Cosmetic, Other Surgeries, Devices, Screening, Diagnostics and Other Therapies
Information and forms can be found by using the search facility on the right of the table below (just above Process Pathway). Type a word associated with the intervention you require and a limited list of policies and forms to be displayed. For example Assisted Conception would be displayed if any of the following is typed Assisted, Conception, IVF.
Smoking Cessation before planned surgery: Patients are encouraged to stop smoking prior to planned surgery. Please refer to Thames Valley Policy Statement 78 Smoking cessation before planned surgery.
Fully completed application forms should be saved locally and sent from an NHS.net email account (or other email account which meets the secure email standard and is DCB1596 accredited) to scwcsu.cpis.requests@nhs.net for consideration.
| INTERVENTION | POLICY STATEMENT | PROCESS PATHWAY |
|---|---|---|
| Acupuncture for managing low back pain with or without sciatica Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and funding approval must always be obtained from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. The GP must fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Adenoidectomy Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC20 Surgical Management of Otitis Media (under the age of 18 years) v2.0 | This procedure is funded subject to audit. Please refer your patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: Surgical management of glue ear Otitis media effusion (OME) in children under the age of 18 years and Adjuvant Adenoidectomy Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| ADHD Treatment Pathway for Adults with Attention Deficit Hyperactivity Disorder Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC71 Treatment pathway for adults with attention deficit hyperactivity disorder (ADHD) - December 2017 | Funded subject to audit. Outside of the local service this is a procedure not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Adhesive Capsulitis (Frozen Shoulder) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC74 Adhesive Capsulitis v2.0 | This is a procedure that requires prior approval. If after assessment, the Consultant wishes to treat, they must apply for prior approval by fully completing the following: Adhesive Capsulitis Form Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Aesthetic/Cosmetic Breast Surgery including: - breast augmentation, revision of breast augmentation, breast asymmetry, breast mastopexy - breast lift, mammoplasty, reconstruction/revision of breast (not including post breast cancer), inverted nipple, corrective surgery to nipple, removal of supernumerary nipples, breast implant removal and replacement, female breast reduction, reduction mammoplasty, male breast reduction for gynaecomastia Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: IFR application form Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Aesthetic/Cosmetic Procedures: Eyelid surgery (blepharoplasty) including: blepharoptosis(an abnormal low-lying upper eyelid margin) and dermatochalasis (skin redundancy of the upper lid), ptosis of eyelid Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: Eyelid Surgery Blepharoplasty, Dermatochalasis, Correction of Ptosis Form BW Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net |
| Aesthetic/Cosmetic Procedures Benign skin lesions and lipomata including: Acne vulgaris, Dermatofibromas (skin growths), Naevi (benign pigmented naevi, epidermal, haemangioma, moles, spider, congenital and port-wine, Sebaceous cysts (pilar and epidermoid cysts), Seborrhoeic keratosis (benign skin growths, basal cell papilloma, senile warts), Skin tags, Telangiectasia (HHT, spider veins and thread veins), Vitiligo, Warts (plantar including verrucae, filiform and common), Xanthelasmas (cholesterol deposits underneath the skin) (excluding ?histology ie cancer), Lipoma and Lipomata (fat deposits underneath the skin) Laser removal of skin lesions, haemangioma, congenital naevi Excluding BCC and SCC Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: Benign-Skin-Lesions-and-Lipomata-v1.2-BW Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Aesthetic/Cosmetic Procedures Excess skin removal and body contouring including but not limited to: abdominoplasty, apronectomy, (tummy tucks), reconstruction/revision of body (excess skin removal for all areas, reconstruction/revision of body (excess skin removal all areas) post bariatric surgery/ weight loss, body contouring procedures (buttock, thigh, calf implants, arm lifts), plastic operations on the umbilicus, brachioplasty (arm lifts), liposuction, facial procedures including eye bags, facelift (rhytidectomy/ surgical removal of wrinkles)/ brow lift and submental lipectomy Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: IFR application form Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net |
| Aesthetic/Cosmetic Procedures Nose reshaping including: Rhinoplasty / Septorhinoplasty (cosmetic nose surgery), Reconstruction/revision of nose surgery Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: IFR application form Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Aesthetic/Cosmetic Procedures Other procedures including: brow lift and submental lipectomy, botox for cosmetic reasons, pinnaplasty for adults and children (bat ears), reconstruction /revision of external ear, split earlobes, meatoplasty/plastic operations on external ear (lobe repair) irregularities of aesthetic significance, Onychomycosis (fungal nail infections), Scars including keloid (removal and revision), Tattoo (removal or revision), Rhinophyma, Rosacea, excision of skin tag of anus (not including fistula's), excision of sweat bearing glands, laser treatment, excessive hirsutism, minor skin procedures (not including BCC and SCC), aesthetic/cosmetic genital surgery (male or female), clitoroplasty, labiaplasty, vaginoplasty, hymenopathy, penile prosthesis / enlargement, repair of traumatic /chronic clefts due to avulsion of body piercing, skin resurfacing (dermabrasion, laser and chemical peels), correction of Alopecia (hair loss including Intralace), correction of male pattern baldness, hair transplantation, hair grafting, intralace treatments for hirsutism/ hair depilation, electrolysis for hair removal, appliances and devices for cosmetic purposes (high-grade silicon cosmesis and/or prosthesis) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: IFR application form Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net |
| Anal Irrigation Systems for the Management of Faecal Incontinence/Constipation Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC3a Anal Irrigation Systems Policy Update v3.0 | This is a procedure that requires prior approval. Outside of the local service this is a procedure not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Anterior Cruciate Ligament (ACL) reconstruction - Knee Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC83 Anterior Cruciate Ligament (ACL) reconstruction policy recommendation v2 | Prior approval is always required from the IFR service. Please fully complete the appropriate form: Anterior Cruciate Ligament (ACL) reconstruction Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.netfor consideration. |
| Anti-VEGFs rare eye conditions | Thames Valley Priorities Committee Commissioning Policy Statement TVPC96 Anti-VEGFs rare eye conditions v1.0 | The Thames Valley Committee has concluded that there is sufficient evidence of clinical and cost-effectiveness to support the use of anti-VEGF in the management of patients with the following rare conditions, this list may not be exhaustive: • Multifocal choroidopathy (including punctuate inner choroidopathy and multiple • evanescent white dot syndrome) • Atypical choroiditides (including histoplasmosis, tuberculous, syphilitic, etc). • CNV in angioid streaks • CNV in pseudoxanthoma elasticum (also known as Gronblad-Strandberg syndrome) • CNV in vitelliform macular dystrophy • CNV in serpiginous choroiditis • CNV in choroidal sarcoma • CNV in Stargardt’s Disease • Intravitreal uveitis • Toxoplasma chorioretinitis • Von Hippel-Lindau syndrome There are no associated thresholds for treatment. Treatment will be funded based on clinicians’ judgement. Bevacizumab (Avastin®) is recommended as the preferred agent for the treatment of these conditions. The use of other anti-VEGF agents including ranibizumab (Lucentis®) or aflibercept (Eylea®) will require an individual funding request application. |
| Anti-VEGF treatments and dexamethasone implants for macular oedema caused by central and branch retinal vein occlusion | Thames Valley Priorities Committee Commissioning Policy Statement TVPC5 Anti-VEGF treatments and dexamethasone implants for macular oedema caused by central and branch retinal vein occlusion - May 2014 / updated April 2019 | As detailed in the policy the use of any of these treatments is recommended in line with the associated NICE technology appraisal. Note this policy should be read in conjunction with TVPC45 Policy update Sequential use of biologics in opthalmology Jan 19 v2, which in addition to sequential use, also provides recommendations on stopping criteria. |
