Introduction to Prior Approval Procedures
Like all other public services, NHS and social care resources are likely to be significantly constrained over the coming years. Working with patients and the public we need to find new, more efficient ways to care effectively for our population and to make difficult choices about where we invest resources to deliver the greatest benefit.
NHS Nene Clinical Commissioning Group is committed to make the best use of tax payers’ money by following evidence based and national guidance to change commissioning procedures with limited clinical effectiveness. To enable this Nene launched a Prior approval scheme in April 2012, the scheme sets out criteria that must be met before the procedure or treatment can be carried out.
The procedure based policies and approval forms can be viewed and downloaded below under Prior Approval Policies. If patients don't meet the criteria to have the procedure or they want to undergo a procedure/treatment which is not normally commissioned their clinicians can apply for an Individual Funding Request.
Implications for you
This may mean that your doctor is not able to offer you a certain treatment because it would not be funded by the local NHS. This does not mean that you will not be offered alternative healthcare that can be delivered within the GP practice or the community. This policy is the best way to ensure that local NHS funds are spent on the things that will bring greatest benefit to local people in a way that is affordable and fair.
Please note, where a patient has learning disabilities or has a diagnosis of autism or behaviour that challenges, we recognise reasonable adjustments must be made to ensure an equitable health outcome. We expect an assessment of capacity to be made, based upon the principles of the Mental Capacity Act, with a subsequent best interest decision made following the best practice guidelines.