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) Procedure that requires Prior Approval | 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 there is exceptional health need for this procedure without myringotomy or tonsillectomy, 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 Proforma for CRS Prior approval Adenoidectomy for CRS v1 |
| Adult Mental Health IFR Procedure Not Routinely Funded | No policy statement for these interventions. | This procedure is not routinely funded. 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.CPIS.requests@nhs.net for consideration. IFR application form |
| Arthroscopic hip surgery in impingement Orthopaedics/ MSK Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 006 Arthroscopic femoro-acetabular surgery for hip impingement - November 2015 | 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. Prior Approval hip arthroscopy in impingement v1 - Word format |
| Knee arthroscopy (in adults over 40 years old) Orthopaedics/ MSK Procedure that requires Prior Approval | 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 | Prior approval is not required for cases of traumatic knee pain. In all other circumstances this procedure is not routinely funded and prior approval is always required from the IFR service. In the first instance, GP's to refer to the local MSK community service. Requests are normally expected from Secondary Care or the MSK community service. If MSK service wishes to refer to secondary care, or if a Consultant wishes to treat, they must fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval knee Arthroscopy (in adults over 40 years old) v4 Prior Approval Arthroscopic Surgery for Meniscal Tears v2 |
| Assisted conception Infertility treatments Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 002 Assisted Conception Services Policy Recommendation SHIP8 review July 2019 Covers: Hampshire and Isle of Wight ICB including Portsmouth. | 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. IVF-Referral-Form-2020 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 Policy 24 Use of AB and PRP Injections for musculoskelatal conditions v2.0 | This procedure is not routinely funded and prior approval is always required from the IFR service Prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must 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.cpis.requests@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 Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 031 Bariatric Surgery Revision v1.1 | 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. Prior Approval revision bariatric v1 |
| 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 Procedure that requires Prior Approval | IFR Policies and Procedure extract: 51 Bunions (Hallux Valgus) | This procedure is not routinely funded and in the first instance, GP's to refer to the local MSK community service. Requests are normally expected from Secondary Care or the MSK community service. If MSK service wishes to refer to secondary care, or if a Consultant wishes to treat, they must fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Bunions (Hallux valgus) v4 |
| 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 Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 22 Carpal Tunnel Syndrome reviewed November 2020 | This procedure is not routinely funded and prior approval must be obtained before treatment from the IFR service. Requests are normally expected from Primary Care, Secondary Care or MSK service. Please fully complete the following appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Carpal tunnel v5 |
| Cataract Removal Procedure Funded Subject to Audit | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 32 Cataract removal v3.0 | For information only. |
| Erectile Dysfunction | SHIP8 Clinical Commissioning Groups' Priorities Committee 63 Erectile Dysfunction and Penile Rehabilitation Policy FINAL v1.0 | For information only. |
| Complementary and alternative therapy Procedure Not Routinely Funded | Hampshire and Isle of Wight Integrated Care Board Priorities Policy 70 Complementary and alternative therapy v2.0 | For Information Only. |
| Complex Children IFR Procedure Not Routinely Funded | No policy statement for these interventions. | This procedure is not routinely funded. 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.CPIS.requests@nhs.net for consideration. Complex Children IFR Form |
| Cosmetic interventions for adults and children Procedure Not Routinely Funded | Hampshire and Isle of Wight Integrated Care Board Priorities Policy 72 Cosmetic interventions for adults and children v1.1 | For Information Only. |
| Cholecystectomy - Asymptomatic Gallstones Procedure Not Routinely Funded | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 12 Cholecystectomy for asymptomatic gallstones v3.0 | For information only. |
| Treatment of Chronic Anal Fissure (CAF) in Adults Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 25 Treatment of Chronic Anal Fissure (CAF) in Adults v3.0 | 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 Please fully complete the following form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Chronic Anal Fissure 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 |
| Complex Neurological Rehabilitation for acquired brain injury | Complex Neurological Rehabilitation - Initial Referral form Please email the completed forms to the IFR service at ifrcasemanagement@nhs.net |