| Anti-VEGFs for sight-threatening eye conditions other than 'wet' age related macular degeneration. | BPC BPC 160 Anti-VEGFs for sight-threatening eye conditions other than wet age related macular degeneration - October 2009 | Refer to policy TVPC5 for Anti-VEGF treatments and dexamethasone implants for macular oedema caused by central and branch retinal vein occlusion(RVO) 2014 |
| Application of the use of ADL to IFR 2020 | Thames Valley Priorities Committee Commissioning Policy Statement TVPC101_Application of the use of ADL to IFR 2020 v1.0 | Policy for information. |
| Aquatic Physiotherapy (Hydrotherapy) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement Aquatic physiotherapy (Hydrotherapy) v0.1 | This treatment is not routinely funded. If there is an exceptional health need please fully complete the following: Aquatic Physiotherapy (Hydrotherapy) form and email it to the CPI Service at BerksWest.IFRrequests@nhs.net for consideration. July 2021 - This service is now available at Royal Berkshire Hospital. Only funding requests from RBH clinicians will be accepted and considered. |
| Arthroscopic lavage and debridement for patients with osteoarthritis of the knee Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC6 Arthroscopy May21 v3.0 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Assisted Conception Services (including IVF/ICSI) Procedure that requires Prior Approval | TVPC11g Assisted reproduction services v3 Appendix to Policy Statement 11g Summary of the rationale behind departing from NICE guidelines TVPC80 Primary Care Pathway for Subfertility v2.0 | Please note the TVPC80 Primary care Pathway for Subfertility is for information only and does not require IFR consideration. Patients/couples requesting specialist infertility treatment and meeting the eligibility criteria must be referred for specialist infertility treatment(s) by a NHS Consultant Gynaecologist. Please complete the following Assisted Reproduction Services Form and submit it to the tertiary provider of the patient’s choice. If the patient meets the criteria the referring gynaecologist should apply to the provider unit of the patient's choice. If the patients/couples do not meet the criteria then the IFR application form should be completed detailing how the couple are clinically exceptional. Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net Patient leaflet - Assisted Reproduction Policy - Nov 2013 Please note: Immigration health surcharge; removal of assisted conception services (Legislation.gov.uk) Amendments to the NHS (Charges to Overseas Visitors) Regulations 2015 were introduced into Parliament on 19 July 2017. As a result, from 21 August 2017, assisted conception services will no longer be included in the scope of services available for free for those who pay the immigration health surcharge. It is therefore important that to ensure potential users of these services are aware of the changes. Consultants must ensure that funding is in place prior to treatment. |
| Atomoxetine in Adults with Attention Deficit Hyperactivity Disorder (ADHD) Procedure Funded Subject to Audit | MOBBB 15 Atomoxetine in Adults with Attention Deficit Hyperactivity Disorder (ADHD)- July 2010 | Where the patient fully meets the criteria outlined in the policy then prior approval is not required. These cases may be audited. If the criteria are not met but the consultant wishes to treat then prior approval will be required. If there is exceptional health need please complete fully the following form: Exceptional Circumstances Submission Form Please email the completed application to BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Autologous blood injections and Platelet rich plasma injections Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC57 Autologous blood injections and Platelet rich plasma injections - March 2017 / updated March 2019 - June 2019 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: IFR application form and email it with any supporting documents to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Autologous Cartilage Transplantation Excluded Specialised : NHS England | NHS England | Follow the appropriate pathway. For further information contact NHS England |
| Bespoke orthopaedic prostheses Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Biological and immunomodulatory therapies in moderate Rheumatoid Arthritis | Thames Valley Priorities Committee Commissioning Policy Statement TVPC103 Biological and immunomodulatory drugs for moderate RA 1.0 | Application for treatment should be made via the Berkshire West High Cost Drugs Portal. |
| Biologic drugs for the management of axial spondyloarthritis Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC92 Biologic drugs for the management of axial spondyloarthritis - May 2019 | Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: IFR application form or provide detailed clinic letters which clearly indicate the patient exceptionality. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biologic drugs for the management of Crohn’s disease Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC93 Biologic drugs for the management of Crohn's disease - May 2019 | Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: IFR application form or provide detailed clinic letters which clearly indicate the patient exceptionality. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biologic therapies for ulcerative colitis in adults (18 years and over) Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC43 Use of biological therapies for ulcerative colitis v2.0 | Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: Exceptional Circumstances Submission Form or provide detailed clinic letters which clearly indicate how the policy criteria are met. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biologic therapy in Ophthalmology - Sequential use Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC45 Policy update Sequential use of biologics in opthalmology Jan 19 v2 | Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: Exceptional Circumstances Submission Form or provide detailed clinic letters which clearly indicate how the policy criteria are met. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biologic therapy in Psoriatic Arthritis - Sequential use Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC46 Policy update Psoriatic Arthritis Interim v2 | Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: Exceptional Circumstances Submission Form or provide detailed clinic letters which clearly indicate how the policy criteria are met. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biologic therapy of psoriasis - Sequential use of a third or subsequent biologic Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC44 Sequential use of a third or subsequent biologic therapy for psoriasis - July 2016 / Updated January and May 2019 | Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: Exceptional Circumstances Submission Form or provide detailed clinic letters which clearly indicate how the policy criteria are met. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biological and immunomodulatory therapies in Rheumatoid Arthritis Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC51 Use of biological and immunomodulatory therapies in RA Interim v2.0 | Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: Exceptional Circumstances Submission Form Or provide detailed clinic letters which clearly indicate how the policy criteria are met. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biological Mesh Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC14 Biological Mesh v3.0 | This procedure is not routinely funded and funding approval must always been obtained prior to referral and treatment. If after assessment, the Consultant wishes to treat, they must apply for prior approval by either fully completing the following: Biological Mesh Form v1.0 or providing detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment |
| Bone Anchored Hearing Aids Excluded Specialised : NHS England | National Policy NHS England Bone anchored hearing aids - April 2013 | For further information contact NHS England |
| Botulinum Toxin A (Botox) - Chronic Anal Fissure Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Botulinum Toxin A (Botox) - Long term Bell's Palsy Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Botulinum Toxin A (Botox) - Sialorrhoea (Severe drooling) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Botulinum Toxin A (Botox) for chronic headaches (excluding migraines) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. TA 260 Botulinum Toxin Type A for the prevention of headaches in adults with chronic migraine |
