Procedure that requires Prior Approval – Prior approval is not required for any of these policies for patients registered in the North East Hampshire & Farnham locality, as there are no prior approval arrangements currently in place. The exception to this is Assisted Conception, which does still require prior approval. The clinicians still must ensure the criteria for the below policies are met before proceeding with treatment.
Procedure Not Routinely Funded – Cases that are not routinely funded will require an Individual Funding Request (IFR) funding application to be submitted. A fully completed IFR form with supporting clinical detail should be submitted, and cases will be considered on the grounds of exceptionality.
Cosmetic, Other Surgeries, Devices, Screening and 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.
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 (CURRENT POLICY, REFERRAL GUIDELINES) | PROCESS PATHWAY (PATHWAY FOR TREATMENT AND APPROPRIATE FORMS) |
|---|---|---|
| Adenoidectomy ENT Procedure Not Routinely Funded Adenoidectomy for children with chronic rhinosinusitis (CRS) No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 008 Adenoidectomy revised March 2020 | This procedure is not routinely funded except when offered in combination with Myringotomy (grommet insertion) and /or Tonsillectomy which require prior approval. If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Appliances and devices for cosmetic purposes (high-grade silicon cosmeses and /or prostheses) Plastic surgery Procedure Not Routinely Funded | IFR Policies and Procedure extract: Appliances and devices for cosmetic purposes (high-grade silicon cosmesis and /or prosthesis | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must be provided. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Arthroscopic hip surgery in impingement Orthopaedics/ MSK No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 006 Arthroscopic femoro-acetabular surgery for hip impingement - November 2015 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Knee arthroscopy (in adults over 40 years old) Orthopaedics/ MSK No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 010 The place of arthroscopy in knee pain without true locking in adults over 40 years old - revised July 2018 55 Arthroscopic Surgery for Meniscal Tears reviewed 2021 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Assisted conception Infertility treatments Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Group's Priorities Committee 002-Assisted-Conception-Services-Policy-Recommendation-SHIP8-review-July-2019 Covering North East Hants & Farnham within NHS Frimley ICB Excluding GP Practices - Downing Street Surgery, River Wey Medical Practice, Farnham Dene Medical Practice, Holly Tree Surgery and The Ferns Medical Practice This procedures is not routinely funded and prior approval is always required from the IFR service. |
Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. NEHF-ICB-IVF-Referral-Form-2020 - check list of eligibility form - Word format for patients registered with North East Hants & Farnham within NHS Frimley ICB. 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. |
| Assisted conception Infertility treatments Procedure that requires Prior Approval | Assisted Conception Policy Feb 2012 Covering only Farnham GP Practices - Downing Street Surgery, River Wey Medical Practice, Farnham Dene Medical Practice, Holly Tree Surgery and The Ferns Medical Practice | Please note this policy is an inherited policy, and is currently in the process of being aligned across Frimley ICB. This procedures is not routinely funded and prior approval is always required from the IFR service. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IVF-Referral-Form-Farnham-pts-2020- check list of eligibility form - Word format for patients registered with a Farnham GP Surgery 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. |
| Autologous Blood Injections for Musculoskeletal Conditions Procedure Not Routinely Funded | SHIP8 Clinical Commissioning Group's Priorities 024 Use of Autologous Blood Injections for Musculoskeletal Conditions - December 2017 | This procedure is not routinely funded and prior approval is always required from the IFR service Prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must be provided. If there is exceptional health need, please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Balloon catheter sinus dilation for chronic rhinosinusitis Procedure Not Routinely Funded | SHIP8 Clinical Commissioning Groups' Priorities Committee 018 Balloon Catheter Sinus Dilation for Chronic Rhinosinusitis - v1.0 | This procedure is not routinely funded and prior approval is always required from the IFR service. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Bariatric Surgery | SHIP8 Clinical Commissioning Groups' Priorities Committee 013 Bariatric Surgery June 2016 reviewed Jan 2020 | For information only. |
