An Individual Funding Request application can be made by the clinician treating you. They will make a request on your behalf if they believe that your clinical circumstances are exceptional, and you may benefit from a treatment or service that isn’t routinely offered by the NHS.
Individual Funding Requests need to be submitted to the NHS body that is responsible for funding the treatment you are making the request about. Some services are paid for by NHS England, other services are paid for by us, NHS North East London, as your local integrated care board (ICB).
Information on how to submit an Individual Funding Request to us can be found below, including details of the criteria you need to meet and how requests are processed. A guide for patients is also available to read here.
There may be some cases where a treatment is not available on the NHS. This can be because there is limited evidence to show how well the treatment works or because it has a very high cost and doesn’t offer good value for money for taxpayers and the NHS.
An individual funding request application can be made and considered for a treatment that is not routinely offered by the NHS when:
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Every person has the same rights to treatment under the NHS no matter what their social, family or other circumstances are. For this reason, it is important that non-clinical factors are not considered when decisions about Individual Funding Requests are made.
For example, factors such as the effect of a treatment on a patient’s ability to work or study, care for dependants, or meet financial commitments cannot be considered as part of the process. The decision is based on clinical circumstances only, which ensures the process is fair, equitable and non-discriminatory.
An Individual Funding Request application is made by a clinician. We cannot accept individual funding requests directly from patients, although patients can work with their clinician to input into the process if their clinician believes they are eligible.
Your application will first go through a screening process to make sure all relevant information has been submitted and the application meets the criteria for an Individual Funding Request.
If the application meets the criteria, it will then be considered by an independent panel who have not been involved in your treatment. The panel is made up of clinicians, public health experts, pharmacists, representatives from NHS North East London ICB who would, if approved, fund the service, and people with experience of using health and care services. The panel will consider the application in detail before making a decision, usually within a few weeks. All panel members regularly receive training to enable them to assess Individual Funding Requests fairly and thoroughly.
Treatments agreed through the Individual Funding Request process must be funded from the same budget available for other established treatments. Because of this, every single case is considered extremely carefully before a decision is taken to fund a treatment for an individual that is not usually available on the NHS.
Your personal details will be kept confidential. We will let your clinician know the outcome of the funding request.
If your application is unsuccessful, your clinician will discuss with you the reasons for the decision and what other treatment options may be available.
As long as all the required information is submitted, it usually takes 30 working days from receiving an application to a decision, but it can often be sooner. Urgent cases, for example where significant or irreversible loss of function is likely to occur, can be processed more quickly if needed.
We will keep in contact with your clinician during the application process and let them know how the application is progressing and if there are any delays. You should therefore speak to your clinician in the first instance for any updates.
If the panel hasn’t supported funding for a requested treatment, or if it has approved a treatment subject to conditions and you don’t agree, you should speak to your clinician who may be able to request a review of the decision. A review of the decision can be requested if you and your clinician believe that the process hasn’t been followed correctly.The review request must be made within 28 days of when your clinician was informed of the decision.
If your situation changes or more clinical evidence becomes available about the effectiveness of your treatment your clinician may also submit additional information which will be considered.
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