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 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 - Updated Jan 2020 | 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 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Acupuncture Procedure Not Routinely Funded | BPC 17 17 Acupuncture | This procedure is not routinely funded and funding approval must always been obtained prior to referral and treatment. If there is exceptional health need the GP must obtain funding from the IFR service by fully completing the following: IFR Application Form and emailing it to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Adenoidectomy Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC20 Surgical management of otitis media with effusion in children (under the age of 12 years) - November 2015 / updated September 2018 Adjuvant adenoidectomy in the absence of persistent and/or frequent upper respiratory tract symptoms is a low priority, and will not normally be commissioned | This procedure always requires prior approval from the IFR service. If after assessment, the Consultant wishes to treat, they must apply for prior approval by either fully completing the following Adenoidectomy with Grommets Application Form or providing detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| ADHD Treatment Pathway for Adults with Attention Deficit Hyperactivity Disorder Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC71 Treatment pathway for adults with attention deficit hyperactivity disorder (ADHD) - November 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 BerksEast.IFRrequests@nhs.net for consideration. |
| Adhesive Capsulitis (Frozen Shoulder) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC74 Adhesive Capsulitis (Frozen Shoulder) - January 2018 | This procedure always requires prior approval from the IFR service. If after assessment, the Consultant wishes to treat, they must apply for prior approval by either fully completing the following: Adhesive Capsulitis Form or providing detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Aesthetic/Cosmetic Breast Surgery including: breast augmentation, revision of breast augmentation, breast asymmetry, revision of breast augmentation, breast mastopexy - breast lift, mammoplasty, reconstruction /revision of breast (not including post breast cancer), inverted nipple, removal of supernumerary nipples, female breast reduction, reduction mammoplasty, male breast reduction for gynaecomastia, corrective surgery to nipple (excluding cancer), breast implant removal and replacement Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children v1.4 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, 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 or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration and the exceptional health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 v1.4 | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, 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 checklist: Benign-Skin-Lesions-and-Lipomata-v1.2-BE or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration and the exceptional health need. Please email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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, arm lifts, calf implants), plastic operations on 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 v1.4 | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, 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 or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration and the exceptional health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Aesthetic/Cosmetic Procedures including: Blepharoplasty - upper and lower lid surgery, Eyelid surgery (blepharoplasty) including blepharoptosis (an abnormal low-lying upper eyelid margin) and dermatochalasis (skin redundancy of the upper lid), Correction of Ptosis Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children v1.4 | This procedure always requires prior approval from the IFR service prior to referral and treatment. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval from the IFR service must be obtained. Please complete fully the following: Eyelid Surgery Blepharoplasty, Dermatochalasis, Correction of Ptosis Form BE or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration and the health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Aesthetic/Cosmetic Procedures Nose reshaping including Rhinoplasty / Septorhinoplasty (cosmetic nose surgery), Reconstruction/revision surgery Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC16 Aesthetic treatments for adults and children v1.4 | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, 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 or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration and the exceptional health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Aesthetic/Cosmetic Procedures Other procedures including: 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, excision of sweat bearing glands, laser treatment, excessive hirsutism, minor skin procedures (not including BCC and SCC), Onychomycosis (fungal nail infections), Scars including keloid (removal and revision), Tattoo (removal or revision), Rhinophyma, Rosacea, 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 v1.4 | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, 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 or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration and the exceptional health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Anal Irrigation Systems for the Management of Faecal Incontinence/Constipation Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC3a Anal Irrigation Systems for the Management of Faecal Incontinence - Constipation - October 2014 / updated September 2018 - EB | 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 BerksEast.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 - March 2019 | Prior approval is always required from the IFR service. Please fully complete the appropriate form: ACL Reconstruction for under 25 Form ACL Reconstruction for 25 - 55 year Form ACL Reconstruction for over 55 Form or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Anti-VEGF agents for the management of sight-threatening rare eye conditions involving neo-vascularisation | Thames Valley Priorities Committee Commissioning Policy Statement TVPC96 Anti-VEGF agents for the management of sight-threatening rare eye conditions involving neo-vascularisation September 2019 | 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 Procedure Funded and Subject to Audit | 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 May 2019 | Prior approval is not required where the patient meets the criteria in full. Note this policy should be read in conjunction with TVPC45 Sequential use of biologic therapy in Opthalmology which in addition to sequential use, also provides recommendations for stopping criteria. 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Anti-VEGFs for sight-threatening eye conditions other than 'wet' age related macular degeneration | BPC 160 Anti-VEGFs for sight-threatening eye conditions other than 'wet' age related macular degeneration - October 2009 | This procedure is not routinely funded. For these cases a strong case on grounds of exceptional health need must be provided. Please fully complete the following form clearly detailing the exceptionality: Exceptional Circumstances Submission Form Please email the completed form /letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Application of the use of ADL to IFR 2021 | Thames Valley Priorities Committee Commissioning Policy Statement TVPC101 Application of the use of ADL to IFR 2020 v1.0 | Policy for Information. |
