The Secretary of State’s Directions underpinning the guiding principles for processes supporting local decision making about medicines will come into force on 1 April 2009.  The directions are intended to make explicit PCTs’ existing legal duties.   They require PCTs to:

• Have arrangements in place for making decisions and adopting policies on health care interventions, including arrangements for dealing with individual funding requests (IFRs).
• Take account of guidance and principles published by Secretary of State.
• Give reasons in writing for policies and for IR refusal.

Local decisions about medicines should be made in the context of, and be consistent with, national policies including World Class Commissioning and local priorities, prioritisation processes and governance frameworks. Decisions should take into consideration clinical and cost effectiveness relative to other interventions commissioned by the PCT for its population, as well as the available budget.

A guiding principles document has been developed to support local decision making about medicines. It is aimed at helping PCTs improve the consistency and quality of local decision making medicines.  This includes decisions on medicines made as part of the development of the annual operating plan as well as consideration of in-year service developments and individual funding requests (IFRs). The principles are designed to cover decision making across primary and secondary care on all medicines not, or not yet, appraised by National Institute for Health and Clinical Excellence (NICE).

Our current policies and procedures are being reviewed in light of this new good practice guidance and with the new strengthening commissioning arrangements across NWL and London.

Current Position in NHS Brent

Effective from 25 March 2011 all Individual Funding Requests (IFRs), previously known as TOSLAs in NHS Brent, will be dealt with at Cluster level by a Cluster IFR Team.  This team will be responsible for the full implementation of IFR receipt and processing.

Any new cases post this date should be forwarded onto the Cluster at: ppwtnw.london@nhs.net

Key contacts at the Cluster IFR Service:

Phone number for staff and clinical stakeholders: (020) 3313 9461
Phone number for patients and carers: (020) 3313 9462

Further details and all related documentation to the IFR service can be found at: www.northwestlondon.nhs.uk/IFR