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| Continuous Glucose Monitoring for Diabetes in Adults Procedure Funded Subject to Audit | Hampshire and Isle of Wight Integrated Care Board Priorities Policy 7 Continuous Glucose Monitoring for Diabetes in Adults v2 | Continuous Glucose monitors are commissioned for patients with diabetes who meet the criteria outlined in the policy. Prior approval is not required from the IFR service if these criteria 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.CPIS.requests@nhs.net for consideration. IFR application form |
| Cryopreservation - Fertility preservation Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 30 Fertility preservation v2.0 | This procedure is not routinely funded and prior approval is always required from the IFR service. Requests are normally expected from Secondary Care. Fertility Preservation Form 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.cpis.requests@nhs.net for consideration. |
| Dupuytren’s contracture / Palmar fasciectomy Orthopaedics/ MSK Procedure that requires Prior Approval | IFR Policies and Procedure extract: 46 Dupuytrens Contracture HANTS | 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 MSK community service. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Dupuytrens v4 - Word format |
| Excision of skin following massive weight loss including abdominoplasty, mammoplasty and removal of skin folds from the inner thighs Cosmetic/Plastic/ Aesthetic surgery Procedure that requires Prior Approval | IFR Policies and Procedure extract: 56 Excision of skin following massive weight loss.docx | 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 Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Skin reduction surgery after massive weight loss v3 - Word format |
| Eyelid Surgery Ophthalmology Procedure that requires Prior Approval Chalazia | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 54 Chalazia v2.0 | Where there is a suspicion of malignancy, the patient is referred using a two-week wait referral form for suspected cancer. In all other circumstances this procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment in secondary care. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.cpis.requests@nhs.net for consideration. Eyelid Surgery Chalazia Form |
| Eyelid Surgery Ophthalmology Procedure that requires Prior Approval Ectropion and Entropion | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 53 Ectropion and Entropion v2.0 | Where there is a suspicion of malignancy, the patient is referred using a two-week wait referral form for suspected cancer. In all other circumstances this procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment in secondary care. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.cpis.requests@nhs.net for consideration. Eyelid Surgery Ectropion and Entropion Form |
| Eyelid Surgery Ophthalmology Procedure that requires Prior Approval Ptosis and Dermatochalasis | Hampshire and Isle of Wight Integrated Care Board Priorities Committee 52-Eyelid-surgery-for-ptosis-and-dermatochalasis | Where there is a suspicion of malignancy, the patient is referred using a two-week wait referral form for suspected cancer. In all other circumstances this procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment in secondary care. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.cpis.requests@nhs.net for consideration. Prior-Approval-Eye-Lid-Surgery-ptosis-and-dermatochalasis |
| 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 Procedure that requires Prior Approval | IFR Policies and Procedure extract: 45 Female Sterilisation Hants | This procedure is not routinely funded and prior approval is always required from the IFR service prior to treatment. Requests are normally expected from Primary Care or Gynaecology Service. Please fully complete the following appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Female sterilisation v4 - Word format |
| Skin surface Functional electrical stimulation (FES) for foot drop as a result of a condition of central neurological origin Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 5 Skin surface FES for foot drop ... central neurological origin v3.0 | Prior approval must be obtained before assessment and treatment from the IFR service. Functional Electrical Stimulation may be considered as a second line treatment option for carefully selected patients with drop foot (most commonly due to multiple sclerosis or stroke). Please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Functional Stimulation Form |
| Sinus surgery for chronic rhinosinusitis ENT/Audiology (FESS) Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 19 Sinus surgery for chronic rhinosinusitis v3.0 | Prior approval is required from the IFR service. Please fully complete the appropriate form and together with all relevant documentary evidence, email it to email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Sinus surgery for Chronic Rhinosinusitis |
| Functional nasal airways surgery (which may include septo-rhinoplasty) ENT/ Audiology Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 23 Nasal surgery for nasal blockage and/or deformity reviewed November 2020 | Emergency procedures recorded under admission 21-28 do not require prior approval. In all other cases this procedure is not routinely funded and prior approval must be obtained before treatment from the IFR service. Requests are normally expected from Primary Care or ENT. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Nasal surgery for nasal blockage and/or deformity v5 |
| Ganglion Surgery General surgery/ hand surgery/ Procedure that requires Prior Approval | IFR Policies and Procedure extract: 48 Ganglion excision Hants | 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. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Ganglion v3 - Word format |
