HNY Policy and Pathway Repository
Individual Funding Request (IFR)
The Integrated Care Board (ICB) is responsible for using NHS funds fairly and efficiently, considering the health needs of the entire local population. In general, funding is allocated for treatments outlined in the ICB’s commissioning plans.
However, in certain cases, a clinician—often a GP or hospital doctor—may believe that a patient’s condition is significantly different from others with the same diagnosis. If this clinical difference justifies a treatment that isn’t routinely funded, it is considered a case of clinical exceptionality.
In such situations, the clinician can submit an Individual Funding Request (IFR) to apply for NHS funding for the treatment. Patients cannot make these requests themselves; it is the responsibility of the clinician overseeing their care to prepare the IFR and provide supporting medical evidence.
Important Update – IFR System Change
From this date, referrers must submit IFR applications using the electronic application form available on the this webpage and completed forms must then be submitted via email to the new IFR inbox: hnyicb.individualfundingrequests@nhs.net
In addition, from 31st March 2026, the Prior Approval system will no longer be available. Clinicians who wish to check their patients’ eligibility for treatments and interventions should instead refer to the ICB’s Clinical Commissioning Policies, which are available on the Humber and North Yorkshire Policy and Pathway Repository: Home – HNY Policy and Pathway Repository
What is an IFR?
An IFR is a formal request for NHS funding for a treatment not usually offered. It is only considered under specific circumstances and applies to any clinical intervention not already included in ICB commissioning agreements.
Because NHS resources are limited, funding decisions through IFRs are based on:
- The clinical evidence of the treatment’s safety and effectiveness.
- The degree to which the patient’s condition is clinically exceptional.
- Whether the treatment will deliver the greatest possible health benefit from the available resources.
1. When can a request be made?
It is possible to make an IFR in the following situations:
- When the ICB does not have a policy stating who can have the treatment that is being requested
- When the ICB has a policy, but the patient’s clinical circumstances do not meet the criteria for treatment
- When the ICB has a policy stating that it will not routinely fund the treatment
- When the patient has a rare medical condition that is not covered by an ICB policy.
The referring clinician is responsible for keeping the patient updated throughout the process and clearly explaining the outcome of the IFR.
North of England Commissioning Support (NECS) has developed an online self-service system, Check+, which allows registered users to generate an Individual Funding Request.
Check+ allows primary and secondary care users to submit and track the progress of their IFR cases. It will support two-way communication with the IFR team and a referring clinician and provide email notifications to the respective users of any status update.
What does exceptional mean?
The patient’s clinical circumstances may be considered to be ‘exceptional’ if:
- The patient has clinical features that makes the patient significantly different from other patients who have the same clinical condition.
Exceptional does not mean
The fact that a treatment is likely to be successful in producing the desired or intended result is not by itself an exceptional circumstance. The Panel has to consider if there is likely to be a group of patients:
- With the same or similar clinical circumstances, OR
- Whose clinical condition means that they could make the same request, OR
- Who could be expected to benefit from the requested treatment to the same or similar degree.
Individual personal and social circumstances will not be part of the decision, the decision is purely a clinical decision.
2. What happens to the application?
If the request is not covered by an existing policy, or the patient falls outside the criteria of a policy, it will be triaged by the IFR Team and, if necessary, referred to the HNY IFR Panel. The panel generally meets twice a month and includes at least three clinicians.
3. How does the IFR panel make decisions?
IFR applications are taken through a formal, clinically-led triage and, where this is appropriate, referred on to a monthly clinically-led IFR panel for a funding decision.
Decision making is based on the ICB’s Individual Funding Request Policy. We aim to make these difficult choices in a robust way which is fair, clear and consistent. If the Panel considers the request to be exceptional, it reviews the following criteria:
- Clinical effectiveness (If the treatment is likely to be beneficial and safe.)
- Cost effectiveness (How much it costs to achieve the health benefit predicted. The proposed treatment should be the most cost-effective option that meets the clinical need.)
- Affordability (Resources used to support an individual patient will reduce the availability of resources for other treatments or services.)
- Exceptionality (Clinical exceptionality of the patient within the group/cohort of patients.)
Information submitted to the Panel is anonymised. Only the patient’s medical condition will be considered as part of the IFR process. Social and personal circumstances cannot be taken into account. These factors cannot set the patients case apart from that of another patient without implying that one patient is more deserving than another because of who the patient is or what the patient does.
If there are likely to be other similar patients who would also benefit from the requested treatment, the Panel cannot agree funding under the IFR process. In this instance the ICB may need to consider developing a case for change for a new service the evidence for which will be considered by ICBs prioritisation and commissioning investment/disinvestment process and may ask for the referring clinician to submit a Business Plan.
Decisions are communicated through the IFR system within 10 working days of the IFR Panel meeting. Once a decision has been uploaded the referring clinician will receive a notification via email.
If a funding request is declined by the IFR panel, the referring clinician can ask for it to be reconsidered but only if new, clinically significant information or evidence is provided. Patients are unable to ask for a reconsideration directly.
4. Can a decision be appealed?
If your individual funding request (IFR) has been declined, your referring clinician may submit an appeal—if there are valid grounds to do so.
Appeals are reviewed by a separate panel from the original IFR panel to ensure fairness and avoid any conflicts of interest. An appeal must be submitted by your referring clinician within three months of the original decision. An appeal can only be considered if there is evidence that the IFR process wasn’t properly followed. For example:
- Relevant evidence or important information was not taken into account
- The panel applied the decision-making criteria incorrectly
5. Where to find documents on the IFR process?
The following will be links to the actual documents
6. What key information do referrers need to know before making a request?
The ICB can only review funding requests for patients registered with a GP in the Humber and North Yorkshire area. If the patient lives outside this area, please use the IFR process for their local ICB. The HNY ICB Places are as follows: East Riding, Hull, North Lincolnshire, North East Lincolnshire, North Yorkshire, York.
When submitting an Individual Funding Request (IFR), it’s important that referrers provide all the necessary information as part of the application. This includes selecting the correct clinical specialty relevant to the request. Providing complete and accurate details from the outset helps us process applications more efficiently and reduces delays. Incomplete or incorrect submissions may lead to unnecessary back-and-forth or extended processing times. To support a smooth and timely review of your request, please double-check the following before submitting:
- All relevant clinical information is included
- The appropriate specialty is selected
- Any supporting documentation is attached
Thank you for your attention to detail and for helping us improve the experience for both clinicians and patients.
Referrers are asked to note that when considering a provider, NHS funding remains subject to an appropriate qualifying NHS Standard Contract being established between the Provider and an ICB which explicitly states the location and services/specialties covered by the contract. The ICB will validate activity invoices following the provision of the qualifying contract and against activity data submitted to SUS (where applicable). Providers are responsible for ensuring they are fully compliant with the nationally directed requirements prior to accepting referrals. Where a qualifying contract has not been established, providers are advised to request further pre-payment approval from the contracting team in your local ICB to avoid the risk of non-payment.