Policies and Application forms – Surrey Heath

Prior approval is not required for patients registered in the Surrey Heath locality of NHS Frimley ICB, as there are no prior approval arrangements currently in place. The exception to this is any Assisted Conception intervention, which does still require prior approval. 

Clinicians still must ensure that policy criteria are met before proceeding with treatment.

Cases that are not routinely funded or do not meet policy criteria 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, 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 a secure NHS.net account to scwcsu.cpis.requests@nhs.net for consideration.

InterventionPolicy StatementProcess Pathway
Assisted Conception
Procedure that requires Prior Approval
Assisted Conception Policy v11All applications should be made via Blueteq.
List of Procedures with Restrictions and ThresholdsList of Procedures with Restrictions and ThresholdsPrior approval is not required for any interventions listed in this policy for patients registered in the Surrey Heath locality, as there are no prior approval arrangements currently in place.
Clinicians still must ensure that policy criteria are met before proceeding with treatment.
Cases that do not meet policy criteria will require an Individual Funding Request (IFR) funding application to be submitted.
IFR-application-form
List of Procedures Not Routinely Funded
Procedure Not Routinely Funded
List of Procedures Not Routinely FundedAll applications should be made via Blueteq.
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