| Bariatric Surgery Revision No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 031 Bariatric Surgery Revision v1.1 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Low Intensity Pulsed Ultrasound (Exogen) in delayed and non union fractures Procedure Not Routinely Funded | South Central Priorities Committee (Southampton, Hampshire, Isle of Wight and Portsmouth PCTs) 65 Exogen policy FINAL v1.0 250820 | This procedure is not routinely funded and prior approval is always required from the IFR service. If there is exceptional health need for this procedure please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Bunions (hallux valgus) Orthopaedics/ MSK No prior approval arrangements for this procedure | IFR Policies and Procedure extract: 51 Bunions (Hallux Valgus) | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Bursledon House - Assessment and admission for in-patient treatment Children’s Services Procedure Not Routinely Funded | IFR Policies and Procedure extract: Assessment and admission to Bursledon House in Southampton for in-patient treatment | This treatment is not routinely funded and prior approval is always required from the IFR service. If there is exceptional health need please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Carpal tunnel release/nerve entrapment at wrist Orthopaedics/MSK No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 22 Carpal Tunnel Syndrome reviewed November 2020 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Cataract Removal | SHIP8 Clinical Commissioning Groups' Priorities Committee 32 Cataract Removal - April 2018 | For information only. |
| Erectile Dysfunction | SHIP8 Clinical Commissioning Groups' Priorities Committee 63 Erectile Dysfunction and Penile Rehabilitation Policy FINAL v1.0 | For information only. |
| Cholecystectomy - Asymptomatic Gallstones | SHIP8 Clinical Commissioning Groups' Priorities Committee 012 Cholecystectomy for patients with asymptomatic gallstones - April 2018 | For information only. |
| Chronic Anal Fissure (CAF) in Adults No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 025 Treatment of Chronic Anal Fissure (CAF) in Adults - December 2017 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Chronic Fatigue Syndrome(CFS)/ Myalgic Encephalomyelitis(ME) - inpatient treatment Mental health Procedure Not Routinely Funded | IFR Policies and Procedure extract: In patient treatment for severe chronic Fatigue/ME in patient treatment | This treatment is not routinely funded. Severe cases require prior approval from the IFR service prior to referral and treatment but Mild-to-Moderate cases are available within the commissioned outpatient service run by South Coast Fatigue. For severe cases a strong case on grounds of exceptional health need must be provided. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Complementary therapies/medicine Alternative/ complementary/ homeopathic therapies Procedure Not Routinely Funded | IFR Policies and Procedure extract: Complementary therapies/medicine | This treatment is not routinely funded as a separate procedure but can be used without prior approval when included as an adjunct to usual therapy e.g. acupuncture within physiotherapy or pain management services. Not funded as a separate procedure If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Continuous glucose monitoring (CGM) for adults with Type 1 Diabetes Mellitus Procedure Not Routinely Funded | SHIP8 Clinical Commissioning Groups' Priorities Committee 007 Continuous Glucose Monitoring (CGM) for adults with Type 1 Diabetes Mellitus - February 2016 | This treatment is not routinely funded for patients requiring Continuous Glucose Monitoring (CGM) without the use of pump therapy. Applications are expected from Secondary Care/Diabetes Specialists. For these cases a strong case on grounds of exceptional health need must be provided. If there is exceptional health need, please complete fully the following form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Cryopreservation - preservation of fertility (Male and Female) Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 30 Cryopreservation options for patients about to start NHS treatment which might impair their future fertility - April 2018 | This procedure is not routinely funded and prior approval is always required from the IFR service. Requests are normally expected from Secondary Care. Prior Approval Cryopreservation v1 If Secondary Care/Consultant wishes to treat, they must provide details of the diagnosis, prospective treatment and evidence of how this may impair future fertility. Please email this to scwcsu.ship.ifrrequests@nhs.net for consideration. |
| Dupuytren’s contracture / Palmar fasciectomy Orthopaedics/ MSK No prior approval arrangements for this procedure | IFR Policies and Procedure extract: 46 Dupuytrens Contracture HANTS | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Excision of skin following massive weight loss including abdominoplasty, mammoplasty and removal of skin folds from the inner thighs Cosmetic/Plastic/ Aesthetic surgery No prior approval arrangements for this procedure | IFR Policies and Procedure extract: 56 Excision of skin following massive weight loss.docx | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Eyelid Surgery Ophthalmology including Blepharoplasty, Chalazia (meibomian cysts), Ectropion/ Entropion, Ptosis & Dermatochalasis No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 54 Chalazia 53 Entropion and Ectropion 52 Eyelid surgery for ptosis