| Botulinum Toxin A (Botox) in the management of severe hyperhidrosis Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC25 Hyperhidrosis (excessive sweating) - Botulinum Toxin A and Endoscopic Thoracic Sympathectomy - November 2015 / updated November 2018 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Botulinum toxin Type A (Botox) - Overactive Bladder Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A | This is a procedure that requires prior approval. Please complete the following: General Funding Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Botulinum toxin Type A (Botox) - Spasticity Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A | This is a procedure that requires prior approval. Please complete the following: General Funding Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Cannabis-based products for medicinal use Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC81 Cannabis based medicinal products v2 | This is not routinely funded and prior approval must always be obtained from the IFR service prior to treatment. For these cases a strong case on grounds of exceptional health need must be provided. Please complete the following: IFR application form or provide detailed clinical letters which clearly indicate the exceptional health need. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Carotid Endarterectomy and Endovascular Stent Excluded Specialised : NHS England | National Policy NHS England Complex Endovascular Stent Grafts in Abdominal Aortic Aneuruysm - April 2013 | For further information contact NHS England |
| Carpal Tunnel Syndrome Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC19 Carpal Tunnel Syndrome v2.0 | This is a procedure that requires prior approval. Please complete the following: Carpal Tunnel Syndrome v1.3 email it and the supporting information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Cataract removal in adults (including second eye cataract surgery) Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC60 Cataract Removal in Adults - Threshold for Surgery - April 2018 (update October 2018) | This procedure is funded subject to audit. Please refer your patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: IFR application form Email the fully completed form to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Cerebellar Stimulator Implants Excluded Specialised : NHS England | National Policy NHS England Cerebellar Stimulator Implants - April 2013 | For further information contact NHS England |
| Chalazia Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC95 Treatment of Chalazia - July 2019 | This is a procedure that requires prior approval. Please complete the following: Eyelid Surgery Chalazia Form BW or provide detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) Procedure Not Routinely Funded | South Central Priorities Committee TVPC98 Chronic Fatigue Syndrome_ v1.0 | Follow the appropriate pathway and refer patients to the local Clinical Health Psychology Services, NHS Berkshire Health NHS Foundation Trust Inpatient stay is a procedure not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Circumcision and Preputioplasty Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC63 Circumcision and Preputioplasty Updated July 2020 | This procedure is a procedure which requires prior approval. Please fully complete the following: Male-Circumcision-BW-v1.5 and email it and any supporting documents to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Closure of patent foramen ovale for migraine (PFO) Excluded Specialised : NHS England | National Policy NHS England Patent Foramen Ovale PFO Closure - April 2013 | For further information contact NHS England |
| Cochlear Implants Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Colonoscopy in the management of hereditary CRC Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC107 Colonoscopy in the management of hereditary CRCv1.0 | Funded subject to audit. Outside of the local service this is a procedure not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Complex Neurological Rehabilitation for acquired brain injury not including injury due to stroke Procedure that requires Prior Approval | Rehabilitation Categories: | This is a procedure that requires prior approval. Please complete all the following forms: 1 Complex Neurological Rehabilitation Needs 2 The Rehabilitation Complexity Scale - Trauma (RSCE-Trauma) 3 Complex Neurological Rehabilitation Referral Complex Neurological Rehabilitation - referral forms Please email the completed forms to the IFR Service at BerksWest.IFRrequests@nhs.net |
| Complementary and alternative therapies Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC100 Complementary and alternative therapies_v1.0 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Continuous Glucose Monitoring System Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC64 Continuous glucose monitors v2 | Where the patient meets the criteria within the published commissioning policy, prior approval funding should be requested via the Blueteq High Cost Drugs Portal (click here) If the patient does not meet the criteria and there is a strong case on grounds of an exceptional health need please fully complete the following: or provide detailed clinic letters which clearly indicate the exceptional health need. Email the completed form/letters to the IFR service at scwcsu.CPIS.requests@nhs.net for consideration. |
| Continuous subcutaneous insulin infusion for adults with type 1 diabetes Insulin pumps Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC65 Continuous subcutaneous insulin infusion (insulin pumps) for adults with type 1 diabetes - April 2018 | Where the patient meets the criteria within the published commissioning policy, prior approval funding should be requested via the Blueteq High Cost Drugs Portal (click here) If the patient does not meet the criteria and there is a strong case on grounds of an exceptional health need please fully complete the following: or provide detailed clinic letters which clearly indicate the exceptional health need. Email the completed form/letters to the IFR service at scwcsu.CPIS.requests@nhs.net for consideration. |
| Contribution to Reimbursement of Expenses for Living Donors (Renal Transplantation) Excluded Specialised : NHS England | National Policy NHS England Reimbursement of Expenses for Living Kidney Donors - April 2013 | For further information contact NHS England |
| Coronary Artery Stents Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Corticosteroid injections for patella, elbow and Achilles tendinopathy (jumpers knee, tennis elbow) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC84 Corticosteroid injections for patella elbow and Achilles tendinopathy - March 2019 | This procedure is not routinely funded and is considered low priority. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Corticosteroid injections for pre patellar (in the front of the kneecap) and olecranon (elbow) bursitis Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC85 Corticosteroid injections for pre patellar (in the front of the kneecap) and olecranon (elbow) bursitis Updated March 2020 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Cryopreservation - preservation of fertility (Male and Female) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC17 Policy for the preservation of fertility - January 2015, Updated October 2018 | This is a procedure that requires prior approval. Please complete the following: Preservation of Fertility Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Cryotherapy (salvage) for recurrent prostate cancer Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Cryotherapy for localised Prostate cancer Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Deep Brain Stimulation for Parkinson’s Disease Excluded Specialised : NHS England | National Policy NHS England Deep Brain Stimulation in movement disorders - April 2013 | For further information contact NHS England |
| Deep Brain Stimulation for primary dystonia and essential tremor Excluded Specialised : NHS England | National Policy NHS England Deep Brain Stimulation in movement disorders - April 2013 | For further information contact NHS England |
| Deep Brain Stimulation including other interventions Excluded Specialised : NHS England | National Policy NHS England Deep Brian Stimulation for Indications except movement disorders - April 2013 | For further information contact NHS England |