| Arthroscopic Lavage and Debridement for Patients with Osteoarthritis of the knee Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC6 Arthroscopic lavage and debridement for patients with osteoarthritis of the knee - November 2015 / updated 2018 | These procedures are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment in secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, a strong case on grounds of exceptional health need must be provided. Please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Assisted Conception Services (including IVF/ICSI for infertile couples) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC11g Assisted reproduction services v3 Appendix to Policy Statement 11g Summary of the rationale behind departing from NICE guidelines | 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 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 BerksEast.IFRrequests@nhs.net for consideration. 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 and Subject to Audit | MOBBB 15 Atomoxetine in Adults with 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 BerksEast.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 - Updated Jan 2020 | 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 exceptional health need must be provided. Please fully complete the following form clearly detailing the exceptionality: IFR application form Please email the completed form /letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Autologous Cartilage Transplantation | NHS England | Follow the appropriate pathway. For further information contact NHS England |
| Biologic and Immunomodulatory therapies in Rheumatoid Arthritis | Thames Valley Priorities Committee Commissioning Policy Statement TVPC51 Use of biological and immunomodulatory therapies in Rheumatoid Arthritis - September 2018 | 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 - New Jan 2020 | 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 BerksEast.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 - New Jan 2020 | 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biologic therapy in Ophthalmology - Sequential use | Thames Valley Priorities Committee Commissioning Policy Statement TVPC45 Sequential use of biologics in Opthalmology - November 2016 / updated 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biologic therapy in Psoriatic Arthritis - Sequential use | Thames Valley Priorities Committee Commissioning Policy Statement TVPC46 Sequential use of biologic therapy in Psoriatic Arthritis - November 2016 / updated 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biologic therapy in Sequential use of a third or subsequent biologic - Sequential use | Thames Valley Priorities Committee Commissioning Policy Statement TVPC44 Sequential use of a Third or Subsequent Biologic Therapy for Psoriasis - Updated Jan 2020 | 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 BerksEast.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 - Updated Jan 2020 | This procedure requires prior approval prior to treatment. If the Consultant wishes to treat, prior approval must be obtained from the IFR service by either fully completing the following: General Funding Form or sending detailed clinic letters which clearly outline how the patient meets the criteria by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Biological therapies for ulcerative colitis in adults (18 years and over) | Thames Valley Priorities Committee Commissioning Policy Statement TVPC43 Use of biological therapies for ulcerative colitis in adults - August 2016 | 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Bone Anchored Hearing Aids | National Policy NHS England Bone anchored hearing aids - April 2013 | For further information contact NHS England |
| Botulinum toxin Type A (Botox) - Chronic Anal Fissure Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A - Nov 2019_v1.1 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat a strong case on grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Botulinum toxin Type A (Botox) - chronic headaches (excluding migraines) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A - Nov 2019_v1.1 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat a strong case on grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. TA 260 Botulinum Toxin Type A for the prevention of headaches in adults with chronic migraine |
| Botulinum toxin Type A (Botox) - Hyperhidrosis (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 September 2018 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat a strong case on grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Botulinum Toxin Type A (Botox) - Long term Bell's Palsy Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A - Nov 2019_v1.1 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat a strong case on grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Botulinum toxin Type A (Botox) - Overactive Bladder and Spasticity Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A - Nov 2019_v1.1 | This procedure requires prior approval from the IFR service. If after assessment the Consultant wishes to treat, they must apply for prior approval by either fully completing the following: Botulinum toxin Type A (Botox) - Overactive Bladder and Spasticity form or sending detailed clinic letter(s) which clearly outline how the patient meets the criteria to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Botulinum toxin Type A (Botox) - Sialorrhoea (Severe Drooling) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC12 Botulinum Toxin A - Nov 2019_v1.1 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat a strong case on grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Cannabinoids in the Management of Multiple Sclerosis and Chronic Pain | BPC 147 Cannabinoids in the Management of Multiple Sclerosis and Chronic Pain - March 2009 | |
| Cannabis-baseded products for medicinal use Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC81 Prescribing of cannabis-based products for medicinal use - Interim statement - November 2018 | This is not routinely funded and prior approval must always be obtianied 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 how the policy criteria are met. Please email the completed form /letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Carotid Endarterectomy and Endovascular Stent | 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 - November 2015 / updated September 2018 | This procedure requires prior approval from the IFR service prior to referral to secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from IFR service by either fully completing the following: Carpal Tunnel Syndrome Form or sending detailed clinic letter(s) which outlines clearly how the patient meets criteria. Please email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Cataract removal in adults (including second eye cataract surgery) threshold referral for surgery Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC60 Cataract Removal in Adults - Threshold for Surgery - August 2017 | This procedure is funded subject to audit. Please refer your patient directly by the electronic referral service if they fully meet the criteria outline in the policy. If the Optometrist wishes to refer the patient but they do not fully meet the criteria, prior approval is always required from the IFR service. Please fully complete the following: Cataract-Form Email the fully completed form and any supporting evidence to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Cerebellar Stimulator Implants | NHS England | For further information contact NHS England |
| Chalazia Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC95 Treatment of Chalazia - New Jan 2020 | This is a procedure that requires prior approval. Please complete the following: Eyelid Surgery Chalazia Form BE 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 BerksEast.IFRrequests@nhs.netfor consideration. |
| Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) inpatient stay Procedure Not Routinely Funded | BPC 130 130 Chronic Fatigue Syndrome | In the first instance the patient should be referred into local CBT service. Inpatient and outpatient treatment are not routinely funded and prior approval is always required prior to referral and treatment. If the GP wishes to refer there must be a strong case on the grounds of an exceptional health need. If there is an exceptional health need for treatment please complete the following: IFR application form and email it to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Closure of patent foramen ovale for migraine (PFO) | National Policy NHS England Patent Foramen Ovale PFO Closure - April 2013 | For further information contact NHS England |
| Complementary and Alternative Therapies Procedure Not Routinely Funded | TVPC100 Complementary and alternative therapies v1.0 | 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 also be provided. Please fully complete the following: IFR application form or provide detailed clinical 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Complex Neurological Rehabilitation for acquired brain injury not including injury due to stroke | Rehabilitation Categories: | Rehabilitation Categories: 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 BerksEast.IFRrequests@nhs.net |
| Continuous subcutaneous insulin infusion (insulin pumps) for adults with type 1 diabetes Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC65 Continuous subcutaneous insulin infusion (insulin pumps) for adults with type 1 diabetes - April 2018 | This device is funded subject to audit if the criteria outlined in the policy are fully met. |
| Contribution to Reimbursement of Expenses for Living Donors (Renal Transplantation) | National Policy NHS England Reimbursement of Expenses for Living Kidney Donors - April 2013 | For further information contact NHS England |
| Coronary Artery Stents | 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 patella, elbow & 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 BerksEast.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 patella (in front of the kneecap) and olecranon (elbow) bursitis - 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 BerksEast.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 - November 2015 / Updated January 2019 | Prior approval is always required from the IFR service before referral and treatment. The NHS Fertility Service or the Consultant wishing to treat, should fully complete the following: Preservation of Fertility Form or provide detailed clinical letters which clearly indicate how the policy criteria are met. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Cryotherapy (salvage) for recurrent prostate cancer | NHS England | For further information contact NHS England |
| Cryotherapy for localised Prostate cancer | NHS England | For further information contact NHS England |
| Deep Brain Stimulation for Parkinson’s Disease | National Policy NHS England Deep Brain Stimulation DBS in movement disorders - April 2013 | For further information contact NHS England |
| Deep Brain Stimulation for primary dystonia and essential tremor | National Policy NHS England Deep Brain Stimulation DBS in movement disorders - April 2013 | For further information contact NHS England |
| Deep Brain Stimulation including other interventions | National Policy NHS England DBS for Indications except movement disorders - April 2013 | For further information contact NHS England |
| Dental Implants | NHS England | For further information contact NHS England |
| Dilatation and curettage (D&C) for abnormal uterine bleeding Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC29 Dilatation and curettage (D&C) for abnormal uterine bleeding - November 2015 / updated September 2018 Medicines & Healthcare product Regulatory Agency (MHRA) MRHA Safety Altert - 7 August 2018 | This procedure is not normally funded. If there is exceptional health need the Consultant must obtain funding from the IFR service by fully completing the following: IFR application form or provide detailed clinic letter(s) that clearly outline how the patient meets criteria for consideration and the exceptional health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Disc replacement surgery Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and Sciatica - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, and there is exceptional health need please fully complete the following form and demonstrate the exceptional health need: IFR application form Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Donepezil, galantamine, rivastigmine and for the treatment of dementia associated with Parkinson's disease of Lewy Bodies | BPC 146 Donepezil , galantamine, rivastigmine for the treatment of dementia associated with Parkinson's disease or Lewy Bodies (AChEIS) - February 2009 | |
| Donepezil, galantamine, rivastigmine and mematine for the treatment of Alzheimer's disease | BPC 11b Donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer's disease (AChEIS)- updated Februrary 2009 | |
| Dupuytren’s Contracture Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC18 Dupuytrens contracture - October 2017 | This procedure requires prior approval from the IFR service prior to referral to secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from the IFR service by either fully completing the following: Dupuytrens-Form-BE-v1.2 or by sending detailed clinic letter(s) which outline clearly how the patient meets criteria. Please email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Earwax - Referral to ENT Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC88 Management of Earwax - March 2019 | This policy does not apply to patients with Down’s syndrome, patients with cleft palate (whether repaired or not) or other craniofacial abnormalities. This procedure required prior approval for referral to ENT. Please fully complete the following form: ENT Earwax Removal Form or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Ectropion and Entropion - indications for surgery Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC70 Ectropion and Entropion - indications for surgery - November 2017 | This procedure requires prior approval from the IFR service prior to referral to secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from the IFR service by either fully completing the following: Eyelid Surgery Entropion and Ectropion Form BE or by sending detailed clinic letter(s) which outline clearly how the patient meets criteria. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Elective Endovascular repair infrarenal abdominal aortic aneurysms | 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 | BPC 68 68 Eligibility for NHS Transport | As per the policy. |
| Endoscopic Thoracic Sympathectomy for 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 September 2018 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat a strong case on the grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 - Updated Jan 2020 | This is a procedure not routinely funded and prior approval is always required from the IFR service. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, and there is exceptional health need please fully complete the following form and demonstrate the exceptional health need: IFR application form Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration for consideration. Consultants must ensure that funding is in place prior to treatment. 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 - Updated Jan 2020 | This procedure always requires prior approval from the IFR service. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, please fully complete the following: Low Back Pain and Sciatica Form or provide detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration for consideration. Consultants must ensure that funding is in place prior to treatment. Epidural injections for neurogenic claudication in people who have central spinal canal stenosis are not normally funded. |
