Clinician Individual Funding Request Guide

What is an Individual Funding Request (IFR)?

An Individual Funding Request (IFR) is an application for NHS funding for a procedure, treatment, drug, or piece of equipment that is not routinely commissioned. It can also be a request for when the individual falls outside of the range of services or treatments commissioned by the ICB. In these circumstances, clinical exceptionality or extenuating factors are considered.

The Individual Funding Request process is needed to make sure that requests for treatments not normally funded are assessed in a fair and equitable manner. This is part of a robust decision-making process that will stand up to due diligence and scrutiny.

The IFR process is clinically led and must be submitted by an NHS doctor or health care professional directly involved in the care of the patient. If you deem the patient to have exceptional clinical circumstances, as the treating clinician, it is your responsibility complete the IFR form as accurately and comprehensively as possible.

Things to consider within an IFR

The NHS has limited resources and the ICB has a duty to manage them carefully. This means we must establish:

If there are clinical features of the case which make the individual different to the population of patients who could also benefit from the requested intervention?
If not, would we set a precedent by approving this application?
If the patient would gain greater clinical benefit compared to what is expected for that intervention for a similar cohort of patients?

Personal, demographic or social factors cannot be taken into account when considering an IFR and only factors which are clinical in nature can be considered.

The IFR process cannot be used to progress the funding of a service development.

The fact that a diagnosis is very rare, or a treatment might be effective for the patient or is the only treatment option is not grounds for exceptionality. If a patient’s clinical condition matches the ‘accepted indications’ for a treatment that is not funded, they are, by definition, not exceptional.

How to make an IFR

When clear evidence of clinical and cost effectiveness/affordability can be identified within the patients case the treating clinician can submit an IFR application.

The IFR documents including the policy and application form can be found on the ICB website. You can submit an IFR form to the Funding Team for consideration at: [email protected]

Patients can support the IFR by submitting a personal statement highlighting symptoms and any functional impairment.

If the request relates to a service or intervention commissioned by NHS England, an NHSE IFR request should be completed. To access the NHSE IFR details please use the following link:
www.england.nhs.uk/commissioning/policies/gp

Is there an existing service or policy?
Yes: Go to question 2
No: Go to question 3
Does the patient meet the clinical criteria for treatment?
Yes: Refer to service
No: Go to question 3
Does the request relate to a service or intervention commissioned by NHS England?
Yes: Submit IFR to NHS England or visit their website: www.england.nhs.uk/commissioning/policies/gp
No: Go to question 4
Does the request meet the following requirements for consideration as an IFR:
a) There is sufficient clinical evidence to confirm that the patient is significantly different to the general population of patients with the condition in question
AND
b) The patient is likely to gain significantly more benefit from the intervention than might be normally expected for patients with that condition.

Yes: Go to question 5
No: Advise patient that request cannot be progressed
Do you think that there are likely to be more patients within Mid and South Essex requiring the same treatment?
Yes: Go to number 6
No: Submit IFR application
This is likely to be a service development. The treating clinician will need to submit a business case via the ICB Trust. (Note: Such requests will NOT be funded during the current financial year.)