Individual Funding Requests (IFR)

The NHS belongs to us all.  It exists to:

  • Improve our health and well-being
  • Support us to keep mentally and physically well
  • Help us get better when we are ill
  • Stay as well as we can throughout our lifetime especially when we cannot fully recover

To make sure that the NHS can provide the best care for the maximum number of people it is vital that every penny is spent wisely.  This means only funding treatments that have been demonstrated to work and where there is also a high likelihood of benefit for as many people as possible and a low likelihood of harm.  We always have to bear in mind that carrying out treatment that is not of great health benefit uses up resources that could be spent on really making a difference elsewhere.

We may decide that a treatment or procedure should not be routinely funded because:

  • There is only limited or no evidence of its effectiveness (whether it works or not).
  • It is considered a low priority for funding, (for example, cosmetic surgery) compared to other treatments (for example, dementia or stroke care).

Where there is a new or rare treatment or a policy specifies a treatment is ‘not routinely commissioned’ meaning a decision has been taken not to commission (fund) that specific treatment, an IFR (clinically exceptional case) Approval will be required.  This means treatment will only be funded if the application proves exceptional clinical need compared to other people with the same or similar condition. Funding approval must be obtained via the IFR process prior to any treatment commencing or a patient being placed on a waiting list. 

An IFR application can also be submitted when the patient does not meet the specified clinical criteria within a specific treatment policy and where a clinician considers their patient has exceptional clinical need.

Funding applications can be made in either Primary or Secondary Care. Applications for funding should ideally be made by the clinician who has the most knowledge of the condition and intervention that the request relates to.

A clinician may think that their patient’s clinical situation is so different to other patients with the same condition, that it is appropriate that they should have a specific treatment.  Believing that their patient will gain greater benefit than other patients within the same cohort or similar clinical circumstances. In such circumstances, clinicians, on behalf of their patient, may submit an IFR. This route should only be used in exceptional clinical circumstances and not as a route to gain consideration of funding a new treatment or to start a service development.

There can be no exhaustive description of the situations which are likely to come within the definition of exceptional clinical circumstances.  The onus is on the clinician making the request to set out the grounds for clinical exceptionality clearly for the IFR Panel to consider.

The Integrated Care Board (ICB) defines exceptionality solely in clinical terms.  Personal or social circumstances will not be taken into consideration.  In essence it is a question of equity.  To consider personal, social or other non-clinical factors could introduce inequity.

The IFR process

Should you wish to submit an IFR on behalf of your patient please refer to the IFR management policy, IFR decision making policy and exceptionality policy for further guidance and information regarding the process.

For patients in Central Lancashire, Pennine Lancashire, Fylde Coast and West Lancashire areas, please complete the IFR application form below.

IFR application form

For Morecambe Bay area patients please submit an online application via the link below:

Reconsidering an application that was not approved for funding

If an IFR application has been refused funding and the requesting clinician believes there is significant new clinical information that was not previously submitted, which may alter the decision not to fund treatment, then they may submit the information and request a reconsideration.

A request for a reconsideration of a decision will only be processed where there is new information relevant to the case to be considered.  All reconsiderations must be submitted to the IFR team, using the designated reconsideration form.  The application and the new information will then be reconsidered in line with the IFR process.

For patients in the Central Lancashire, Pennine Lancashire, Fylde Coast and West Lancashire and Morecambe Bay areas, please complete the reconsideration form below.

Reconsideration application form

Appeals process

There is no statutory requirement for the ICB to hold appeals.  However, in line with best practice, the ICB does allow an appeal to be made against the process that was followed to arrive at the decision.

All appeals must be made in writing using the appeals form and submitted to the IFR Team within 12 weeks of the decision.  An appeal can be made by a clinician requesting the treatment. Where an appeal is submitted by a patient, this must have the full support of their clinician.

It must be noted that an appeal panel cannot overturn a decision which has been taken by the IFR panel.

For patients in Central Lancashire, Pennine Lancashire, Fylde Coast, West Lancashire and Morecambe Bay areas, please complete the appeals form below.

Appeals form

Individual Funding Request team contact details - clinicians only

Tel: 01782 916876


If you are a patient and have an enquiry about an IFR application or the process please speak with your clinician in the first instance alternatively, please contact the customer service team.

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