| 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 treatments are not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these requests a strong case on grounds of exceptional health need must be provided. Please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the case and the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Erectile Dysfunction treatments Including: the drugs sildenafil, vardenafil, 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 Consultant wishes to treat and the patient does not fully meet the criteria then prior approval is always required from the IFR service prior to treatment. Please complete the following: Exceptional Circumstances Submission Form or provide detailed clinical letters which clearly indicate how the policy criteria are met. Please email the completed form/letters to the IFR service BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 May 2019 | These are not routinely funded and prior approval must always be obtained. 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 Facet joint injections and medial branch blocks for chronic neck pain - May 2017 | 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 BerksEast.IFRrequests@nhs.netfor consideration. |
| Facet Joint & Medial Branch Block for chronic neck pain - Therapeutic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC56 Facet joint injections and medial branch blocks for chronic neck pain - May 2017 | 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 BerksEast.IFRrequests@nhs.netfor consideration. |
| Facet Joint Injections & Medial Branch Blocks for chronic neck pain - Therapeutic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and Sciatica - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the GP wishes to refer to secondary care or a Consultant wishes to treat, they must always apply for prior approval to the IFR service. Please complete the following: IFR application form and email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Facet Joint Injections & Medial Branch Blocks for low back pain - Diagnostic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and Sciatica - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. For these cases a strong case on grounds of exceptional health need must be provided. If the GP wishes to refer to secondary care or a Consultant wishes to treat, please complete the following form and clearly detail the exceptionality: IFR application form Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Facet Joint Injections & Medial Branch Blocks for low back pain - Therapeutic Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and Sciatica - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. For these cases a strong case on grounds of exceptional health need must be provided. If the GP wishes to refer to secondary care or a Consultant wishes to treat, please complete the following form and clearly detail the exceptionality: IFR application form Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Female Pelvic Organ Prolapse Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC59 Management of Female Pelvic Organ Prolapse - August 2017 | This procedure always requires prior approval from the IFR service. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, they must apply for prior approval by either fully completing the following: Female Pelvic Organ Prolapse Form or providing detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultant must ensure that funding is in place prior to treatment. |
| Female sterilisation Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC68 Female Sterilisation - November 2017 | This procedure is not routinely funded and prior approval is always required from the IFR service. If the Gynae service wishes to refer for treatment or the Consultant wishes to treat, they must have prior approval from the IFR service. Please either fully complete the following: IFR application form or provide detailed clinic letter(s) that clearly outline how the patient meets criteria. Email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 femoro acetabular hip impingement (FAI) (open or arthroscopic) - February 2016 / updated September 2018 | These procedures always require prior approval from the IFR service prior to referral and treatment in secondary care. If the GP or the MSK service wishes to refer to secondary care, or a Consultant wishes to treat, approval from the IFR service must be obtained. Please fully complete the following: Hip Impingement Form or send detailed clinic letter(s) which clearly indicate how the patient meets criteria for consideration and the health need. Please email the form/letters to the IFR service at BerksEast.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 Consultants must ensure that funding is in place prior to treatment. |
| Fenestrated endovascular stent-grafts for abdominal aortic aneurysms | 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 v2 | Prior approval is not required where the patient meets the criteria is full and will be managed by the Berkshire East Medicines Optimisation team. |
| Foetal Alcohol Specturm Disorders (FASD) in children, adolescents and adults - diagnosis and treatment (other than locally commissioned services) Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC77 The diagnosis and treatment of Foetal Alcohol Spectrum Disorders (FASD) in children, adolescents and adults - April 2018 | There are locally commissioned services within Mental Health, Learning Disability and Neurology which are able to identify and treat the difficulties associated with FASD. Due to this, national specialist assessment and treatment programmes solely for the diagnosis and treatment of FASD in children, adolescents and adults are not normally funded. Where such referral and treatment is requested a strong case on grounds of exceptional health need must be provided. Prior to referral and treatment the GP should complete the following form and clearly detail the exceptionality: IFR application form and email to the IFR service at BerksEast.IFRrequests@nhs.net for 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 Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC62 Functional Electrical Stimulation (FES) for Upper and Lower Limb Dysfunction of Central Neurological Origin - October 2017 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat a strong case on the grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Functional endoscopic or sinus surgery, surgery in the management of chronic rhinosinusitis (CRS) and nasal polyposis (NP) (FESS) Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC21 Rhinosinusitis - November 2015 / updated September 2018 | This procedure is funded subject to audit. Please refer you patient directly by the e-Referral Service if they fully meet the criteria outlined in the policy. If the Consultant wishes to treat and the patient does not fully meet the criteria then prior approval is always required from the IFR service prior to treatment. Please complete the following: Rhinosinusitis 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Gallstones - management of asymptomatic gallstones / cholecystectomy Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC75 Management of asymptomatic gallstones - April 2018 | This procedure is funded subject to audit. Please refer your patient directly by the electronic referral service if they fully meet the criteria outline in the policy. If the Consultant wishes to treat and the patient does not fully meet the criteria then prior approval is always required from the IFR service prior to treatment. Please complete the following: Gallstones Form or provide detailed clinical letters which clearly indicate how the policy criteria are met. Please email the completed form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Gamma Knife Surgery for Trigeminal Neuralgia | NHS England | For further information contact NHS England |
