Our role is to plan and fund (commission) healthcare services for the people of North Kirklees. We have limited resources and therefore need to make the best use of our budget so that people living in our area can access the healthcare services they need.
In most cases, the CCG has agreements in place to fund healthcare. However, there may be times when a particular treatment or drug is not routinely available. This may be because they are:
- not covered within existing contracts; and
- expensive or rare.
When a drug or treatment falls outside of the range of services or treatments that the CCG has agreed to fund, an individual funding request (IFR) can be made.
IFRs can only be initiated by a clinician, ie the GP, hospital consultant or dentist making a request for funding for a treatment.
- Your clinician makes a request to the CCG.
- Requests are forwarded to a Screening Panel.
- The Screening Panel may recommend that a request is considered by the Exceptional Cases Committee or refuse the request.
- Where a recommendation is made for consideration of the request, this goes forward to the Exceptional Cases Committee.
- The Exceptional Cases Committee may approve or refuse the request.
- Where a request is refused, either by the Screening Panel or by the Exceptional Cases Committee, your clinician may appeal using the agreed process.
The Screening Panel meets every week.
The Exceptional Cases Committee meets every month.
The Individual Funding Requests Referral Form. This form should be completed by the referring clinician but includes a section to be completed by the patient.
Prior Approval Criteria
The Prior Approval Referral Form. This form should be completed by the referring clinician.
The CCG has adopted the recommended NHS England criteria (Evidence-Based Interventions: Response to the Public Consultation and Next Steps. Published by NHS England) in relation to interventions listed below. You can find out more about what the Evidence-Based Interventions Programme is by watching the video below and reading our patient information leaflet.
The following interventions are included as part of the the Evidence-Based Interventions Programme:
A patient leaflet and short video, where available, explains why each intervention has been included in the Evidence Based Interventions (EBI) programme guidance. Please note the intervention guidance documents are relevant to people living in North Kirklees.