| Gastric fundoplication for chronic reflux oesophagitis Gastroenterology Procedure that requires Prior Approval | South Central Priorities Committee (Hampshire & Isle of Wight PCTs) 58 Gastric Fundoplication in reflux oesophagitis.docx | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment for this indication. Application is expected from secondary care If the Consultant wishes to treat please fully complete the following appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Gastric fundoplication for reflux oesophagitis v4 - Word format |
| Hydrocele Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Policy 26 Treatment of Hydrocele 1.0 | 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 Please fully complete the following form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Hydrocele v3 |
| Hysterectomy and Dilation and Curettage for Heavy Menstrual Bleeding Procedure Not Routinely Funded | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 39 Hysterectomy and D&C for HMB v2.0 | This procedure is not routinely funded. 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.CPIS.requests@nhs.net for consideration. IFR application form |
| Spinal Pain Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee Policy 60 Spinal pain v2.0 | This procedure is not routinely funded and prior approval must be obtained before treatment from the IFR service. Requests are normally expected from Secondary Care. If the Consultant wishes to treat please fully complete the following appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Interventions for Spinal Pain v10 |
| Knee Pressure Offloading Devices for OA | Hampshire and Isle of Wight Integrated Care Board Priorities Policy 69 Knee Pressure Offloading Devices for OA v1.0 | For Information Only. Prior Approval not required. |
| Keloid Scars Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Policy 71 Keloid Scars 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.cpis.requests@nhs.net for consideration. Prior Approval Keloid Scars 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 |
| Liothyronine in the treatment of Primary Hypothyroidism Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 27 Liothyronine in the treatment of primary hypothyroidism v2.0 | This treatment is not routinely funded and prior approval is always required from the IFR service prior to treatment. Applications are expected from Secondary Care. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.cpis.requests@nhs.net for consideration. Prior Approval Liothyronine Form |
| Lymphoedema treatments - Intensive decongestive therapy Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 4 Lymphoedema treatments v2.0 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. Please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Lymphoedema treatments Form |
| Male circumcision Urology Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 43 Circumcision - November 2018 | Where there is a suspicion of malignancy, the patient should be referred using the two-week wait referral form. In all other cases this procedure is not routinely funded and prior approval must be obtained before treatment from the IFR service. Requests are normally expected from Secondary Care and Primary Care If the GP wishes to refer or the Consultant wishes to treat please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Male circumcision v5 - Word format |
| Management of Haemorrhoids Procedure Funded Subject to Audit | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 40 Management of Haemorrhoids v2.0 | For information only. |
| Rotator Cuff Tears Orthopaedics/MSK Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 41 Rotator cuff tears v2.0 | Prior approval is not required if the tear is caused by trauma. For all other procedures prior approval is required. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Rotator Cuff Tears 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 Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 37 Grommet insertion - adults and children Updated 2021 | This procedure is not routinely funded and prior approval must be obtained before treatment from the IFR service. Requests are normally expected from Secondary Care. If the Consultant wishes to treat please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Grommets 12 years and over v5 |
| Myringotomy/ grommet insertion for children (≥12 years of age) ENT/Audiology Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 37 Grommet insertion - adults and children Updated 2021 | Children under 3 years of age may be treated without prior approval. This procedure is not routinely funded in all other circumstances and prior approval must be obtained before treatment from the IFR service. Requests are normally expected from Secondary Care. If the Consultant wishes to treat please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Grommets 3-11 years v6 |
| Negative Pressure Wound Therapy | SHIP8 Clinical Commissioning Groups' Priorities Committee 61 Negative Pressure Wound Therapy | 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 |
| Pulse oximetry for the diagnosis of obstructive sleep apnoea Procedure Funded Subject to Audit | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 34 Pulse oximetry for the diagnosis of obstructive sleep apnoea v2.0 | For information only. |
| The Use of Partial Knee Arthroplasty in patients with OA of the knee | Hampshire and Isle of Wight Integrated Care Board Priorities Policy 3 The Use of Partial Knee Arthroplasty in Patients with OA v2.0 | For information only. |