| Ganglion (including Ganglion of the wrist) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC15 Ganglion cysts - November 2015 / updated September 2018 | This procedure always requires prior approval from the IFR service in secondary care. If the GP or MSK service wishes to refer to secondary care, or a Consultant wishes to treat, approval from the IFR service must be obtained. Please fully complete the following: Ganglion Form or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration and the health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Gender Reassignment surgery for the treatment of Gender Dysphoria | National Policy NHS England Interim Gender Dysphoria Protocol and Service Guidelines 2013/14 Thames Valley Priorities Committee Commissioning Statement TVPC2 policy recommendation Gender Dysphoria October 2014 | 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 - January 2018 | Prior approval is always required from the IFR service 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 or send detailed clinic letter(s) which clearly indicate how the patient meets criteria to the IFR service by email at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 May 2019 | This procedure requires prior approval from the IFR service before referral to secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from the IFR service by either fully completing the following: Bunion Form or sending detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Hearing aids for adults Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC86 Hearing aids for hearing loss in adults - May 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 hearing loss in adults Form-EB or provide detailed clinic letters and email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Hemicraniectomy for malignant middle cerebral artery infarction | NHS England | For further information contact NHS England |
| Hernia (abdominal/ventral) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Elective surgical hernia repair in adults - February 2017 / updated May 2019 | Prior approval is always required from the IFR service 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: Hernia Form or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Hernia (Epigastric) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Elective surgical hernia repair in adults - February 2017 / updated May 2019 | Prior approval is always required from the IFR service 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: Hernia Form or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Hernia (Femoral, Spigelian or Inguino-scrotal) Prior Approval not required | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Elective surgical hernia repair in adults - February 2017 / updated May 2019 | 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 Elective surgical hernia repair in adults - February 2017 / updated May 2019 | Prior approval is always required from the IFR service 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: Hernia Form or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Hernia (Inguinal) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Elective surgical hernia repair in adults - February 2017 / updated May 2019 | Prior approval is always required from the IFR service 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: Hernia Form or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Hernia (Umbilical, Para-umbilical) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC48 Elective surgical hernia repair in adults - February 2017 / updated May 2019 | Prior approval is always required from the IFR service 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: Hernia Form or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| High-intensity focused ultrasound for colorectal liver metastases | MOBBB 76 76 High-intensity focused ultrasound for colorectal liver metastases | For further information contact NHS England |
| Hip and Knee Replacement Surgery - follow up appointment Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC8 Follow-up appointments after primary hip and knee joint replacement surgery - March 2019 | Follow the appropriate pathway as outlined in the policy. Prior approval is always required for further appointments following the initial routine follow-up appointment. Prior to referral the GP must obtain approval from the IFR service by either fully completing the following: General Funding Form or sending detailed clinic letter(s) which outline clearly how the patient meets criteria. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Hip joint revision surgery Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC55 Primary hip and knee replacement revision surgery - March 2018 / updated May 2019 | Prior approval is always required from the IFR service before referral to secondary care. If the GP/Consultant wishes to treat, they must always apply for prior approval to the IFR service. Please fully complete the following: Primary Hip Replacement Revision Surgery Form and email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 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. |
| Homeopathy - Complementary therapy - body massage, hypnosis Procedure Not Routinely Funded | BPC 10 10 Homeopathy | This procedure is not routinely funded and funding approval must always been obtained prior to referral and treatment. If there is exceptional health need the GP must obtain funding from the IFR service by fully completing the following: IFR application form and emailing it to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Hysterectomy (excludes Cancer) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC58 Hysterectomy - indications for surgery - August 2017 / Updated April 2018 Medicines & Healthcare product Regulatory Agency (MHRA) MRHA Safety Altert - 7 August 2018 | This procedure always required prior approval. If the Consultant wishes to treat they must have prior approval from the IFR service. Please either fully complete the following: Hysterectomy Form or provide detailed clinic letter(s) which clearly indicate how the patient meets the criteria. Email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Immunotherapy for allergic rhinoconjunctivitis Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC97 Immunotherapy for allergic rhinoconjunctivitis v1.0 | This is not routinely 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Impacted Third Molars - Wisdom Teeth | NHS England | For further information contact NHS England |
| Implantable Cardioverter Defibrillator devices for non-ischaemic cardiomyopathy | 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 IPGs, MTGs and DTGs - May 2016 / updated May 2019 | These are not routinely funded and prior approval must always be obtained. IFR application form |
| Inpatient pain management programmes for adults with chronic pain | NHS England | For further information contact NHS England |
| Interventions for non-union fracture: Low-intensity Pulsed Ultrasound (marketed in the UK as the Exogen® system) and teriparatide Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC10 Interventions for non-union fracture: Low-intensity Pulsed Ultrasound (marketed in the UK as the Exogen® system) and teriparatide - July 2016 | Prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat approval must be obtained from the IFR service by either fully completing the following: General Funding Form or sending detailed clinic letter(s) which clearly outline how the patient meets criteria and the health. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Intracranial Aneurysms – treatment of incidentally discovered IAs | National Policy NHS England Flow Diverting Device for Intracranial Aneurysms - April 2013 | For further information contact NHS England |
| Intrathecal Baclofen pumps for severe spascity | 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 NEW March 2019 | This procedure is not routinely funded and prior approval is always required from the IF service prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must also be provided. If there is an exceptional health need, please complete fully the following form: IFR application form and email the form to the IFR service at Berkseast.IFRrequests@nhs.net for consideration. |