and dermatochalasis | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Faecal microbiota transplants - Recurrent or refractory C. difficile infection up to a maximum of two transplants Procedure Funded Subject to Audit - For all other indications Procedure Not Routinely Funded | SHIP8 Clinical Commissioning Groups' Priorities Committee 017 Faecal Microbiota Transplants - February 2017 | Faecal Microbiota Transplants are commissioned for recurrent or refractory C. difficile infection up to a maximum of two transplants. Prior approval is not required from the IFR service if the policy criteria outlined in the policy are met. All other indications are not routinely funded and prior approval is always required from the IFR service. If the Consultant wishes to treat outside of policy please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Foetal Alcohol Spectrum Disorder | SHIP8 Clinical Commissioning Groups' Priorities Committee 62 Foetal Alcohol Spectrum Disorders | This procedure is not routinely funded and prior approval is always required from the IFR service. If there is exceptional health need for this procedure please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR form for primary care - Word format IFR form secondary care - Word format |
| Female sterilisation Gynaecology No prior approval arrangements for this procedure | IFR Policies and Procedure extract: 45 Female Sterilisation Hants | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| 'Flash' Glucose Monitoring in Diabetes | SHIP8 Clinical Commissioning Groups' Priorities Committee 028 'Flash' Glucose monitoring in Diabetes - January 2018 | For notification only. Providers are expected to keep a record of all patients set up with a Flash glucose monitor in line with the criteria and this should be reported with CCG medicines management teams. |
| Functional electrical stimulation (FES) in drop foot Other services No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 005 Functional electrical stimulation in the management of drop foot of central neurological origin (specifically post stroke and multiple sclerosis) - July 2015 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Functional endoscopic sinus surgery ENT/Audiology No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 019 Functional endoscopic sinus surgery for chronic rhinosinusitis and nasal polyps - February 2017 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Functional nasal airways surgery (which may include septo-rhinoplasty) ENT/Audiology No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee Nasal surgery for nasal blockage and/or deformity reviewed November 2020 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Ganglion Surgery General surgery/Hand surgery No prior approval arrangements for this procedure | IFR Policies and Procedure extract: 48 Ganglion excision Hants | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Gastric fundoplication for chronic reflux oesophagitis Gastroenterology No prior approval arrangements for this procedure | South Central Priorities Committee (Hampshire & Isle of Wight PCTs) 58 Gastric Fundoplication in reflux oesophagitis.docx | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Hydrocele No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Policy 26 Treatment of Hydrocele 1.0 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Hysterectomy in heavy menstrual bleeding/dysmennorhea (menorrhagia) Gynaecology No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 39 Hysterectomy for heavy and/or painful menstrual bleeding - September 2018 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Inguinal hernia - Asymptomatic General surgery/hand surgery No prior approval arrangements for this procedure | South Central Priorities Committee (Hampshire & Isle of Wight PCTs) 148 Repair of asymptomatic inguinal hernias in adults - February 2013 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Spinal Pain No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee Policy 60 Spinal pain v2.0 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Laser therapy for recurrent pilonidal sinus Procedure Not Routinely Funded | SHIP8 Clinical Commissioning Groups' Priorities Committee 016 Laser Therapy for Recurrent Pilonidal Sinus updated June 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Laser treatment including Removal of skin Excessive hirsutism Surgical shaving Chemical destruction of skin Plastic surgery Procedure Not Routinely Funded | IFR Policies and Procedure extract: Laser removal of skin and excessive hirsutism | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must be provided. Requests are normally expected from Primary Care. