Individual funding requests (IFR)

NCL Wide

An individual funding request (IFR) is a request for NHS funding for treatment that is not normally available and that is only paid for under certain circumstances.

The NHS has limited resources and everyone has a duty to manage them carefully.

This means:

  • looking at the clinical reasons for exceptionalism in individual cases
  • looking at evidence for the safety and effectiveness of any treatment
  • ensuring that the services paid for will give patients the greatest health gains from the resources available.

There may be situations where a clinician believes that their patient’s clinical situation is so different to other patients with the same condition that they should have their treatment paid for when other patients would not. 

An IFR is a request for NHS funding for a treatment that is not routinely offered and that is only paid for under certain circumstances. IFR applies to all clinical interventions which are not funded through ICB Operating Plans and commissioning contracts, where funding needs to be considered on an individual patient basis.

For example

  • when there is no policy in place and when there is evidence of clinical exceptionality that gives access to an intervention for a group of patients with a specific set of clinical circumstances, that the clinician believes there are no other patients with similar clinical circumstances who might benefit from the treatment in a similar way

or

  • when there is a policy in place that gives access to an intervention for a group of patients and your patient does not meet the policy criteria. The referring clinician believes that the clinical circumstances are clearly different from other patients with the same condition who do not meet the criteria and there is a reason why the patient would respond differently to other patients with the same condition who do not meet the criteria - and therefore gain more clinical benefit from the treatment
  • and, there is evidence of clinical effectiveness of the requested treatment for the condition
  • and, the requested treatment will be a good use of NHS resources.

As the NHS has limited resources and everyone has a duty to manage them carefully.

This means:

  • looking at the clinical reasons for exceptionality in individual cases
  • looking at evidence for the safety and effectiveness of any treatment
  • ensuring that the services paid for will give patients the greatest health gains from the resources available.

Exceptionality

For the purposes of IFR decision-making process, a patient’s clinical condition will be agreed as exceptional if the following two points are fully demonstrated in the IFR application:

  • significantly different to the general population of patients with the condition in question; and are 
  • likely to gain significantly more benefit from the intervention than might be expected for the average patient with the condition.

The IFR process is clinically led and must be submitted by you, as the referring clinician, where you deem there are exceptional clinical circumstances for a treatment or drug to be provided that NCL ICB does not usually fund. 

Further to review of the NCL Evidence Based Interventions and Clinical Standards (EBICS) Policy and/or the relevant fertility policy (see right), to ensure that the treatment is not listed, the case should be referred to the NCL IFR Service via the IFR Blueteq system (email applications will only be accepted only in exceptional circumstances; see the NCL IFR Policy).

The main objective of the online IFR Blueteq system is to simplify and streamline the application process and ensure that applicants provide only the relevant information required for proposed interventions to help the IFR decision-making. 

Patient consent

All applications need to show clearly that patient consent has been obtained. Without patient consent, the IFR team will not be able to accept the referral and it will be returned.

Urgent IFR request

Refer to the NCL Policy.

Please note: All applications need to clearly show that patient consent has been obtained. Without this, the IFR team are unable to accept referrals and these will be returned.

IFR applications are taken through a formal, clinically-led weekly triage and, where this is appropriate, referred on to a monthly clinically-led IFR panel for a funding decision. 

In reaching a decision, the IFR panel takes a number of factors into consideration, including clinical effectiveness, cost effectiveness, grounds for exceptionality and equality considerations for other similar patients. Should the outcome of a IFR panel decision not be favourable for the applicant, this can be raised with the IFR Appeals Panel to consider whether due process was followed.

The NCL IFR Policy sets out the principles behind the decisions on individual treatments. It also explains the system for processing each request for treatment.

To create an account, visit the Blueteq website (see right) and then click on the Register Here button.

Visit the Blueteq website (see right) and enter your login details, then select as follows:

Individual Funding Requests (IFR) Team
North Central London Integrated Care Board
Laycock PDC
Laycock Street 
London 
N1 1TH
e: nclicb.ifr@nhs.net

NCL Prior Approvals Teams

Barnet: barnet.EBICS@nhs.net
Camden: camden.EBICS@nhs.net
Enfield: enfield.EBICS@nhs.net
Haringey: haringey.EBICS@nhs.net
Islington: islington.EBICS@nhs.net

London IFR Teams

NHS North Central London (Barnet, Camden, Enfield, Haringey, Islington): nclicb.ifr@nhs.net
NHS North East London (Barking and Dagenham, Havering, Redbridge, City and Hackney, Newham, Tower Hamlets, Waltham Forest): nelondonicb.ifr@nhs.net
NHS South East London (Bexley, Bromley, Greenwich, Lambeth, Lewisham, Southwark): ifr@selondonics.nhs.uk
NHS South West London (Croydon, Kingston, Richmond, Merton, Sutton, Wandsworth): ifr@swlondon.nhs.uk
NHS North West London (Brent, Ealing, Fulham, Hammersmith, Harrow, Hillingdon, Hounslow, Kensington, Chelsea, and Westminster): nhsnwl.ifr@nhs.net

North East London Prior Approval and IFR Teams

The Prior Approval Team email address for North East London ICB is: nelondonicb.hcdpas@nhs.net 

The Individual Funding Request Team (IFR) email address for North East London ICB is: nelondonicb.ifr@nhs.net

Review date: Wednesday, 04 September 2024

Useful resources

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NCL EBICS Policy v9.1

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NCL ICB Fertility Policy v1.0

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NCL ICB IFR Policy (July 2022)

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NCL IFR Policy

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NCL IFR Policy Appendix D: IFR Panel Terms of Reference

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NCL IFR Policy Appendix D: IFR Appeals Panel Terms of Reference

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NCL IFR Policy Appendix D: IFR Triage Group Terms of Reference

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IFR Blueteq Submission Guidance