| Iron Chelation in Myelodysplastic Syndrome (MDS) Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC79 Iron Chelation in Myelodysplastic Syndrome (MDS) - February 2019 | This procedure is funded subject to audit. Please refer your patient directly if they fully meet the criteria outlined in the policy. If there is exceptional health need and the patient does not meet the criteria then prior approval must be obtained from the IFR service prior to referral or treatment. For these a strong case on the grounds of exceptional health need must be provided. Please fully complete the following: Exceptional Circumstances Submission Form or send detailed clinic letter(s) which clearly outline the case and the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Knee Arthroscopy for Meniscal Tears Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC76 Arthroscopic Knee Surgery for Meniscal Tears v2 | This procedure always requires prior approval from the IFR service prior to referral and treatment. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval from the IFR service must be obtained. Please complete fully the following: Arthroscopic Knee Surgery for Meniscal Tears Form or send detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration and the health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Knee joint revision surgery Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC55 Primary hip and knee replacement revision surgery - March 2018 / updated May 2019 | Prior approval is always required from the IFR service before referral to secondary care. If the GP/Consultant wishes to treat, they must always apply for prior approval to the IFR service. Please fully complete the following: Primary Knee Replacement Revision Surgery Form and email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Laparoscopic fundoplication for chronic reflux oesophagitis (funding for use in any other circumstance is Low Priority) Procedure that requires Prior Approval | BPC 161 161 Gastric fundoplication for chronic reflux oesophagitis - Berkshire | Prior approval is always required from the IFR service before treatment If the Consultant wishes to treat, they must apply for prior approval from the IFR service by fully completing the following: General Funding Form or sending detailed clinic letter(s) which clearly indicate how the patient meets criteria to the IFR service by email at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Laparoscopic gastro-oesophageal reflux surgery (LGORS) for patients with chronic gastro-oesophageal reflux disease Procedure Funded Subject to Audit | BPC 93 93 Laparoscopic gastro oesophageal reflux surgery | 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 Consultant wishes to treat and the patient does not fully meet the criteria then prior approval is always required from the IFR service prior to treatment. Please complete the following: General Funding Form or provide detailed clinical letters which clearly indicate how the policy criteria are met. Please email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Laparoscopic surgery for colorectal cancer | NHS England | For further information contact NHS England |
| Lower Urinary Tract Symptoms in Men | NHS England | For further information contact NHS England |
| Lung resection for metastases | NHS England | For further information contact NHS England |
| Circumcision and preputioplasty Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC63 Circumcision and preputioplasty v2.0 | This procedure requires prior approval from the IFR service prior to referral and treatment in secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from the IFR service by either fully completing the following: Circumcision and preputioplasty Form or sending detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 May 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 | Thames Valley Priorities Committee Commissioning Policy Statement TVPC54 Melatonin treatment in Children - Updated Jan 2020 | 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Methylphenidate and atomoxetine in attention deficit hyperactivity disorder (ADHD) in children and adolescents Procedure Funded and 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Methylphenidate, dexamfetamine and atomoxetine in attention deficit hyperactivity disorder (ADHD) in adults | Prescribing arrangement for the use of methylphenidate, dexamfetamine and atomoxetine in adult ADHD | |
| Microwave ablation for lung metastases | NHS England | For further information contact NHS England |
| Myringotomy and Grommets for otitis media with effusion (Grommets) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC20 Surgical management of otitis media with effusion in children (under the age of 12 years) - November 2015 / updated September 2018 | This procedure always requires prior approval from the IFR service. If after assessment, the Consultant wishes to treat, they must apply for prior approval by either fully completing the following: Grommets Application Form or providing detailed clinic letter(s) which clearly indicate how the patient meets criteria Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 - May 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 and emailing it to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Neurosurgery for cerebral metastases | National Policy NHS England Stereotactic radiosurgery - radiotherapy for cerebral metastases - April 2013 | For further information contact NHS England |
| NHS England Specialised Commissioning Services Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC67 NHS England Specialised Commissioning Services - November 2017 | 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 non-specialised provider. |
| NHS Prescribing following private consultation | Thames Valley Priorities Committee Commissioning Policy Statement TVPC36 NHS Prescribing following private consultation - April 2016 / updated May 2019 | |
| Non pharmacological services for dementia patients Procedure Not Routinely Funded | MOBBB 63 63 Non pharmacological services for dementia patients | These services are not routinely funded and prior approval is always required from the IFR service. If the GP wishes to refer, a strong case on grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 - Updated Jan 2020 | This procedure 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: Open MRI or provide detailed clinic letter(s) which clearly indicate how the patient meets the criteria for consideration. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Orthodontics | NHS England | For further information contact NHS England |
| Orthognathic surgery | 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 - Updated Jan 2020 | 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 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 BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Patella resurfacing as part of total knee replacement (TKR) Procedure Not Routinely Funded | Berkshire East Clinical Commissioning Groups Policy Statement Berkshire East CCGs policy patella resurfacing as part of total knee replacement (TKR) - October 2016 | This procedure in not routinely funded and prior approval is always required from the IFR service prior referral and treatment in secondary care. It is expected that these patients will have been referred, assessed and treated for their painful knee. If a Consultant wishes to treat, they must apply by fully completing the following: IFR application form and emailing it to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 May 2019 | This intervention is not routinely funded and prior approval is always required from the IFR service. If the GP or a Consultant wishes to treat, a strong case on the grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Percutaneous pulmonary valve implantation | 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 fractures in men - September 2012 | |
| Photodynamic Therapy (with Verteporfin) | BPC 50 Photodynamic Therapy (with Verteporfin) - October 2002 | |
| Polysomnography in the investigation of children with sleep-related disorders | NHS England | For further information contact NHS England |
