Commissioning Policies
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 30 September 2024. 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
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) – this decision comes into effect on 1 April 2024 at which point any former CCG policy will no longer apply.
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
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
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.
Policies which are currently under review
The order in which commissioning policies will be reviewed can be found below. The policy review process considers any new clinical evidence, national guidance such as NICE, Evidence Based Interventions, or any empirical evidence. The review will consider variations across the ICB’s geographical area and explore possible options for harmonisation. In some cases, this may result in a recommendation to increase or reduce access to some services.
Phase 1 – reviews expected to be completed by 31 March 2024
- Benign Skin Lesions – Surgical Removal
- Breast Surgery: Breast Prosthesis Removal
- Breast surgery: Correction of congenital breast asymmetry
- Breast surgery: Male gynaecomastia reduction surgery
- Cataracts Surgery
- Circumcision
- Haemorrhoid Surgery
- Hip Replacement
- Irrigation of the external Auditory Canal
- Knee Replacement
- Sleep Study
Phase 2 – reviews expected to be completed later in 2024
- Adult Snoring Surgery (in the absence of OSA)
- Alternative and complementary therapies
- Arthroscopic shoulder decompression for subacromial shoulder pain
- Botox for Overactive Bladder
- Carpal tunnel syndrome release
- Chalazia removal
- Cleft earlobe surgery
- Corrective surgery, lens implants and laser treatment for refractive error
- Dilatation and curettage (D&C) for heavy menstrual bleeding in women
- Elective C section – non clinical reasons
- Epididymal Cyst Surgery
- Extra Corporeal Shockwave Therapy (ESWT) – Ankle
- Extra Corporeal Shockwave Therapy (ESWT) – Elbow
- Extra Corporeal Shockwave Therapy (ESWT) – Heel
- Extra Corporeal Shockwave Therapy (ESWT) – Hip
- Extra Corporeal Shockwave Therapy (ESWT) – Shoulder
- Eyelid Surgery – Ectropion
- Eyelid Surgery – Entropion
- Eyelid Surgery – Epiphora
- Face, Neck and Brow Lifts
- Facet Joint Injections
- Ganglion excision
- Gynaecomastia Surgery
- Hair loss treatments
- Hair removal for hirsuitism
- Hip Arthroscopy
- Hyperhidrosis treatment with Botulinium Toxin
- Ilizarov Technique/Taylor Spatial Frame (TSF)
- Infusion Therapy – Chronic (non-cancer) pain relief
- Liposuction – Lipoedema
- Lycra dynamic splinting for children with neurological impairment
- Open and Wide-Bore Magnetic Resonance MRI Scanning
- Penile implants
- Photodynamic Therapy (PDT) – for CSR
- Pinnaplasty
- Plastic Surgery: Abdominoplasty or Apronectomy
- Plastic Surgery: Diastasis recti repair
- Plastic Surgery: Liposuction
- Referral to Specialist Chronic Fatigue Services
- Replacement of Breast Implants
- Resperate© (Intercure Ltd)
- Reversal of sterilisation
- Sativex – Delta-9-Tetrahydrocannabinol and Cannabidiol Oromucosal Spray
- Sacral Nerve Stimulation (SNS) – Faecal Retention
- Sacral Nerve Stimulation (SNS) – Men with Urinary Retention
- Sacral Nerve Stimulation (SNS) – Women with Urinary Retention
- Spinal Injections of Local Anaesthetic and Steroid in people with Non-Specific Low Back Pain without Sciatica
- Surgical fillers
- Tattoo removal
- Tendinopathies and musculoskeletal conditions
- Thigh life, buttock lift and arm lift, exclusion of redundant skin or fat
- Tonsillectomy for Recurrent Tonsillitis
- Trigger finger release in adults
- Varicose vein interventions
- Vasectomy under general anaesthetic
- Wireless or Implantable Functional Electrical Stimulation (FES)
Phases 3 & 4 – Additional 60 policies each phase (to be confirmed)
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.