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Liothyronine in the treatment of Primary Hypothyroidism No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 027 Liothyronine in the treatment of Primary Hypothyroidism - January 2018 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Lymphoedema - Intensive decongestive therapy Other services No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 004 Treatments for patients with lymphoedema - June 2015 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Male circumcision Urology No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 43 Circumcision - November 2018 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Management of Haemorrhoids No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 40 Management of Haemorrhoids - September 2018 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Management of rotator cuff tears and rotator cuff syndrome Orthopaedics/MSK No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 41 Management of rotator cuff tears and rotator cuff syndrome - September 2018 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Microsuction for the removal of ear wax in adults of 16 yeasrs and over. | SHIP8 Clinical Commissioning Groups' Priorities Committee 33 Microsuction for the removal of ear wax in adults of 16 years and over - June 2018 | For information only. |
| Myringotomy/grommet insertion for adults ENT/Audiology No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 37 Grommet insertion - adults and children Updated 2021 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Myringotomy/grommet insertion for children (≥12 years of age) ENT/Audiology No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 37 Grommet insertion - adults and children Updated 2021 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Negative Pressure Wound Therapy | SHIP8 Clinical Commissioning Groups' Priorities Committee 61 Negative Pressure Wound Therapy | For information only |
| Non-Alcoholic Fatty Liver Disease | SHIP8 Clinical Commissioning Groups' Priorities Committee 38 Non-Alcoholic Fatty Liver Disease - July 2018 | For information only. |
| Non-NHS residential placements Mental health Procedure Not Routinely Funded | IFR Policies and Procedure extract: Non-NHS residential placements | This treatment 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 be provided. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Obstructive Sleep Apnoes - Diagnosis using Pulse Oximetry | SHIP8 Clinical Commissioning Groups' Priorities Committee 34 Pulse Oximetry for the diagnosis of Obstructive Sleep Apnoea - June 2018 | For information only. |
| Partial Knee Arthroplasty inpatients with Osteoarthritis of the knee | SHIP8 Clinical Commissioning Groups' Priorities Committee 003 The Use of Partial Knee Arthroplasty in patients with Osteoarthritis of Knee - April 2015 | For information only. |
| Pelvic Organ Prolapse No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 29 Policy Pelvic Organ Prolapse FINAL v1.0 250820 Reviewed July 2020 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Erectile Dysfunction and Penile Rehabilitation following radical prostatectomy Procedure Not Routinely Funded | South Central Priorities Committee (Southampton, Hampshire, Isle of Wight and Portsmouth PCTs) 63 Erectile Dysfunction and Penile Rehabilitation Policy FINAL v1.0 Policy update July 2020 amalgamated with updated policy, Treatments for erectile dysfunction (March 2020) and replaced policy recommendation 137. | For information only. Managed by NHS England & Improvement. |
| Plastic/Cosmetic procedures including: Abdominoplasty Buttock lift, thigh lift, upper arm lift (brachioplasty) Facelift Female cosmetic genital surgery (labiaplasty) Implant removal and replacement Liposuction Pinnaplasty/meatoplasty/plastic operations on external ear Rhinoplasty/reconstruction of nose Procedure Not Routinely Funded | IFR Policies and Procedure extract: Plastic/cosmetic procedures surgery South Central Priorities Committee (Southampton, Hampshire, Isle of Wight and Portsmouth PCTs) 121 - Aesthetic surgery in children - Dec 2011 Guidance Notes Policy and Procedure for Individual Funding Requests - Appendix 6 | 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 exceptional health need must be provided. Requests are normally expected from Primary Care. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Plastic/Cosmetic procedures including: Breast and nipple procedures Breast augmentation Breast reduction Gynaecomastia Implant removal and replacement Mastopexy Procedure Not Routinely Funded | IFR Policies and Procedure Statement: Appendix 1 - Breast and nipple procedures South Central Priorities Committee (Hampshire & Isle of Wight PCTs) 15 Cosmetic breast surgery - Sept 2008 Guidance Notes Policy and Procedure for Individual Funding Requests - Appendix 6 | Reconstructive procedures may go ahead as part of established pathways and must take place within one year of the last cancer treatment. Outside of the above exclusion 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 exceptional health need must be provided. Requests are normally expected from Primary Care. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Primary hip and knee replacement in patients with a BMI above 35 Orthopaedics/MSK No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Policy Statement 50 Policy 50 Primary joint replacement for hip and knee osteoarthritis for patients with a body mass index of 35 and above v1.1 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Primary hip or knee replacement surgery - routine follow-up Orthopaedics Procedure Not Routinely Funded | South Central Priorities Committee (Hampshire & Isle of Wight PCTs) 110 Routine follow up after primary hip or knee replacement surgery - August 2011 | Following the initial routine follow-up appointment, further follow-up appointments are not normally funded and will be challenged via the contract. IFR application form |