| Dental Implants Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Dilatation and curettage (D&C) for abnormal bleeding Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC29 D&C for abnormal uterine bleeding Policy Update v2 Medicines & Healthcare product Regulatory Agency (MHRA) MRHA Safety Alert - 7 August 2018 | This is a procedure that is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Disc replacement surgery for low back pain with or without sciatica Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Dupuytren’s Contracture Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC18 Dupuytren's Contracture Release v2.0 | This is a procedure that requires prior approval. Please complete the following: Dupuytrens Form Email the completed form with supporting clinical information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Earwax - Referral to ENT Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC88 Management of Earwax - June 2019 | This policy does not apply to patients with Down’s syndrome, patients with cleft palate (whether repaired or not) or other craniofacial abnormalities. Prior Approval is required for referral to ENT. Please fully complete the following form: ENT Earwax Removal Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Ectropion and Entropion Surgery Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC70 Ectropion and entropion v2.0 | This is a procedure that requires prior approval. Please fully complete the following: Eyelid Surgery Ectropion and Entropion Form BW and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Elective Endovascular repair infrarenal abdominal aortic aneurysms Excluded Specialised : NHS England | National Policy NHS England Complex Endovascular Stent Grafts in Abdominal Aortic Aneuruysm - April 2013 | For further information contact NHS England |
| Eligibility for NHS transport for patients in non-emergency situations | Berkshire 68 Eligibility for NHS Transport for patient's in non-emergency situations | Policy for information. |
| Endoprosthetic replacement for benign bone tumours Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Endoscopic Thoracic Sympathectomy for excessive sweating Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC25 Hyperhidrosis (excessive sweating) - Botulinum Toxin A and Endoscopic Thoracic Sympathectomy - November 2015 / updated November 2018 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Epidural injections for acute and severe sciatica - Diagnostic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Epidural injections for neurogenic claudication in people who have central spinal canal stenosis are not normally funded. |
| Epidural injections for acute and severe sciatica - Therapeutic Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure always requires prior approval from the IFR service. Please fully complete the following: Low back pain and sciatica Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Epidural injections for neurogenic claudication in people who have central spinal canal stenosis are not normally funded. |
| Erectile Dysfunction treatments - Including: the drugs sildenafil, vardenafil and tadalafil and avanafil and prostaglandin E1 intracavernosal injections and intraurethral instillations Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC34 Erectile Dysfunction v3.0 | Prior approval is not required where the patient meets the criteria in full for the listed drugs. If the patient does not meet fully the policy criteria complete the following: Exceptional Circumstances Submission Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. This intervention will be audited as per the contract audit process. |
| Erectile Dysfunction treatments Including: Alprostadil cream, Erectile pumps/devices and psychosexual interventions Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC34 Erectile Dysfunction v3.0 | These procedures not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Excess Treatment Costs (ETCs) for non-commercial clinical trials Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC37 Excess Treatment Costs (ETCs) for non-commercial clinical trials - April 2016 / updated April 2019 | This is not routinely funded. IFR application form |
| Facet Joint & Medial Branch Block for chronic neck pain - Diagnostic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC56 FJI and MBB for chronic neck pain v2.0 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Facet Joint & Medial Branch Block for chronic neck pain - Therapeutic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC56 FJI and MBB for chronic neck pain v2.0 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Facet Joint & Medial Branch Block for low back pain - Diagnostic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Facet Joint & Medial Branch Block for low back pain - Therapeutic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Female sterilisation Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC68 Female sterilisation v2.0 | This is a procedure not routinely funded and prior approval is always required. For these cases a strong case on grounds of exceptional health need must be provided. Please complete the following: IFR application form and email it with any supporting documents to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Femoro-acetabular (Hip) Impingement (Arthroscopic and open Approaches) – Surgical Treatment - Hip Impingement surgery Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC33 Surgical treatment of hip impingement Policy Update v2 | Prior approval is always required from the IFR service before referral and treatment. Please fully complete the following: Hip-Impingement-Form-BW-v1.2 and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. In reference to TVPC33 Policy statement for Hip Impingement Surgery and prior approval process agreed providers and referral contacts are: Frimley Health NHS Foundation Trust Hospitals (Frimley Park, Heatherwood and Wexham Park Hospitals): Mr Jonathan Hull and Mr Sebastian Sturridge Royal Berkshire NHS Foundation Trust, Reading: Mr Tom Pollard and Mr Tony Andrade Nuffield Orthopaedic Centre, Oxford: Mr Sion Glyn-Jones Buckinghamshire Healthcare NHS Trust: Mr Gurdeep Biring Basingstoke and North Hampshire Hospital: None |
| Fenestrated endovascular stent-grafts for abdominal aortic aneurysms Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Flash Glucose Monitoring System (Freestyle Libre®) | Thames Valley Priorities Committee Commissioning Policy Statement TVPC73 Flash Glucose System policy v2 | Prior approval is not required where the patient meets the criteria is full and will be managed by the West Berkshire Medicines Optimisation team. |
| Foetal Alcohol Spectrum Disorders (FASD) in children, adolescents and adults - diagnosis and treatment outside of normal locally commissioned services Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC77 Foetal Alcohol Spectrum Disorders v2.0 | There are locally commissioned services within Mental Health, Learning Disabilities and Neurology. National specialist assessment and treatment programmes soley for the diagnosis and treatment of FASD in children, adolescents and adults are not normally funded. For these requests a strong case on grounds of exceptional health need must be provided. If there is exceptional health need please complete fully the following form : IFR application form Please email the completed application to BerksWest.IFRrequests@nhs.netfor consideration. Consultants must ensure that funding is in place prior to treatment. |
| Functional Electrical Stimulation (FES) for upper and lower limb dysfunction of central neurological origin Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC62 Functional electrical stimulation v2 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: Prior Approval Functional Stimulation Form and email it with any supporting documents to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Functional endoscopic or sinus surgery, surgery in the management of chronic rhinosinusitis (CRS) and nasal polyposis(NP) (FESS) Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC21 Chronic rhinosinusitis v2.0 | This procedure is funded subject to audit. Please refer your patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: Rhinosinusitis Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Gallstones - management of asymptomatic gallstones / cholecystectomy Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC75 Management of asymptomatic gallstones v2.0 | This procedure is funded subject to audit. Please refer your patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: Management of asymptomatic gallstones Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Gamma Knife Surgery for Trigeminal Neuralgia Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Ganglion cysts (including Ganglion of the wrist) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC15 Ganglion cysts v2.0 | All ganglion surgery is a procedure not routinely funded. If there is exceptional health need please fully complete the following: Ganglion Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Gender Dysphoria non core treatments Including but not limited to breast augmentation, reduction thyroid chondroplasty / tracheal shave, rhinoplasty / other facial bone reduction, blepharoplasty, face-lift, hair removal / electrolysis which is additional to core facila hair removal, body contouring procedures e.g. suction-assisted lipoplasty of the waist, procedures to decrease areas of baldness, skin resurfacing e.g. acid peel (a method of removing the upper layer of skin in order to improve skin smoothness), scar revision Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC2 Treatments for Gender Dysphoria - October 2014, Updated October 2018 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: IFR application form Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.netfor consideration. These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional. |
