NHS England has finite resources, and needs to make decisions to ensure the best possible outcome for all of the patients for whom it has commissioning responsibility.
Decisions must be made in a systematic, consistent and transparent way, with the aim of fairly and rationally distributing these resources across different patient groups, and across competing demands.
NHS England is currently using the interim Ethical Framework to underpin its decision-making.
The interim Ethical Framework sets out 15 ethical principles, some of which relate to legal and statutory duties, and have to be adhered to by NHS England as a public body.
These principles, along with the generic commissioning policies, and some standard operating procedures, need to be applied consistently, throughout a structured governance process. Without these elements, a public organisation cannot deliver fair and robust decision-making.
NHS England is currently reviewing its interim Ethical Framework and policies, in partnership with its stakeholders, as part of the development of a comprehensive Prioritisation Framework to support future decision-making. View more information about Revising the Ethical Framework and Commissioning Policies.
- Ethical Framework for Priority Setting and Resource Allocation: Sets out a framework for fair and consistent decision-making for the direct commissioning arm of NHS England
Individual Funding Requests
NHS England’s policy on the conditions, processes and criteria used for decision-making in the case of Individual Funding Requests (IFRs).
- Interim Commissioning Policy: Individual funding requests
- Interim Standard Operating Procedures: The Management of Individual Funding Requests
- Application form for IFRs
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). As of January 2016, improvements have been made to the administrative processes for managing IFRs. These changes have made been as a result of the experience gathered over the past 3 years, since NHS England took on responsibility for the IFR process, and have been made following engagement with a range of stakeholders, including the NHS England Patient and Public Voice Assurance Group. The aim of the revised IFR process is to ensure a more timely and consistent approach to managing IFRs for NHS England prescribed services.
An amended standard operating procedure for the management of individual funding requests has been published to reflect the changes.
A single point of entry system for clinicians to submit all IFR applications has also been implemented with the aim of providing a clear route for submission of requests. Healthcare professional wishing to submit an IFR should send the relevant completed documentation to: firstname.lastname@example.org.
- Standard Operating Procedure for funding Requests for Clinically Critically Urgent Treatment outside Established Policy
- In-Year Service Developments
States NHS England’s position on requests for the recurrent funding of new services.
- Implementation and Funding of NICE Guidance
Sets out how NHS England will respond to the implementation and related funding of new guidance from the National Institute of Clinical Excellence (NICE)
- Experimental and Unproven Treatments
Sets out the circumstances in which NHS England may wish to fund a treatment or intervention which is either considered experimental or not to be of proven effectiveness
- On-going Treatment Following a NHS CB Funded Trial
Sets out NHS England’s policy on access to treatment following the completion of a trial which it has explicitly funded
- On-going Treatment Following Non-Commercially Funded Clinical Trials
Sets out NHS England’s policy on access to treatment following the completion a non-commercially funded trial
- On-going access to treatment following a trial of treatment
Sets out NHS England’s policy with regard to the funding of a patient’s treatment at the end of a ‘trial of treatment’ which it does not normally commission.
- Patients changing responsible commissioner
States NHS England’s policy on when it will accept responsibility for existing funding commitments made by patients’ previous commissioning bodies e.g. PCT or CCG
Policy on choices for elective referrals for which NHS England is responsible.
- Defining the boundaries between NHS and private healthcare
This policy defines the boundaries between privately funded treatment and entitlement to NHS funding, under a range of circumstances.
- On-going Access to Treatment Following Industry Sponsored Clinical Trails or Funding
Sets out NHS England’s policy on access to treatment following the completion of industry sponsored clinical trials or funding
- Clinical Service Derogation of Commissioned Specialised Services
Sets out the circumstances under which clinical providers may apply for a derogation, or temporary delay, in meeting key service requirements in full, as described in the service specification, or other mandatory commission requirements
- Commercial Service Derogation of Commissioned Specialised Services
Sets out the circumstances under which commercial providers may apply for a derogation, or temporary delay, in meeting key service requirements in full, as described in the service specification, or other mandatory commission requirements