This is national guidance developed in partnership with NICE and the Academy of Medical Royal Colleges (AoMRC). It reflects NICE, NICE accredited guidance and the latest guidance from the relevant specialist societies. The EBI programme is a continuous improvement programme. The most recent wave of guidance, List Two, was published in November 2020.

The aim of the guidance is to reduce harm and unnecessary interventions, by ensuring that interventions routinely available on the NHS are evidence-based and appropriate.

For providers who are using a local system to review patients against EBI guidance, you will be required to capture whether the patient meets the criteria of the EBI guidance or not at procedure level. Checks against EBI guidance forms part of your clinical prioritisation, so should be completed as part of your full clinical prioritisation for patients and embedded in standard practice moving forward.

The application of the national EBI policy is a minimum requirement. Providers should follow local commissioning arrangements alongside national EBI policy.

Shared decision-making is at the heart of the clinical prioritisation programme. The clinician should talk to the patient and outline the relevant EBI guidance and the alternative treatments available to them sharing the outcome of the discussion and any follow up activity with the patients GP where relevant. They can use the patient information leaflets and direct them to the patient videos for more information.

If the provider can demonstrate clinical exceptionality, they should apply for an Individual Funding Request (IFR) following the agreed process for completing an IFR, during which time the RTT clock will continue to run.

If clinical exceptionality cannot be demonstrated, the clinician should agree with the patient that they will be removed from the waiting list for the procedure but remain on the waiting list for any alternative treatment and the RTT clock continues to run.

Where an IFR is agreed the patient remains on the waiting list and again the RTT clock continues to run.

Across the country we have assessed the approximate number of patients on a waiting list for any one of the interventions included in the guidance by provider. We will share data with all providers so you understand the volume of patients we anticipate will need reviewing against the evidence-based interventions guidance.

No. Where reviews have already been carried out, we do not require the process to be repeated.

For all reviews carried out with immediate effect, an assessment should now be completed against the EBI guidance during clinical prioritisation for any interventions listed in the EBI guidance.