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Referrers guide

NHS Kernow must provide healthcare within the budget it has been given. That legal requirement means that some hard choices have to be made.
Demand for healthcare continues to grow and we have to prioritise the most clinically and cost effective treatments available. Decisions to fund new treatments mean less is available for other health services. Difficult choices have to be made over the healthcare we can afford, and which benefits the most people. We try hard to make these choices in a way which is impartial, consistent, and fair.

What is an individual funding request?

This is a request made by you, for treatment which is not routinely funded by the NHS. In making a request, you need to show evidence that there is an exceptional clinical need.

What does exceptional clinical need mean?

You should provide evidence that:

  • the person is significantly different to the general population of people with the condition in question
  • is likely to gain significantly more benefit from the intervention than might be normally expected for those others

How do I apply for funding?

Please complete an application form. Forms are available on our individual funding request page. Read our individual funding request policy (PDF, 521 KB) before completing the form.

What happens next/?

Your application will be triaged and:

  • agreed where the requested treatment meets an existing policy or pathway
  • refused when there is a clear policy covering the situation and where there is no evidence of exceptional clinical need
  • returned if further information is required
  • forwarded to the relevant panel

What happens after the panel has met?

You will be informed of the decision within 5 working days.

What can I do if funding is not approved?

Reconsideration

If there is new or additional evidence which the panel did not see, a case can be made for reconsideration.

Appeal

If it is felt that the panel did not follow the decision making process outlined in our individual funding request policy (PDF, 521 KB). Any appeal must be made within 4 weeks of the panel decision, stating the grounds for appeal.

Complain

If you are unhappy with the outcome, you can make a complaint.

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