Exceptional and Individual Funding
Where a treatment or service is not routinely offered by the NHS, a healthcare professional may submit to NHS England an Individual Funding Request (IFR). If the NHS approves the request it will then pay for the treatment that is being recommended for you.
An individual funding request can be made by a clinician, doctor or other health professional and will ensure that you get the best treatment, given your individual clinical circumstances.
Every year clinical commissioning groups (CCGs) receive money from the government to pay for healthcare for everyone registered with a GP in the areas that they cover. This includes services from GPs, hospitals, clinics and other providers.
Because of the limited resources available to the NHS your local CCG may decide that it will not normally provide certain types of treatment or will provide them only for certain types of cases.
A GP or other healthcare professional can make an Individual Funding Request (IFR) on your behalf for treatment which is not routinely funded or for a treatment which is normally only funded in line with specific criteria which you do not meet.
For either of the above, funding can only be approved if a case of “exceptional clinical need” has been demonstrated.
It is important for patients to be aware that only evidence of clinical need will be considered. Factors such as gender, ethnicity, age, lifestyle or other social factors such as employment or parenthood will not be considered. The fact that the treatment might be effective for the patient is not, in itself, grounds for ‘exceptionality’.
If you have been advised that a particular treatment would be beneficial for you, but your local CCG does not routinely pay for this, you should discuss the possibility of an IFR with your medical adviser.
If an IFR made on your behalf is refused by the NHS you should discuss other options, such as private healthcare, with your medical adviser.
There is more information on IFRs here.