Commissioning policies (containing information about treatments)

Commissioning policies contain information about treatments, and who can have those treatments paid for by the NHS.  The majority of health care services provided by the NHS are routinely available and free at the point of delivery; this provision is not changing. 

However, some drugs, operations and care may not be routinely funded by the NHS. Normally this is because they:

• Are not deemed clinically effective or effectiveness has yet to be determined.
• Are not cost-effective in comparison to all the competing demands on NHS funding.
• Have a low clinical priority and offer little health gain.
• Are largely cosmetic in nature.

As an Integrated Care Board (ICB), we have a responsibility to make rational decisions in determining the way in which we allocate resources and to act fairly between patients. In June 2022, we inherited approximately 150 commissioning policies from former Clinical Commissioning Groups (CCGs) which set out their local position for the more common clinical conditions/treatments which are not routinely funded.  This has highlighted a variation across the geographic areas of Humber and North Yorkshire. A clinically and professionally led group is therefore leading the review of all clinical policies with the ultimate aim of reducing variation in approach and to help reduce health inequalities. This work is expected to be completed by 31 March 2025. Until a commissioning policy has been harmonised, the existing policy will remain in operation.  Current policies and those policies under review are set out below.

ICB-wide approved commissioning policies can be found here

Abdominoplasty (including repair of Diastasis Recti) and Apronectomy IIA Abdominoplasty (including repair of Diastasis Recti) and Apronectomy	Commissioning Policy Integrated Impact Assessment
Adult Bariatric Surgery Tier 4 and follow-up pathway IIA Adult Bariatric Surgery Tier 4 and follow-up pathway	Commissioning Policy Integrated Impact Assessment
Arthroscopic hip surgery IIA Arthroscopic hip surgery	Commissioning Policy Integrated Impact Assessment
Arthroscopic shoulder decompression IIA Arthroscopic shoulder decompression	Commissioning Policy Integrated Impact Assessment
Botulinum toxin A injections into the bladder wall IIA Botulinum toxin A injections into the bladder wall	Commissioning Policy Integrated Impact Assessment
Breast Asymmetry Correction IIA Breast Asymmetry Correction	Commissioning Policy Integrated Impact Assessment
Breast Prosthesis Removal with or without Replacement IIA Breast Prosthesis Removal with or without Replacement	Commissioning Policy Integrated Impact Assessment
Carpal Tunnel Syndrome Release IIA Carpal Tunnel Syndrome Release	Commissioning Policy Integrated Impact Assessment
Cleft (split) earlobe surgery  IIA Cleft (split) earlobe surgery	Commissioning Policy Integrated Impact Assessment
Complementary alternative therapies IIA Complementary alternative therapies	Commissioning Policy Integrated Impact Assessment
Corrective Surgery, Lens Implants and Laser Treatment for Refractive error (short or long sightedness, astigmatism)  IIA Corrective Surgery, Lens Implants and Laser Treatment for Refractive error (short or long sightedness, astigmatism)	Commissioning Policy Integrated Impact Assessment
Continuous Glucose Monitoring IIA Continuous Glucose Monitoring	Commissioning Policy Integrated Impact Assessment
Dermal Fillers IIA Dermal Fillers	Commissioning Policy Integrated Impact Assessment
Dilation and Curettage (D&C) for diagnosis or treatment for heavy menstrual bleeding IIA Dilation and Curettage (D&C) for diagnosis or treatment for heavy menstrual bleeding	Commissioning Policy Integrated Impact Assessment
Elective Caesarean Section (non-clinical reasons) IIA Elective Caesarean Section (non-clinical reasons)	Commissioning Policy Integrated Impact Assessment
Epididymal Cyst Surgery IIA Epididymal Cyst Surgery	Commissioning Policy Integrated Impact Assessment
Extra Corporeal Shockwave Therapy (ESWT), Ankle, Elbow, Heel, Hip, Shoulder IIA Extra Corporeal Shockwave Therapy (ESWT), Ankle, Elbow, Heel, Hip, Shoulder	Commissioning Policy Integrated Impact Assessment
Eyelid Surgery (Blepharoplasty) IIA Eyelid Surgery (Blepharoplasty)	Commissioning Policy Integrated Impact Assessment
Face, Neck and Brow lifts (Rhytidectomy) IIA Face, Neck and Brow lifts (Rhytidectomy)	Commissioning Policy Integrated Impact Assessment
Ganglion Excision IIA Ganglion Excision	Commissioning Policy Integrated Impact Assessment
Hair Removal by Intense pulsed light (IPL), laser or electrolysis for Hirsutism IIA Hair Removal by Intense pulsed light (IPL), laser or electrolysis for Hirsutism	Commissioning Policy Integrated Impact Assessment
Hair Replacement Technologies IIA Hair Replacement Technologies	Commissioning Policy Integrated Impact Assessment
Health Optimisation IIA Health Optimisation	Commissioning Policy Integrated Impact Assessment
Hyperhidrosis treatment with Botulinum Toxin IIA Hyperhidrosis treatment with Botulinum Toxin	Commissioning Policy Integrated Impact Assessment
Ilizarov Technique Taylor Spatial Frame (TSF) (Frame surgery) IIA Ilizarov Technique Taylor Spatial Frame (TSF) (Frame surgery)	Commissioning Policy Integrated Impact Assessment
Incision and Curettage of Chalazion IIA Incision and Curettage of Chalazion	Commissioning Policy Integrated Impact Assessment
Infusion therapy – Chronic non-cancer pain IIA Infusion therapy – Chronic non-cancer pain	Commissioning Policy Integrated Impact Assessment
Liposuction IIA Liposuction	Commissioning Policy Integrated Impact Assessment
Male Gynaecomastia Reduction Surgery IIA Male Gynaecomastia Reduction Surgery	Commissioning Policy Integrated Impact Assessment
Open, Wide Bore and Upright Magnetic Resonance Imaging (MRI) IIA Open, Wide Bore and Upright Magnetic Resonance Imaging (MRI)	Commissioning Policy Integrated Impact Assessment
Photodynamic Therapy (PDT) – for Central Serous Retinopathy IIA Photodynamic Therapy (PDT) – for Central Serous Retinopathy	Commissioning Policy Integrated Impact Assessment
Pinnaplasty (Otoplasty) IIA Pinnaplasty (Otoplasty)	Commissioning Policy Integrated Impact Assessment
Referral to Specialist Chronic Fatigue Services IIA Referral to Specialist Chronic Fatigue Services	Commissioning Policy Integrated Impact Assessment
Resperate© (Intercure Ltd) IIA Resperate© (Intercure Ltd)	Commissioning Policy Integrated Impact Assessment
Reversal of Sterilisation IIA Reversal of Sterilisation	Commissioning Policy Integrated Impact Assessment
Sacral nerve stimulation (neuromodulation) for Idiopathic chronic urinary retention in Men and Women IIA Sacral nerve stimulation (neuromodulation) for Idiopathic chronic urinary retention in Men and Women	Commissioning Policy Integrated Impact Assessment
Sacral Nerve Stimulation (SNS) – Faecal Retention IIA Sacral Nerve Stimulation (SNS) – Faecal Retention	Commissioning Policy Integrated Impact Assessment
Snoring Surgery (in the absence of obstructive sleep apnoea)  IIA Snoring Surgery (in the absence of obstructive sleep apnoea)	Commissioning Policy Integrated Impact Assessment
Spinal Injections & Facet joint injections of Local Anaesthetic and Steroid (Sciatica) IIA Spinal Injections & Facet joint injections of Local Anaesthetic and Steroid (Sciatica)	Commissioning Policy Integrated Impact Assessment
Tattoo Removal IIA Tattoo Removal	Commissioning Policy Integrated Impact Assessment
Thigh and buttock lift IIA Thigh and buttock lift	Commissioning Policy Integrated Impact Assessment
Tier 3 Weight Management Services IIA Tier 3 Weight Management Services	Commissioning Policy Integrated Impact Assessment
Tonsillectomy for Recurrent Tonsillitis IIA Tonsillectomy for Recurrent Tonsillitis	Commissioning Policy Integrated Impact Assessment
Trigger finger release surgery IIA Trigger finger release surgery	Commissioning Policy Integrated Impact Assessment
Varicose vein interventions IIA Varicose vein interventions	Commissioning Policy Integrated Impact Assessment
Vasectomy IIA Vasectomy	Commissioning Policy Integrated Impact Assessment
Wireless or Implantable Functional Electrical Stimulation (FES) IIA Wireless or Implantable Functional Electrical Stimulation (FES)	Commissioning Policy Integrated Impact Assessment