| Gender Reassignment surgery for the treatment of Gender Dysphoria Excluded Specialised : NHS England | National Policy NHS England Interim Gender Dysphoria Protocol and Service Guidelines 2013/14 | This is a procedure commissioned by NHS England. Patients should be referred to a specialist centre in line with the NHS England National Policy and Thames Valley policy recommendations. TVPC2 GP referral information for Gender Dysphoria Services October 2014 |
| Haemorrhoids Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC72 Management of haemorrhoids v2.0 | This is a procedure that requires prior approval before referral and treatment in secondary care. If the GP wishes to refer to secondary care they must always apply for prior approval from the IFR service. Please fully complete the following: Haemorrhoids Form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hallux Valgus (Bunions) - Surgery for painful big toe Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC47 Surgery for painful big toe (bunion) - April 2018 / updated April 2019 | This is a procedure that requires prior approval. Please complete the following: Bunion Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hearing aids for adults Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC86 Hearing aids for hearing loss in adults - April 2019 | Please note this policy does not apply to patients with dementia or those with learning disabilities, for whom hearing aids should be provided in line with NICE guidance. Prior approval is always required from the IFR service where policy applies. Please fully complete the following form detailing how the patient fully meets the policy. Hearing Aids for Adults Form or provide detailed clinic letters and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hemicraniectomy for malignant middle cerebral artery infarction Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Hernia (abdominal/ventral) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Policy update Hernia 2021 v2.0 | This is a procedure that requires prior approval. Please complete the following: Hernia Form v1.3 and email it and supporting information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hernia (Epigastric) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Policy update Hernia 2021 v2.0 | This is a procedure that requires prior approval. Please complete the following: Hernia Form v1.3 and email it and supporting information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hernia (Femoral, Spigelian or Inguino-scrotal) Prior Approval not required | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Policy update Hernia 2021 v2.0 | This procedure is funded subject to audit. Please refer your patient directly for surgical opinion for patients with the following conditions where prior approval for surgery is not required: - diagnosis of femoral hernia - diagnosis of Spigelian hernia, following ultrasound confirmation - diagnosis of an inguino-scrotal hernia |
| Hernia (Incisional) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Policy update Hernia 2021 v2.0 | This is a procedure that requires prior approval. Please complete the following: Hernia Form v1.3 and email it and supporting information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hernia (Inguinal) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Policy update Hernia 2021 v2.0 | This is a procedure that requires prior approval. Please complete the following: Hernia Form v1.3 and email it and supporting information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hernia (Umbilical, Para-umbilical) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Policy update Hernia 2021 v2.0 | This is a procedure that requires prior approval. Please complete the following: Hernia Form v1.3 and email it and supporting information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| High-intensity focused ultrasound for colorectal liver metastases Excluded Specialised : NHS England | MOBBB 231 SCP High-intensity focused ultrasound for colerectal liver metastases | For further information contact NHS England |
| Hip and Knee Replacement Surgery - follow-up appointments Procedure Not Routinely Funded | Thames Valley Priorities Committee Policy Statement TVPC8 Follow up appointments after primary hip and knee joint replacement surgery - February 2019 | Further appointments following the initial routine follow-up appointment are not normally funded and prior approval is always required from the IFR service. A strong case on grounds of exceptional health need must be provided. Please complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hip Joint Revision Surgery Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC55 Hip and knee revision surgery, Updated June 2021 | This procedure is funded subject to audit. Please refer your patient directly by the Electronic Referral System if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: IFR Application Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Hip Prostheses | NICE TA 304 | NICE TA 304 states that prostheses for total hip replacement and resurfacing arthroplasty are recommended as treatment options for people with end-stage arthritis of the hip only if the prostheses have rates (or projected rates) of revision of 5% or less at 10 years. This recommendation supersedes the previous prosthesis policy discussing the types of prosthesis used in THR. |
| Hip Resurfacing for Advanced Arthropathy | NICE TA 304 | NICE Technology Appraisal 304 (2014) has superseded the previous Hip Resurfacing for Advanced Arthropathy policy. |
| Hysterectomy - indications for surgery (excluding cancer) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC58 Hysterectomy v2.0 Medicines & Healthcare product Regulatory Agency (MHRA) MRHA Safety Alert - 7 August 2018 | This is a procedure that requires prior approval. Please complete the following: Hysterectomy Form and email it will any supporting documents to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Impacted Third Molars - Wisdom Teeth Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Implantable Cardioverter Defibrillator devices for non-ischaemic cardiomyopathy Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Implementation of NICE Interventional Procedures Guidance (IPGs), Medical Technologies Guidance (MTGs) and Diagnostic Technologies Guidance (DTGs) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC41 Implementation of NICE Interventional Procedures Guidance (IPGs), Medical Technologies Guidance (MTGs) and Diagnostic Technologies Guidance (DTGs) - May 2016 / updated April 2019 | These are not routinely funded and prior approval must always be obtained. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Inpatient pain management programmes for adults with chronic pain Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Interventions for delayed non-union fracture: Low-intensity Pulsed Ultrasound (marketed in the UK as the Exogen® system) and teriparatide Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC10 Non union fracture v1.0 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Intracranial Aneurysms – treatment of incidentally discovered IAs Excluded Specialised : NHS England | National Policy NHS England Flow Diverting Device for Intracranial Aneurysms - April 2013 | For further information contact NHS England |
| Intrathecal Baclofen pumps for severe spascity Excluded Specialised : NHS England | National Policy NHS England Intrathecal Baclofen - April 2013 | For further information contact NHS England |
| Intravenous Lidocaine infusions for chronic pain Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC90 Intravenous Lidocaine infusions for chronic pain - March 2019 - June 2019 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Intravenous versus oral steroids for exacerbations of multiple sclerosis | MOBBB 67 Intravenous versus oral steroids for exacerbations of multiple sclerosis - January 2012 | |
| Iron Chelation in Myelodysplastic Syndrome (MDS) | Thames Valley Priorities Committee Commissioning Policy Statement TVPC79 Iron chelation in Myelodysplastic Syndrome (MDS) - November 2018 | |
