Commissioning policies - drugs and treatment you're entitled to
We have set up this section so that you can find out more about how we commission (fund) healthcare services - drugs, treatments and technologies - that may not be available or routinely provided by the NHS.
Individual Funding Request Policy
NHS Kirklees is a primary care trust (PCT). Our role is to plan and fund (commission) healthcare services for the people of Kirklees. We have limited resources, so we need to make sure that we make the best use of our budget so that people living in Kirklees can access the healthcare services they need. Each year we identify our priorities and agree a plan for the following year.
The Individual Funding Request (IFR) process is in place for situations where the proposed treatment/drugs are:
• new;
• not covered in existing contracts; and
• expensive or rare.
An individual funding request must demonstrate that:
• the patient is significantly different to the general population of patients with the condition in question; and
• that the patient is likely to gain significantly more benefit from the intervention than might be normally expected for patients with that condition.
Please note that due to the technical nature of this policy there may be terms that you are unfamilar with. Should you need any advice or assistance please speak to the healthcare professional looking after you or get in touch with us and we will respond as soon as we can.
Individual Funding Requests process leaflet - Information for patients
Funding high cost drugs
NHS Kirklees routinely commissions drugs approved by the National Institute for Health and Clinical Excellence (NICE) through their technology appraisal process. NHS Kirklees routinely commissions drugs approved by the Scottish Medicines Consortium (SMC). NHS Kirklees also routinely commissions drugs where NICE has produced a consultation appraisal that supports use in the NHS.
NHS Kirklees will not routinely commission drugs where NICE or SMC have rejected their use or where NICE has produced a consultation appraisal that rejects use in the NHS.
Where there is a conflict of advice between NICE and SMC, NICE guidance (including consultation appraisal) takes precedent.
NHS Kirklees commissioning statements are the same as the guidance issued by NICE or SMC and are available at www.nice.org.uk or www.scottishmedicines.org.uk
NHS Kirklees will develop its own commissioning statements for drugs not covered by NICE/SMC/tariff. Where appropriate this will be done collaboratively through the Yorkshire and Humber Specialised Commissioning Group.
An Individual Funding Request (IFR) may be submitted for a patient who is felt to be an exception to the commissioning statements of NHS Kirklees.
Funding interventional procedures:
NHS Kirklees will routinely commission interventional procedures where National Institute for Health and Clinical Excellence (NICE) arrangements indicate “normal” and the evidence of effectiveness is sufficiently robust.
Any proposal to introduce a NICE approved interventional procedure must come through the usual business planning process. NHS Kirklees will not fund interventional procedures introduced outside a business planning process.
NHS Kirklees does not routinely commission interventional procedures where NICE arrangement indicate “special”, “other”, “research only” and “do not use”.
The commissioning statements for individual procedures are the same as those issued by NICE and are available at www.nice.org.uk. NHS Kirklees will develop its own commissioning statements for procedures not covered by tariff. Where appropriate this will be done collaboratively through the Yorkshire and Humber Specialised Commissioning Group.
An Individual Funding Request (IFR) may be submitted for a patient who is felt to be an exception to the commissioning statements of NHS Kirklees.
Yorkshire and the Humber Specialised Commissioning Group
Yorkshire and the Humber Specialised Commissioning Group produces and implements, on behalf of the 14 member PCT's, commissioning policy with respect to specialist services covered by the national definitions set.
To find out more about the policies relating to the specialised services covered by the group please visit the Yorkshire and Humber Specialised Commissioning Group website.
