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We provide comprehensive patient-specific commissioning services including Individual Funding Request (IFR) and Prior Approval case management, as well as evidence-led and value-based Policy Development and Implementation support, to help NHS systems make the best use of resources while offering the best experience to their patients.
We’re already realising huge efficiencies for a range of NHS bodies through our extensive NHS expertise and robust evidence-based approach – could we help yours?
Read more about each part of our integrated service by clicking below.
See how we can support you with patient-centred and effective individual funding request support
We’re helping commissioners make best use of public money by streamlining funding treatment. See how.
Commissioners we support benefit from the development of fair, evidence-based clinical policy development that removes inequity in local areas. See how this support might benefit you.
The NHS exists to deliver patient-centred care. Sometimes, a patient’s unique health needs are not met by existing funding and treatment policies. An example might be where a patient has an extremely rare or highly complex condition, or where there isn’t a huge body of evidence supporting a new treatment. That’s when an individual funding request (IFR) can be made.
IFRs are designed to provide patients and healthcare workers with a thorough, evidence-based and transparent method for deciding the suitability of treatment. Funding for treatment will then be made available when the healthcare benefits are clear.
Individual funding is a highly sensitive, highly detailed and highly specialised part of CCGs’ decision-making responsibilities. Rigour and transparency are vital but our research shows there’s wide variation in how IFRs are managed.
NHS Midlands and Lancashire CSU provide an evidence-led, value-based efficient, robust and – most importantly – a consistent IFR service to 20 CCGs. We deliver expertise, experience, flexibility and economies of scale alongside specific knowledge, resources and technology that support the unique policies and circumstances of each CCG and health system. Our streamlined solution involves educating clinicians and implementing an electronic system for submitting applications for funding.
The NHS exists to deliver a consistent and fair patient experience – offering treatment to patients free at the point of need. CCGs are responsible for providing access to treatments where there is a proven clinical need and ensure that every single pound of NHS money is spent wisely – which is for every patient's benefit.
We deliver a prior approvals service to support CCGs' schemes, which ensures that providers deliver the precise care that CCGs commission – approving appropriate referrals and effective treatment while ensuring those not agreed for CCG funding are not approved. Our support ensures all providers work to the same framework in a health system, supported by a robust and intuitive prior approval system called the Value-Based Commissioning (VBC) Checker.
The outcome? Savings of millions of ‘NHS pounds’ that can be spent elsewhere in the NHS, and constant support and education of clinicians ensuring that only appropriate referrals are made and effective treatments are carried out in line with CCG policies.
NHS Midlands and Lancashire CSU’s prior approval support to two CCGs in the north-west of England realised a 27% reduction in treatment activity (>£1.7m in expenditure) between 2016/17 and 2017/18 alone.
Could we help your ICS, STP or CCG manage the demand for healthcare and adherence to policies better?
- Clinicians request treatment by confirming their patient’s circumstances using the VBC Checker. The required data fields on Blueteq can be tailored for each CCG’s needs.
- The VBC Checker provides an instant decision and if approved, a Prior Approval Ticket (PAT) is generated. The PAT will accompany any referral for treatment and/or list the patient for treatment, where clinically appropriate.
- A reconciliation process is then undertaken through the secondary uses service (SUS). Critically, this means CCGs only pay for activity that has a valid authorisation code.
- CCGs, providers and clinicians are provided with reporting, support and training as needed.
The NHS balances huge patient demand and need every day. Having clear treatment policies in place ensures that referral, treatment and funding decisions are appropriate, clinically and cost-effective, and ethical. It also means the NHS can respond positively to advances in medicine and technology as they occur.
Robust policy development is a process that takes in a range of important components that all need expert programme management, including:
- Clinical evidence review
- Consultation and engagement with health system stakeholders (GPs, consultants, providers, patient interest groups, the third sector)
- Equality impact and risk assessments
- Patient and clinician communications to support adoption, education and understanding
- Support for implementation, such as updating contracts, and ongoing monitoring and evaluation of impact and outcomes.
Our best-in-class approach has influenced the development of NHS England’s nationwide toolkit for policy development. We’re already bringing the benefits or policy development to seven CCGs in the north west and eight in Lancashire – get in touch to learn how we could help your CCG or health system.
Get in touch
- 1829 Building, Chester
- Old Market House
- Clark House
Countess of Chester Health Park