surgery for non-specific, mechanical back pain Haemorrhoids in adults Hallux Valgus (Bunion) - Commissioned pathway Heavy Menstrual Bleeding - Referral for Surgical Management Hip and knee replacement surgery in obese patients (those with a body mass index of 30 or greater) Individual Funding Requests (IFRs) Injections for non-specific low back pain without sciatica Knee arthroscopy for patients with osteoarthritis Lumbar spine procedures for simple lumbar back pain Meibomian cysts (chalazia) Myringotomy/grommets and adjuvant adenoidectomy for the management of otitis media in children under 12 years Myringotomy with and without grommets in adults and children aged 12 years+ Open Magnetic Resonance Imaging (MRI) Scanning Radiofrequency Denervation Reversal of male and female sterilisation Spinal injections for sciatica Surgery for ganglion cyst Surgical procedures for the treatment of LUTS caused by BPH Tonsillectomy Trigger finger release in adults Varicose vein referral
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Individual Funding Requests (IFRs)

Scope

NHS Devon commissions local NHS health services and NHS England commissions highly specialised health services. Both organisations use national and local policies to prioritise treatments based on available resources and competing demands. This page relates solely to services commissioned by the NHS Devon

What are the options for patients and clinicians if a treatment is not commissioned?

We recognise that there will always need to be a process for considering making additional NHS funding available for the atypical or uncommon patient. NHS Devon have an Individual Funding Request Panel to perform this function.

Where a commissioning policy exists, the Individual Funding Request Panel considers whether there are sufficient grounds to agree funding for a treatment contrary to our commissioning decision not to fund the treatment for the population in general. The process for consideration in these circumstances is whether 'exceptionality' has been demonstrated by the evidence presented.

Where no commissioning policy exists, the Individual Funding Request Panel will consider whether 'individual funding' can be supported.

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Referral Criteria

The following bullet points set out some of the key guiding principles for our Individual Funding Request Panel
  • Clinical need – your GP, hospital consultant or healthcare professional must provide evidence of this when submitting your application using their clinical judgement.
  • Evidence of clinical and cost effectiveness – evidence is required to demonstrate the clinical and cost effectiveness of the treatment, drug, operation, referral or second opinion. The proposed treatment must be the most cost effective option that meets your clinical need.
  • Impact of refusal – what would happen if treatment was denied? What alternatives might be available?
  • Exceptionality – there must be an exceptional reason as to why you need to be treated over and above other patients with similar conditions, for whom treatment is not available.
What is the role of the Individual Funding Request Panel?

The role of Individual Funding Request Panel is to consider applications for funding for treatments, on a case-by-case basis that fall outside existing contracts, or for which prior approval is required within existing contracts.

Who can apply for funding?

The Individual Funding Request process applies to individuals who require treatments, drugs or therapies that NHS commissioning organisations do not generally fund.

Referral Instructions

How can I access the service and have an application considered?

To access the Individual Funding Request process, you should approach your GP or specialist clinician and ask them to submit an application on your behalf.

Applications should be submitted by clinicians to the Individual Funding Request Panel via our generic email address: d-icb.ifr@nhs.net

Referral Form

Individual Funding Request Referral form

Patient Information

Can I challenge a decision made by the NHS Devon funding panel?

The decision of the Individual Funding Request Panel cannot simply be challenged because you or your clinician disagrees with the outcome. If you are unhappy with the decision, you have the right to make a complaint to the responsible commissioner and you should follow NHS Devon's complaints procedure to do this.

If you do not feel that the Individual Funding Request Panel followed due process however, you can ask NHS Devon to review its decision.

The decision making process can be reviewed on request by the NHS Devon Treatment Decision Review Panel. This panel is chaired by a member of the senior leadership team and will also include a non-executive director and a senior doctor.

Patient Information Leaflet

The review panel checks:
  • That the funding panel considered all the evidence provided by your clinician correctly
  • Whether new evidence has emerged that was not available at the time your request, which might alter the funding decision
  • That the funding panel acted in accordance with the applicable NHS Devon policies

Publication date: August 2017

Updated: October 2024

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