For a list of low clinical thresholds, please click here
NHS West Suffolk Clinical Commissioning Group aims to provide excellent healthcare to the people of Suffolk through buying the best services, but like all other NHS organisations we have limited resources and have to prioritise funding of treatments.
Procedures or operations which are only done to change a patient’s appearance, and which do not achieve a health gain, will not be funded.
Doctors and consultants wishing to apply for funding on their patients behalf will have to demonstrate that the procedure will offer significant and lasting health benefits for the patient.
The NHS Ipswich and East Suffolk CCG and NHS West Suffolk CCG individual funding request panels (IFR panels) have guidance to support their decision making process. There is no specific criteria that the panels have to meet, as each case will be considered on its own merit and the evidence presented to support the request. Each case will need to demonstrate clinical effectiveness, cost effectiveness and clinical appropriateness.
Information to support a request may include physiotherapy assessments, professional bra fitting, measures of mental health (e.g. PHQ9 or GAD7), Body Mass Index and recent changes to BMI or duration of its stability, effects on the patient’s ability to function e.g. visual acuity, visual field, density of hair, evidence of complication from the condition, such as infection or bleeding and full details of the assessment of the patient e.g. endocrine screening for gynaecomastia requests.
It is essential that patients undergoing treatment should be made aware that subsequent surgery to correct physical defects will only be funded if there will be a health gain and a clear clinical need is demonstrated. Procedures which only result in a change of appearance with no or minimum health gain will not be funded. As a health system we need to ensure that we are able to maximise the population health gain within the available resources and spend this limited resource equitably.
If you need further information, please contact:
West Suffolk Clinical Commissioning Group
Fax: 01473 832511 (safe haven)