ICB-wide approved commissioning policies can be found here
Please note: The lists of commissioning policy statements above are not exhaustive of all interventions not routinely commissioned. For any medical procedure or treatment that is not routinely commissioned and where there is not a specific policy statement, a request via the Individual Funding Request (IFR) process must still be made. Click here to view the IFR policy.

ICB-wide commissioning policies which are not routinely commissioned can be found here

• Hyaluronic Acid Injections for Musculoskeletal Joint Pain (Synvisc)
• Penile Prothesis (Implants) Surgery
• Sativex – Delta-9-Tetrahydrocannabinol and Cannabidiol Oromucosal Spray

Please note: The lists of commissioning policy statements above are not exhaustive of all interventions not routinely commissioned. For any medical procedure or treatment that is not routinely commissioned and where there is not a specific policy statement, a request via the Individual Funding Request (IFR) process must still be made. Click here to view the IFR policy.

Commissioning policies aligned to CCG areas which remain in operation can be found here

Humber aligned (covers all East Riding of Yorkshire, Hull, North East Lincolnshire, North Lincolnshire)

East Riding of Yorkshire Plus Access to Infertility Treatment Policy

Hull Plus Lower urinary tract symptoms in men overview

North East Lincolnshire Plus Goole Neuro Rehab

North Lincolnshire Plus Goole Neuro Rehab

North Yorkshire

Vale of York

Please note: The lists of commissioning policy statements above are not exhaustive of all interventions not routinely commissioned. For any medical procedure or treatment that is not routinely commissioned and where there is not a specific policy statement, a request via the Individual Funding Request (IFR) process must still be made. Click here to view the IFR policy.

Check+ (For Clinical Use Only)

North of England Commissioning Support (NECS) has developed an online self-service system, Check+, which allows registered users to generate a prior approval ticket (PAT), subject to compliance with the agreed local policy criteria, to attach to the patient record before referral or treatment for Evidence Based Interventions (EBI), related conditions.

Check+ is also a replacement of the existing Individual Funding Request (IFR) system. The new platform 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.

Click here to access Check+