| Knee Arthroscopy for Meniscal Tears Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC76 Arthroscopic Knee Surgery for Meniscal Tears v3 | This procedure is funded subject to audit. Prior approval is not required where the patient meets the criteria in full. If the criteria are not fully met, prior to referral and treatment, please complete the following: Knee-Arthroscopy-Form-BW or provide detailed clinic letter(s) which clearly indicate how the patient meets the criteria. Email the completed form/letters to the IFR service at BerksWest.IFRrequests@nhs.netfor consideration. |
| Knee Joint Revision Surgery Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC55 Hip and knee revision surgery, Updated June 2021 | This procedure is funded subject to audit. Please refer your patient directly by the Electronic Referral System if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: IFR Application Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Laparoscopic surgery for colorectal cancer Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Lung resection for metastases Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Management of female pelvic organ prolapse Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC59 Management of female pelvic organ prolapse v2 | Prior approval is always required from the IFR service. Please fully complete the following: Female Pelvic Organ Prolapse and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Managing the boundaries of NHS and privately funded healthcare - NHS v Private Funding | Thames Valley Priorities Committee Commissioning Policy Statement TVPC35 Managing the boundaries of NHS and privately funded healthcare - April 2016 / updated April 2019 | There is no obligation for the GP to prescribe treatment recommended by a private practitioner if it is contrary to local agreement or outside normal clinical practice. The NHS will not normally fund treatments that have been recommended by a private practitioner if that treatment is not normally commissioned within the local area. The fact that a patient can demonstrate they have benefited from the private treatment does not necessarily provide grounds for continuing the treatment in the NHS as an exception. Patients who commence care privately can request that further treatment be provided within the NHS. Their clinical needs should be reassessed for NHS treatment within the same regime of priorities applicable to NHS patients with the same condition. Prior approval will be required from the IFR service if it is a restricted procedure. Please use the appropriate application form for the specific intervention required. The CCG will not be responsible for retrospective funding of earlier treatment where patients who have received private treatment then transfer to the NHS. |
| Melatonin treatment in children Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC54 Melatonin treatment in children - February 2017 / Updated March 2019 - June 2019 | This is funded subject to audit where the patient fully meets the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: Exceptional Circumstances Submission Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Methylphenidate and atomoxetine in attention deficit hyperactivity disorder (ADHD) in adults | Prescribing arrangements for the use of methylphenidate, dexamfetamine and atomoxetine in adult ADHD in Berkshire - May 2013 | |
| Methylphenidate and atomoxetine in attention deficit hyperactivity disorder (ADHD) in children and adolescents Procedure Funded Subject to Audit | MOBBB 14 Methylphenidate and atomoxetine in attention deficit hyperactivity disorder (ADHD) in children and adolescents - July 2010 | Where the patient fully meets the criteria outlined in the policy then prior approval is not required. These cases may be audited. If the criteria are not met but the consultant wishes to treat then prior approval will be required. If there is exceptional health need please complete fully the following form: Exceptional Circumstances Submission Form Please email the completed application to BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Microwave ablation for lung metastases Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Myringotomy and Grommets for otitis media with effusion Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC20 Surgical Management of Otitis Media (under the age of 18 years) v2.0 | This procedure is funded subject to audit. Please refer your patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: Surgical management of glue ear Otitis media effusion (OME) in children under the age of 18 years and Adjuvant Adenoidectomy Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Negative Pressure Wound Therapy for wound healing - Pressure ulcer and venous leg ulcers Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC87 Negative Pressure Wound Therapy for wound healing - April 2019 | This procedure is not routinely funded for pressure and venous leg ulcers and funding approval must always be obtained from the IFR service prior to treatment. For these cases a strong case on grounds of exceptional health need must be provided. Please complete the following: IFR application form or provide detailed clinic letters which clearly indicate the exceptional health need and email the information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Neurosurgery for cerebral metastases Excluded Specialised : NHS England | National Policy NHS England Stereotactic radiosurgery - radiotherapy for cerebral metastases - April 2013 | For further information contact NHS England |
| NHS England Specialised Commissioned Services Procedures not for Clinical Commissioning consideration | Thames Valley Priorities Committee Commissioning Policy Statement TVPC67 NHS England specialised commissioning v2.0 | Thames Valley CCGs do not fund specialised services, treatments or interventions that are directly commissioned by NHS England Specialised Commissioning whether they are provided by a specialised or a non-specialised provider. |
| NHS Prescribing following private consultation | Thames Valley Priorities Committee Commissioning Policy Statement TVPC36 NHS prescribing following private consultation - April 2016 / updated April 2019 | |
| Open magnetic resonance imaging (MRI) scans Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC53 Open magnetic resonance imaging (MRI) scans and standing / upright MRI scans - February 2018 / Updated March 2019 - June 2019 | This is a procedure which always requires prior approval from the IFR service. If the GP / Clinician wishes to treat, approval from the IFR service must be obtained. Please fully complete the following: MRI Scan Form or provide detailed clinic letter(s) which clearly state how the patient meets the criteria for consideration. Please email the completed form/letters to the IFR Service for consideration at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Orthodontics Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Orthognathic surgery Excluded Specialised : NHS England | NHS England Interim Clinical Commissioning Policy: Orthognathic surgery - November 2013 | For further information contact NHS England |
| Osteopathy and Chiropractic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Penile Rehabilitation following prostate surgery Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC40 Penile Rehabilitation following prostate surgery - May 2016 / updated April 2019 | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Percutaneous pulmonary valve implantation Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Pharmacological treatments for the secondary prevention of osteoporotic fragility fractures in men | MOBBB 82 Pharmacological treatments for the secondary prevention of osteoporotic fragility fractrues in men - September 2012 | |
| Photodynamic therapy (with verteporfin) for age-related macular degeneration | BPC 50 Photodynamic therapy (with verteporfin) - October 2002 | |
| Polysomnography in the investigation of children with sleep-related disorders Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Posterior Tibial Nerve Stimulation Policy Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC102 Posterior Tibial Nerve Stimulation policy v1.0 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must also be provided. Please complete the following form. IFR application form or provide detailed clinic letters which clearly indicate the exceptional health need and how the policy criteria are met. Please email the completed form/letters to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Pramipexole in the management of Restless Legs Syndrome | BPC 115 Pramipexole in the management of Restless Legs Syndrome - November 2007 | |
| Preimplant genetic diagnosis (PGD) Excluded Specialised : NHS England | National Policy NHS England Pre-implantation Genetic Diagnosis(PGD) - April 2013 | For further information contact NHS England |
| Primary Hip Joint Replacement Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC49 Policy update primary hip and knee replacement July 2021 v2 | This procedure is funded subject to audit. Please refer your patient directly by Electronic Referral System if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: IFR Application Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration |
| Primary Knee Joint Replacement Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC49 Policy update primary hip and knee replacement July 2021 v2 | This procedure is funded subject to audit. Please refer your patient directly by the Electronic Referral System if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: IFR Application Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Prostate specific antigen testing Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC104 Prostate specific antigen testing v1.0 | This is a procedure that requires prior approval. If after assessment, the Consultant wishes to treat, they must apply for prior approval by fully completing the following: Prostate specific antigen testing form Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Proton Pump Inhibitors in the treatment of dyspepsia | BPC 21 Use of Proton Pump Inhibitors in the treatment of dyspepsia BW | Policy for information only. |
| Radiofrequency Ablation and Cryotherapy for Renal Tumours Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Radiofrequency denervation for chronic low back pain Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This is a procedure that always requires prior approval from the IFR service. Please fully complete the following: Low back pain and sciatica Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Radiofrequency denervation of sacroiliac joint pain Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Real-time continuous glucose monitors for paediatric patients with Type 1 Diabetes Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC89 Real-time Continuous Glucose Monitors for Paediatric Patients with Type 1 Diabetes - March 2019 - June 2019 | Where the patient meets the criteria within the published commissioning policy, prior approval funding should be requested via the Blueteq High Cost Drugs Portal (click here) If the patient does not meet the criteria and there is a strong case on grounds of an exceptional health need please fully complete the following: or provide detailed clinic letters which clearly indicate the exceptional health need. Email the completed form/letters to the IFR service at scwcsu.CPIS.requests@nhs.net for consideration. |
| Reconstructive breast surgery post breast cancer Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC91 Reconstructive breast surgery post breast cancer - May 2019 | The Thames Valley Priorities Committee has considered a review of reconstructive breast surgery post breast cancer, taking account of national guidance, local specialist views and data on reconstructive surgery including; surgery on the affected breast, surgery on the contralateral side and lipofilling. The Committee has acknowledged, as per the national guidance, that due to the complexity of the cancer and patient related factors, breast reconstruction can be a planned programme of operations to optimise cancer and aesthetic outcomes and to support high quality survivorship. Further surgery post 5 years after the completion of the planned reconstructive surgery for cosmetic reasons alone is not normally funded. For these cases a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need and the patient meets the criteria for consideration, please complete fully the following: IFR application form Please email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Research trials and NHS funding: - Excess Treatment cost - Post-trial treatments Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC38 Research trials and NHS Funding - Excess treatment costs - Post-trial treatments - April 2016 / updated April 2019 | These are not routinely funded and prior approval must always be obtained. For these cases a strong case on grounds of exceptional health need must be provided. Please complete the following: IFR application form or provide detailed clinic letters which clearly indicate the exceptional health need and email the information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Restless Leg Syndrome(RLS) (Willis-Ekbom disease) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC94 Primary Restless leg syndrome (RLS) (Willis-Ekbom disease) - July 2019 | Referral for Specialist Opinion requires prior approval. Please complete the following form: Restless Legs Syndrome Form or provide detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the completed form/letters to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Reversal of female sterilisation Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC69 Reversal of female and male sterilisation v2.0 | This procedure is not routinely funded and prior approval is always required from the IFR service. For these cases a strong case on grounds of exceptional health need must be provided. IFR application form If there is exceptional health need email a detailed letter clearly demonstrating the clinical case to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Reversal of male sterilisation (vasectomy) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC69 Reversal of female and male sterilisation v2.0 | This procedure is not routinely funded and prior approval is always required from the IFR service. For these cases a strong case on grounds of exceptional health need must be provided. IFR application form If there is exceptional health need email a detailed letter clearly demonstrating the clinical case to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Robotic-assisted laparoscopic radical prostatectomy Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Sacral Nerve Stimulation in faecal incontinence Excluded Specialised : NHS England | National Policy NHS England Sacral nerve stimulation SNS for faecal incontinence in Adults - April 2013 | For further information contact NHS England |
| Selective Dorsal Rhizotomy Excluded Specialised : NHS England | National Policy NHS England Selective dorsal rhizotomy | For further information contact NHS England |
| Sequential Cochlear implants in profoundly deaf children Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Serum P1NP measurement in the management of osteoporosis | BPC 123 Serum P1NP measurement in the management of osterporosis - February 2008 | |
| Settings for alcohol detoxification | Public Health | Public Health |
| Severe and complex obesity - Tier 4 Eligibility for bariatric surgery Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC39 Severe and complex obesity eligibility for bariatric surgery v2.0 | Weight Management Services including Bariatric Surgery Please note information concerning Tier 1, Tier 2 and Tier 3 services as bariatric surgery is not offered outside of the MDT Tier 3 pathway. Application will be normally be expected from the Tier 3 MDT/Consultants.  Tier 1 and 2 Primary Care Tier 3 accessed by referral from GP/ Primary Care Prior Approval is not require for referral to Tier 3. In addition to offering a programme of care, Tier 3 services will select and refer patients for consideration for bariatric surgery. Tier 4 - Complex and Specialised Obesity Surgery Bariatric Surgery Tier 4 v1.1 Email the completed form with any supporting documents to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Short sight/long sight corrective (laser) surgery (Refractive keratoplasty) Procedure Not Routinely Funded | This procedure in not routinely funded. Cases will only be considered where laser or operative correction is the only treatment available to restore reasonable visual acuity /or where there are substantial other medical reasons that make correction by external visual aids inappropriate. This is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must also be provided. Please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
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| Silicon Cosmesis for Prosthetic Limbs Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Smoking cessation before planned surgery | Thames Valley Priorities Committee Commissioning Policy Statement TVPC78 Smoking cessation pre surgery v2.0 | Policy for information. |
| Snoring and Obstructive Sleep Apnoea / Hypopnoea Syndrome (OSAHS) in adults Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC61 Snoring and Obstructive sleep apnoea hypopnoea syndrome (OSAHS) v2.0 | This is a procedure that requires prior approval. Please complete the following application indicating how the patient meets the criteria: Snoring-and-OSAHS-Form and email it with any supporting documents to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. Link to STOP-Bang Questionnaire http://www.stopbang.ca/osa/screening.php |