| Pramipexole in the management of Restless Legs Syndrome | BPC 115 Pramipexole in the management of Restless Legs Syndrome - November 2007 | |
| Preimplant genetic diagnosis (PGD) | National Policy NHS England Pre-implantation Genetic Diagnosis(PGD) - April 2013 | For further information contact NHS England |
| Primary Hip Joint Replacement Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC49 Patients with osteoarthritis (OA) primary hip and knee replacement - March 2019 | This procedure requires prior approval from the IFR service before referral to secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from the IFR service by either fully completing the following: Primary Hip Replacement Form or sending detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Primary Knee Joint Replacement Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC49 Patients with osteoarthritis (OA) primary hip and knee replacement - March 2019 | This procedure requires prior approval from the IFR service before referral to secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from the IFR service by either fully completing the following: Primary Knee Replacement Form or sending detailed clinic letter(s) which clearly indicate how the patient meets criteria. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Proton Pump Inhibitors in the treatment of dyspepsia | BPC 21 21 Proton Pump Inhibitors in the treatment of dyspepsia | If there is exceptional health need please complete the Exceptional Circumstances Submission Form and email it to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. |
| Radiofrequency Ablation and Cryotherapy for Renal Tumours | 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 - Updated Jan 2020 | This is a procedure which always requires prior approval from the IFR service. If a GP wishes to refer to secondary care or a Consultant wishes to treat, please fully complete the following: Low Back Pain and Sciatica Form or provide detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the completed form/letters to the IFR Service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Radiofrequency denervation for sacroiliac joint pain Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC52 Management of low back pain and Sciatica - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, and there is exceptional health need please fully complete the following form and demonstrate the exceptional health need: IFR application form Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Real-time continuous glucose monitors for adults with type 1 diabetes Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC64 Continuous Glucose Monitors v2 | This device is funded subject to audit if the criteria outlined in the policy are fully met. |
| 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. NEW March 2019 | Prior to referral and treatment please check with our referral triage service that the patient is eligible by fully completing the following: General Funding Form or providing detailed clinic letters which clearly indicate how the policy criteria are met. Please email the letters to the referral triage service at Berkseast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Reconstructive breast surgery post breast cancer Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC91 Reconstructive breast surgery post breast cancer - New Jan 2020 | 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 BerksEast.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 May 2019 | These are not routinely funded and prior approval must always be obtained. IFR application form |
| Restless Leg Syndrome(RLS) (Willis-Ekbom disease) Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC94 Primary Restless Legs Syndrome (RLS) (Willis-Ekbom disease) - New Jan 2020 | 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 BerksEast.IFRrequests@nhs.net for consideration |
| Reversal of Female Sterilisation Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC69 Reversal of female sterilisation and reversal of male sterilisation (vasectomy) - November 2017 | This procedure is not routinely funded and prior approval is always required from the IFR service. If the Gynaecology service, GP or the Consultant wishes to treat, a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need, please either fully complete the following: IFR application form or provide detailed clinic letter(s) that clearly outline the exceptional health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Reversal of Male Sterilisation Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC69 Reversal of female sterilisation and reversal of male sterilisation (vasectomy) - November 2017 | This procedure is not routinely funded and prior approval is always required from the IFR service. If the Gynaecology service, GP or the Consultant wishes to treat, a strong case on grounds of an exceptional health need must be provided. If there is exceptional health need, please either fully complete the following: IFR application form or provide detailed clinic letter(s) that clearly outline the exceptional health need. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Robotic-assisted laparoscopic radical prostatectomy | NHS England | For further information contact NHS England |
| Sacral Nerve Stimulation in faecal incontinence | National Policy NHS England Sacral nerve stimulation SNS for faecal incontinence in Adults - April 2013 | For further information contact NHS England |
| Selective Dorsal Rhizotomy | National Policy NHS England Selective dorsal rhizotomy | For further information contact NHS England |
| Sequential Cochlear implants in profoundly deaf children | NHS England | For further information contact NHS England |
| Serum P1PN 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-Interim Policy - July 2016 | 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 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 Email the completed form with any supporting documents to the IFR service at BerksEast.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 BerksEast.IFRrequests@nhs.net for consideration. |
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| Silicon Cosmesis for Prosthetic Limbs | NHS England | For further information contact NHS England |
| Smoking cessation before planned surgery | Thames Valley Priorities Committee Commissioning Policy Statement TVPC78 Smoking cessation before planned surgery - September 2018 | 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 | Prior approval is always required from the IFR service prior to referral or treatment. If the GP wishes to refer, or the Consultant wishes to treat, they must apply for prior approval by either fully completing the following: Snoring and OSAHS Form or providing detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultant must ensure that funding is in place prior to treatment. Link to STOP-Bang Questionnaire http://www.stopbang.ca/osa/screening.php |
| Sodium Oxybate for cataplexy and excessive daytime sleepiness in narcolepsy | BPC 112 Sodium Oxybate for cataplexy and excessive daytime sleepiness in narcolepsy - June 2007 | |
| Spinal Cord Stimulation for ischaemic pain | NHS England | For further information contact NHS England |
