Each financial year NHS England runs a process for making discretionary investment decisions about which new specialised treatments can be routinely commissioned (funded).

This process is supported by an independently chaired Clinical Priorities Advisory Group (CPAG) and is often referred to as the CPAG annual prioritisation process.

Final funding decisions are based on advice from CPAG – which advises on the relative priority for investment of all the treatments under consideration – against a discretionary level of investment which is determined annually and based on affordability. Full details of this process can be found in our published methods.

As part of the 2024/25 CPAG annual prioritisation round, 11 treatments and procedures have been under consideration. At this point in time, it has not been possible to identify the necessary recurrent headroom in revenue budgets to support the funding of any treatments under consideration. This position takes into account the need to maintain all existing services for patients across the specialised commissioning portfolio; meet statutory funding duties e.g. the legal duty to fund all NICE approved treatments; and, across the whole of the NHS, respond to growth in demand.

This position will be kept under review for the remainder of 2024/25. However, any treatments that are not prioritised for funding during 24/25 will automatically be eligible to be reconsidered at subsequent CPAG prioritisation rounds in line with our policy. The next CPAG annual prioritisation round (25/26) will be deferred until such point that recurrent revenue funding can be identified to support new discretionary spend commitments.