Clinical Commissioning Policies - Prior Approvals and Individual Funding Requests

Prior Approvals

Prior Approvals are to be obtained by the responsible consultant before undertaking an intervention. This is usually a simple tickbox form, based on the relevant clinical policy, confirming that the given patients meet the agreed clinical criteria.

Interventions under Prior Approval include established interventions such as hip replacement. It is not disputed that the intervention/treatment option requested may be effective and/or safe, but it should only be used for patients who will benefit more from this than the risks associated with the intervention/treatment. Prior Approval requests are determined within days and should not delay patient care.

Please note: the Prior Approvals process is applicable only for NHS Thames Valley ICB and NHS Hampshire and Isle of Wight ICB. NHS Surrey and Sussex ICB only operates a Prior Approvals process for Assisted Conception treatments via Blueteq. Clinicians who are now managing patients within the Surrey and Sussex system will be contacted directly regarding local processes and any queries should be directed to their IFR Team.

Individual Funding Requests (IFR)

Interventions that fall under IFRs are not routinely funded by the NHS and before a clinician can perform this, approval must be obtained by the responsible consultant. These are interventions that are not considered to benefit the population at large either on clinical, safety, cost effectiveness or affordability grounds. However, ICBs will consider specific clinical circumstances for individual patients via the IFR process to determine if there is exceptional reason that an individual patient would benefit more from an intervention or treatment than any other patient with the same condition.

Several interventions that are considered purely cosmetic fall into this category given that there are no direct clinical reasons for these to be prioritised for NHS funding. Please note that IFR applications may take several months to conclude, due to the rigorous process required to determine the application.

Changes to the Prior Approvals and IFR process following boundary changes for ICBs

As part of wider NHS reforms, the boundaries of some Integrated Care Boards (ICBs) changed on 1 April 2026. This resulted in the dissolvement of NHS Frimley ICB. The new configuration required a three way adjustment: East Berkshire joined Thames Valley ICB; Surrey Heath and Farnham aligned to Surrey and Sussex ICB; and North East Hampshire aligned to Hampshire and Isle of Wight ICB.

Our priority during the boundary change is a safe and smooth transition. We are committed to keeping services stable and all three new ICBs have agreed to continue to apply existing clinical policies that applied for their populations as of 31 March, including honouring existing referrals and waiting list positions until further notice. Each ICB hosts their own set of clinical policies and as such during transition there will be legacy policies applied as described below:

• NHS Thames Valley ICB will host clinical commissioning policies from NHS Frimley ICB and NHS Buckinghamshire, Oxfordshire and Berkshire West ICB.
• NHS Hampshire and Isle of Wight ICB will host policies for their own organisation, as well as some NHS Frimley ICB policies.
• NHS Surrey and Sussex ICB will host clinical commissioning policies from NHS Surrey Heartlands ICB, NHS Sussex ICB, as well as some NHS Frimley ICB policies.

In the longer term, we plan to align clinical policies to deliver equitable care across our Integrated Care Board system using the best available up to date evidence and thinking about what is right for the whole population. We will involve GPs, service users and other local partners throughout this process and remain clear and transparent in our decision making.

New contact details for funding applications from 1 April 2026 - FOR CLINICIANS ONLY

• Thames Valley ICB (IFRs and Prior Approvals) – This email address is being protected from spambots. You need JavaScript enabled to view it.
• Hampshire and Isle of Wight ICB (IFRs and Prior Approvals) – This email address is being protected from spambots. You need JavaScript enabled to view it.
• Surrey and Sussex ICB (IFRs and Assisted Conception Prior Approvals only) – This email address is being protected from spambots. You need JavaScript enabled to view it.

Please note all three ICBs utilise the IFR Blueteq portal to process IFR requests.

If you are a patient and have an enquiry about an IFR application or the process, please speak with your clinician in the first instance.