Individual Funding Requests (IFR)

An Individual Funding Request (IFR) is an application to fund healthcare which falls outside the range of services and treatments which are “routinely commissioned” because either their clinical and cost-effectiveness is marginal or NHS provision may be inappropriate (e.g. the benefits are purely cosmetic and not clinical).

Making an application

IFR applications must be submitted by the treating clinician. SWL CCG cannot accept IFR applications directly from patients, although patients can work with their clinician to have input into the process if their clinician believes they are eligible.

IFR applications must be submitted online on the IFR template provided on BlueTeq.

Contact the IFR Team

The IFR service will keep in contact with your clinician during the application process and let them know how the application is progressing and if there are any delays. You should therefore speak to your clinician in the first instance.

If you’ve spoken with your clinician but still need to contact the IFR service:

Email: nelcsu.ifrswlondon@nhs.net

Telephone: 020 3668 1222

FAQ

An individual funding request can be made for a treatment that is not routinely offered by the NHS when:

  • Your clinician believes that your clinical circumstances are clearly different to other patients with the same condition, AND
  • There is a reason why you would respond differently to other patients – and therefore gain more clinical benefit from the treatment.

In the application, your clinician will need to explain why your clinical circumstances are different and show all available clinical evidence for why they believe you would benefit more from the treatment than other patients with the same condition. They will also explain to you why they believe that a treatment that is not routinely offered by the NHS is the best treatment option for you.

Patients understand their symptoms better than anyone and may be very well informed on their condition. If you’re aware of a treatment that you think may help you, discuss it with your clinician who can advise you if an individual funding request would be appropriate. If there are likely to be other patients with similar clinical circumstances who might benefit from the treatment in a similar way, your clinician can request that commissioners (CCGs) consider introducing it as a routine treatment. If it is approved, the clinician can then make the treatment available to you.

As long as all the required information is submitted, it usually takes 30 working days from receiving an application to a decision. Commissioners may need to ask your clinician for additional information, which may delay the process to provide a final decision.

Urgent cases can be processed more quickly, if clinically necessary.

Your application will first go through an administrative and clinical screening process to make sure all relevant information has been submitted and the application meets the criteria for an individual funding request.

It will then be considered by the South West London IFR panel. The panel is made up of doctors, public health experts, pharmacists, commissioners and lay members and is led by a lay chair. The panel will consider the application in detail before making a decision, usually within a few weeks. All panel members regularly receive training to enable them to assess individual funding requests fairly and thoroughly.

Treatments agreed through the IFR process must be funded from the same budget available for other established treatments. It’s because of this that every single case is considered extremely carefully before a decision is taken to fund a treatment for an individual that is not usually available on the NHS. Your personal details will be kept confidential.

Commissioners will let your clinician know the outcome of the funding request and you will also be sent a letter to notify you of the decision. If your application is unsuccessful, your clinician will discuss with you the reasons for the decision and what other treatment options may be available.

If the IFR panel hasn’t supported funding for a requested treatment, or if it has approved a treatment subject to conditions and you don’t agree, you should speak to your clinician who may be able to request a review of the decision. The review can be requested if you and your clinician think that the process hasn’t been followed correctly and must be made within 28 days of when you were informed of the decision.

If your situation changes or more clinical evidence becomes available about the effectiveness of your treatment your clinician may also be able to submit additional information which will be considered.

Every person has the same rights to treatment under the NHS no matter what their social, family or other circumstances are. For this reason, it’s important that non-clinical factors are not considered in IFR decision making.

For example, factors such as the effect of a treatment on a patient’s ability to work or study, care for dependants, or meet financial commitments can’t be considered as part of the IFR process. The decision is based on clinical circumstances only, which ensures the IFR process is fair, equitable and non-discriminatory.

Your healthcare is paid for by the NHS. The budget for healthcare is given to various organisations to pay for your treatment. Locally, the CCG is responsible for funding healthcare treatments for the population for which it is responsible.

CCGs are allocated sums of money and have to make decisions to use the money for the healthcare needs of the population that they provide healthcare for. Unfortunately, there is not enough money to fund every possible type of operation, procedure and medication, so decisions have to be made as to what will be available for everyone and what has to be restricted.

CCGs under the NHS constitution have a duty to provide treatment which NICE has recommended in technology appraisals. Other guidance by NICE is advisory only and CCGs prioritise what treatments to fund given their budgetary limits.

If your request for funding has been declined by NHS England, you cannot apply to the CCG via the IFR process. CCGs are not allowed to commission services/treatments that are the responsibility of NHS England.