| Spinal Cord Stimulation in neuropathic pain | 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 - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, and there is exceptional health need please fully complete the following form and demonstrate the exceptional health need: Low Back Pain and Sciatica Form or provide detailed clinic letter(s) which clearly indicate how the patient meets criteria and the exceptional health need. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. For these cases a strong case on grounds of exceptional health need must be provided. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, please complete the following form and clearly detail the exceptionality: IFR application form Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. For these cases a strong case on grounds of exceptional health need must be provided. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, please complete the following form and clearly detail the exceptionality: IFR application form Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. For these cases a strong case on grounds of exceptional health need must be provided. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, please complete the following form and clearly detail the exceptionality: IFR application form Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Spinal Surgery | 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 - Updated Jan 2020 | This procedure is not routinely funded and prior approval is always required from 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 indicate how the patient meets the criteria and the exceptional health need. Email the completed form/letters to the IFR service at BerksEast.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 - Updated March 2018 | This procedure always requires prior approval from the IFR service. If after assessment, the Consultant wishes to treat, they must apply for prior approval by either fully completing the following Subacromial Decompression of the Shoulder Form or providing detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Surgical resection and percutaneous ablation for colorectal liver metastases | NHS England | For further information contact NHS England |
| Surgical techniques for the treatment of Oesophageal Stricture Procedure Not Routinely Funded | BPC 63 63 Oesophageal stricture | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. If the Consultant wishes to treat, a strong case on grounds of exceptional health need must be provided. If there is exceptional health need please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly outline the exceptional health need by email to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Tonsillectomy - Obstructive sleep apnoea in adults Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC22 Tonsillectomy for surgical management of recurrent tonsillitis and obstructive sleep apnoea in children and adults. - Updated Jan 2020 | This procedure always requires prior approval from the IFR service. If the GP wishes to refer to secondary care, or if a Consultant wishes to treat, they must always apply for prior approval from the IFR service. Please fully complete the following: Tonsillectomy for sleep disordered breathing Form - Adults or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Tonsillectomy - Obstructive sleep apnoea in children Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC22 Tonsillectomy for surgical management of recurrent tonsillitis and obstructive sleep apnoea in children and adults. - Updated Jan 2020 | This procedure always requires prior approval from the IFR service. If the GP wishes to refer to secondary care, or if a Consultant wishes to treat, they must always apply for prior approval from the IFR service. Please fully complete the following: Tonsillectomy for sleep disordered breathing Form - Children or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Tonsillectomy - Recurrent tonsillitis Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC22 Tonsillectomy for surgical management of recurrent tonsillitis and obstructive sleep apnoea in children and adults. - Updated Jan 2020 | This procedure always requires prior approval from the IFR service. If the GP wishes to refer to secondary care, or if a Consultant wishes to treat, they must always apply for prior approval from the IFR service. Please fully complete the following: Recurrent Tonsillitis Form or send detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.netfor consideration. Consultants must ensure that funding is in place prior to treatment. |
| Trans-cranial Doppler Ultrasonography with frequent transfusion to prevent stroke in children with sickle cell | NHS England | For further information contact NHS England |
| Transcatheter Aortic Valve implantation for aortic stenosis | National Policy NHS England Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis - April 2013 | For further information contact NHS England |
| Trigger Finger Procedure that requires Prior Approval | Thames Valley Priorities Committee Commissioning Policy Statement TVPC23 Trigger Finger - Updated Jan 2020 | This procedure requires prior approval from the IFR service before referral to secondary care. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from the IFR service by either fully completing the following: Trigger Finger Form or sending detailed clinic letter(s) which clearly indicate how the patient meets criteria. Email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.netfor consideration. Consultants must ensure that funding is in place prior to treatment. |
| Ultrasound guided injections for hip pain (trochanteric bursitis and osteoarthritis of the hip) Procedure Funded and Subject to Audit | Thames Valley Priorities Committee Commissioning Policy Statement TVPC32 Ultrasound guided injections for hip pain (trochanteric buritis and osteoarthritis of the hip) - November 2016 / updated September 2018 | This procedure is funded subject to audit. Please refer your patient directly if they fully meet the criteria outlined in the policy. If there is exceptional health need and the patient does not meet the criteria then prior approval must be obtained from the IFR service prior to referral or treatment. For these a strong case on the grounds of exceptional health need must be provided. Please fully complete the following: General Funding Form or provide detailed clinic letters which clearly indicate the exceptional health need and how the policy criteria are met. Email the completed form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Vagus Nerve Stimulation (VNS) for refractory epilepsy in children and adults | 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 September 2018 | This procedure requires prior approval from the IFR service before referral and treatment. If the GP wishes to refer to secondary care, or a Consultant wishes to treat, approval must be obtained from the IFR service by either fully completing the following: Varicose Veins Form or sending detailed clinic letter(s) which clearly indicate how the patient meets the criteria. Email the form/letters and supporting information to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| Vasectomy - Male Sterilisation Referral into Secondary Care - Procedure Not Routinely Funded | Thames Valley Priorities Committee Commissioning Policy Statement TVPC4 Vasectomy - male sterilisation - November 2017 TVVS vasectomy COVID_referral_guidance | Please refer your patient for local anaesthetic vasectomy in primary care to Thames Valley Vasectomy Services. Please complete the following form and send it direclty to Thames Valley Vasectomy Services tvvs.admin@nhs.net for consideration. Vasectomy referral form - Word Format If the GP wishes to refer into secondary care or the patient does not fully meet the criteria but there is an exceptional health need prior approval is always required from the IFR service prior to treatment. For these requests a strong case on the grounds of exceptional health need must be provided. Please fully complete the following: IFR application form or send detailed clinic letter(s) which clearly indicate how the policy criteria are met and why the patient cannot be treated in primary care. Please email the form/letters to the IFR service at BerksEast.IFRrequests@nhs.net for consideration. Consultants must ensure that funding is in place prior to treatment. |
| 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 BerksEast.IFRrequests@nhs.net for consideration. |
For more information
Please email the IFR service at Berkseast.ifrrequests@nhs.net for all enquiries about the policy statements or the process for considering Individual Funding Requests.