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Clinical commissioning groups (CCGs) commission 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 North, Eastern and Western Clinical Commissioning Group and South Devon & Torbay Clinical Commissioning Group.
We recognise that there will always need to be a process for considering making additional NHS funding available for the atypical or uncommon patient. The Northern, Eastern and Western Devon Clinical Commissioning Group 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.
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.
The Individual Funding Request process applies to individuals who require treatments, drugs or therapies that NHS commissioning organisations do not generally fund.
Applications should be submitted by clinicians to the Individual Funding Request Panel via:
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 your Clinical Commissioning Group's complaints procedure to do this.
If you do not feel that the Individual Funding Request Panel followed due process however, you can ask the Clinical Commissioning Group to review its decision.
The decision making process can be reviewed on request by the Clinical Commissioning Group's 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.
This is an administrative guideline created by DRSS to support referral process as outlined by NEW Devon CCG.
Publication date: August 2017
Review date: July 2019