Evidence Based Interventions Policy (EBI)

The NEL Evidence Based Interventions Policy (NEL EBI) is a list of treatments/interventions that are only funded by the NHS when a patient meets certain clinical threshold criteria. This policy applies to adult patients aged 18 and over only, unless specified otherwise in the body of text within each policy.

Policy development is an on-going process resulting from the publication of new evidence regarding clinical effectiveness. Policy reviews will be undertaken in response to NICE Guidance/Guidelines, health technology assessments etc.

This policy was first published in October 2019 after a rigorous clinically led programme which reviewed and incorporated where appropriate the latest national Evidence Based Interventions Programme1 and the London Choosing Wisely Programme2. The policy replaced the two existing Procedures of Limited Clinical Evidence Policies (POLCE) policies (Barking and Dagenham, Havering and Redbridge POLCE policy and the Waltham Forest, Tower Hamlets, Newham and Waltham Forest (WELC) POLCE policy).

After a review by local clinicians, the majority of those interventions have now been incorporated into this policy. There are however 3 interventions that clinicians decided not to adopt at this time. The first two as it was felt that in the context current waiting, applying this would have a detrimental impact on equality of access and waiting times.

1. Knee MRI should not be routinely used to initially investigate suspected meniscal tears in primary care (policy ref: 2U; table 2B)
2. Imaging for shoulder pain should be offered under the guidance of shoulder specialists where possible. (Policy Ref: 2W(i)(ii); Table: 2B)
3. The third policy that has been put on hold relates to Adenoidectomy in Glue Ear (policy ref: 2D; table 2A) Local ENT consultants felt that this policy did not reflect the latest clinical evidence, and this has been taken up with the national team for more discussion.

For further information on clinical exceptionality please refer to the IFR policy or contact the IFR team in advance of completing an IFR application to discuss the appropriateness of pursuing funding?

Any procedures carried outside of the funding governance arrangements outlined above will be subject to challenge and carries a significant risk of non-payment to the provider.