| Pelvic Organ Prolapse Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 29 Policy Pelvic Organ Prolapse FINAL v1.0 250820 Reviewed July 2020 | This is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. Please complete fully the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Pelvic organ prolapse surgery v4 - Word format |
| 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: 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 Procedure that requires Prior Approval | 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 | Emergency procedures recorded under admission 21-28 do not require prior approval. In all other cases this procedure is not routinely funded and prior approval is always required from the IFR service. Referrals should have been made to the commissioned tier 2 or tier 3 obesity management programme prior to offering surgery. If MSK wishes to refer to secondary care, or if a Consultant wishes to treat, please fully complete the following appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Hip or knee replacement in patients with a BMI above 35 v5 |
| Repair of asymptomatic/minimally symptomatic inguinal hernias in men Procedure Not Routinely Funded | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 20 Repair of asymptomatic and minimally symptomatic inguinal hernias in men v3.0 | This procedure is not routinely funded and prior approval is always required from the IFR service' prior to referral and treatment. For these cases a strong case on grounds of exceptional health need must 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.cpis.requests@nhs.net for consideration. IFR application form |
| Reversal of female sterilisation and male sterilisation (vasectomy) Procedure Not Routinely Funded | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 73 Reversal of female sterilisation and male steralisation v2.0 | For Information Only. |
| 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 |
| Shoulder Radiology Guided Injections and Scans for Shoulder Pain (Ultrasound guided subacromial injections) 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 |
| Subacromial decompression of the shoulder Orthopaedics/ MSK Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 14 Policy Subacromial decompression FINAL v1.0 Reviewed July 2020 | This procedure is not routinely funded and prior approval is always required from the IFR service. In the first instance, GP's to refer to the local MSK community service. Requests are normally expected from Secondary Care or the MSK community service. Please fully complete the following form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval subacromial shoulder decompression v1 - Word format |
| 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 |
| Removal of benign skin lesions Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 57 Removal of benign skin lesions v2.0 | 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.cpis.requests@nhs.net for consideration. Removal-of-Benign-Skin-Lesions-Form |
| Tonsillectomy ENT/ Audiology Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 36 Tonsillectomy- adults and children reviewed November 2020 | Prior approval is not required for patients who have been referred via the two-week wait referral form for suspected cancer. In all other circumstances prior approval must be obtained from the IFR service before treatment. Requests are normally expected from Primary Care or ENT. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Tonsillectomy v7 |
| Treatment of lower urinary tract symptoms (LUTS) as a result of benign prostatic hyperplasia (BPH) Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 66 Treatment of lower urinary tract symptoms (LUTS) as a result of benign prostatic hyperplasia (BPH) v2.1 | This procedure is not routinely funded and prior approval is always required from the IFR service prior to referral and treatment. Prior Approval Treatment of LUTS as a result of Benign Prostatic Hyperplasia Form |
| Treatments for primary focal hyperhidrosis Procedure that requires Prior Approval | Hampshire and Isle of Wight Integrated Care Board Priorities Committee Policy 68 Treatments for primary focal hyperhidrosis v1.0 | Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.cpis.requests@nhs.net for consideration. Treatment for primary focal hyperhidrosis Form |
| Trigger finger surgery Orthopaedics/ MSK Procedure that requires Prior Approval | IFR Policies and Procedure extract: 47 Trigger Finger Hants | 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 or MSK community service. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior Approval Trigger finger surgery v3 - Word format |
| Varicose vein procedures Vascular Surgery Procedure that requires Prior Approval | SHIP8 Clinical Commissioning Groups' Priorities Committee 001-Varicose-veins-policy-recommendation-reviewed-Jan-2020 | Emergency procedures recorded under admission 21-28 do not require prior approval. In all other circumstances this procedure is not routinely funded and prior approval must be obtained from the IFR service before referral and treatment in secondary care. Requests normally are expected from Primary Care. Please fully complete the appropriate form and together with all relevant documentary proof, email it to scwcsu.ship.ifrrequests@nhs.net for consideration. Prior-Approval-Varicose-veins-v4 |
| 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.ship.ifrrequests@nhs.net for all enquiries about the policy statements or the process for considering Individual Funding Requests.