| Surgical Removal of Kidney stones in Adults Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC105 Surgical removal of kidney stones in adults v1.0 | This is a procedure that requires prior approval. If after assessment, the Consultant wishes to treat, they must apply for prior approval by fully completing the following: Surgical removal of kidney stones in adults Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Sodium oxybate Procedure Not Routinely Funded | BPC TVPC99 Sodium oxybate v1.0 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Speech and Language Therapy in Parkinson's Disease Procedure Not Routinely Funded | MOBBB 89 Speech and language therapy in Parkinson's Disease | This procedure is not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Spinal Cord Stimulation for ischaemic pain Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Spinal Cord Stimulation in neuropathic pain Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Spinal decompression for sciatica (including laminectomy, foraminotomy, undercutting facetectomy and discectomy) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This is a procedure that always requires prior approval from the IFR service. Please fully complete the following: Low back pain and sciatica Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Spinal fusion for people with low back pain Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Spinal injections for managing low back pain including: facet joint injections, medial branch blocks, intradiscal injections, prolotherapy (proliferation therapy or regeneration injection therapy) and trigger point injections Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Spinal manipulation for the treatment of chronic, non-specific low back pain Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and sciatica Dec20 v2 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. Please fully complete the following form and clearly detail the exceptionality: IFR application form Email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Spinal Surgery (Specialist surgery not listed here) Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Standing and Upright Magnetic resonance imaging (MRI) scans Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC53 Open magnetic resonance imaging (MRI) scans and standing / upright MRI scans - February 2018 / Updated March 2019 - June 2019 | This procedure is not routinely funded and prior approval is always required for the IFR service. If there is exceptional health need please fully complete the following and indicating the exceptional health need: IFR application form or provide detailed clinic letter(s) which clearly state how the policy criteria are met and the exceptional health need Please email the completed form/letters to the IFR Service for consideration at BerksWest.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Subacromial decompression for shoulder impingement Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC50 Subacromial decompression for shoulder impingement v2 Dec 2020 | Prior approval is always required from the IFR service before referral and treatment except for RED FLAG symptoms as stated on the policy. Please fully complete the following: Subacromial-Decompression-of-the-Shoulder-Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Surgical resection and percutaneous ablation for colorectal liver metastases Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Surveillance colonoscopy Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC106 Surveillance colonoscopy v1.0 | Funded subject to audit. Outside of the local service this is a procedure not routinely funded. If there is exceptional health need please fully complete the following: IFR application form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Temporomandibular Joint Replacement Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Tonsillectomy - Obstructive sleep apnoea in adults Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC22 Tonsillectomy update Sep 2019 v1.0 | This procedure is funded subject to audit. Please refer your patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: Tonsillectomy for sleep disordered breathing in Adult Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Tonsillectomy - Obstructive sleep apnoea in children (<16) Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC22 Tonsillectomy update Sep 2019 v1.0 | This procedure is funded subject to audit. Please refer your patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: Tonsillectomy sleep disordered breathing in Children Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Tonsillectomy - Recurrent tonsillitis Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC22 Tonsillectomy update Sep 2019 v1.0 | This procedure is funded subject to audit. Please refer your patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: Tonsillectomy Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Trans-cranial Doppler Ultrasonography with frequent transfusion to prevent stroke in children with sickle cell Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Transcatheter Aortic Valve implantation for aortic stenosis Excluded Specialised : NHS England | National Policy NHS England Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis - April 2013 | For further information contact NHS England |
| Treatment of voiding Lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) - Transurethral resection of the prostate (TURP). Other treatments for e.g. TUIP, TUVP etc., all included in the policy Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC109 Treatment of voiding LUTS due to BPH v1.0 | This is a procedure that requires prior approval. Please complete the following: Treatment of voiding LUTS due to BPH form email it and the supporting information to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Trigger Finger (Stenosing Tenosynovitis,Stenosing Tenovaginosis) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC23 Trigger finger - May 2015 / Updated July 2019 | This is a procedure that requires prior approval. Please complete the following: Trigger Finger Form or provide detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the completed form/letters and supporting evidence to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Ultrasound guided injections for hip pain (trochanteric bursitis and osteoarthritis of the hip) Procedure Funded Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC32 Ultrasound Guided Injections for Hip Pain Policy Update v2 | This procedure is funded subject to audit. Please refer your patient directly if they fully meet the criteria outlined in the policy. If the patient does not meet fully the policy criteria complete the following: General Funding Form Email the fully completed form and any supporting evidence to the IFR service at BerksWest.IFRrequests@nhs.net for consideration. |
| Upper Gastrointestinal Endoscopy in Adults Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC108 Upper Gastrointestinal Endoscopy in Adults v1.0 | This is a procedure that requires prior approval. For patients under a Consultant in secondary care this intervention is funded subject to audit. The consultant must ensure that the patient meets policy criteria before proceeding. If a GP wishes to refer a patient directly for a GI endoscopy then prior approval is required. Please complete the form to apply for funding. Upper Gastrointestinal Endoscopy in Adults Form Please email the completed form to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Vagus Nerve Stimulation (VNS) for other indications Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Vagus Nerve Stimulation (VNS) for refractory epilepsy in children and adults Excluded Specialised : NHS England | NHS England | For further information contact NHS England |
| Varicose Veins Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC1 Interventional Procedures for Varicose Veins - October 2014 / updated November 2018 | This is a procedure that requires prior approval. Please complete the following: Varicose Veins Form and email it and supporting documents to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Vasectomy Services - Male Sterilisation Procedure Not Routinely Funded | Berkshire West Clinical Commissioning Groups Commissioning Policy StatementBerkshire West CCGs policy Vasectomy (male sterilisation) - October 2016 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of an exceptional health need must be provided. IFR application form If there is an exceptional health need please email a detailed letter clearly demonstrating the clinical case to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
| Vertebroplasty and Kyphoplasty | NICE TA 279 | If the patient does not meet in full the NICE TA prior approval is always required from the IFR service before referral and treatment. Please fully complete the following: Exceptional Circumstances Submission Form and email it to the IFR Service at BerksWest.IFRrequests@nhs.net for consideration. |
For more information
Please email the IFR service at Berkswest.ifrrequests@nhs.net for all enquiries about the policy statements or the process for considering Individual Funding Requests.