| Reversal of sterilisation/ vasectomy Urology Procedure Not Routinely Funded | IFR Policies and Procedure extract: Reversal of sterilisation/ vasectomy | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must be provided. Requests are normally expected from Primary Care If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Revision of Knee Replacement Orthopaedics/MSK Procedure Funded Subject to Audit | SHIP8 Clinical Commissioning Groups' Priorities Committee 44 Revision of Knee Replacement - November 2018 | For information only. |
| Sativex | SHIP8 Clinical Commissioning Groups' Priorities Committee 64 Sativex | For information only |
| Second eye cataract surgery Ophthalmology Procedure Funded Subject to Audit | IFR Policies and Procedure extract: Second eye cataract surgery NHS Portsmouth, NHS Farenham & Gosport, NHS South East Hampshire CCGs | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment in secondary care. Requests are normally expected from Primary care or community optometry services. Requests from secondary care ophthalmology should only involve patients on long-term follow-up or listed for bilateral two-stage procedures. Please complete the following form and submit with the relevant documentary evidence to scwcsu.ship.ifrrequests@nhs.net for consideration. Cataract Surgery in Second Eye Form - Word format |
| Shoulder Radiology Guided Injections and Scans for Shoulder Pain Procedure Not Routinely Funded | SHIP8 Clinical Commissioning Groups' Priorities Committee 067 Shoulder Radiology Guided Injections and Scans for Shoulder Pain 1.1 | This procedure is not routinely funded and prior approval is always required from the IFR service. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Short sight/long sight corrective (laser) surgery (Refractive keratoplasty) Ophthalmology Procedure Not Routinely Funded | IFR Policies and Procedure extract: Short sight/long sight corrective (laser) surgery (Refractive keratoplasty) | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. Requests are normally expected from Secondary care. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Subacromial decompression of the shoulder Orthopaedics/MSK No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 14 Policy Subacromial decompression FINAL v1.0 Reviewed July 2020 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Surgery for snoring ENT Procedure Not Routinely Funded | SHIP8 Clinical Commissioning Groups' Priorities Committee 009 Treatments for people who snore - February 2016 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
| Surgical removal of skin lesions and Lipoma Dermatology/general surgery Procedure Not Routinely Funded | IFR Policies and Procedure extract: 57 Removal of benign skin lesions final.docx | If there is a suspicion of malignancy, the patient should be referred using the two-week wait referral form for suspected cancer or via the local BCC fast track pathway. Where the treatment is for Hidradenitis suppurutiva then prior approval is not required. Outside of the above exclusion this procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. Requests are normally expected from Primary Care. If there is exceptional health need send all relevant documentary proof to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval removal of benign skin lesions v2 - Word format |
| Tonsillectomy ENT/ Audiology No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 36 Tonsillectomy- adults and children reviewed November 2020 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Treatment of LUTS as a result of Benign Prostatic Hyperplasia Orthopaedics/MSK No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 66 Treatment of LUTS as a result of Benign Prostatic Hyperplasia (2020) | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Trigger finger surgery Orthopaedics/MSK No prior approval arrangements for this procedure | IFR Policies and Procedure extract: 47 Trigger Finger Hants | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Varicose vein procedures Vascular Surgery No prior approval arrangements for this procedure | SHIP8 Clinical Commissioning Groups' Priorities Committee 001 Varicose veins policy recommendation reviewed Jan 2020 | If the patient does not meet the criteria but there is exceptional health need for this procedure, please complete the form together with all relevant documentary proof, email it to scwcsu.CPIS.requests@nhs.net for consideration. IFR application form |
| Dilation and curettage in heavy menstrual bleeding Gynaecology Procedure Not Routinely Funded | IFR Policies and Procedure extract: 49 Dilation and curettage in HMB Hants | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must be provided. If there is exceptional health need, please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. IFR application form |
For more information
Please email the IFR service at scwcsu.cpis.requests@nhs.net for all enquiries about the policy statements or the process for considering Individual Funding Requests.