Your Primary Care Trust (PCT) is responsible for providing care and treatment on behalf of the whole population of Bournemouth and Poole.
Decisions on which services to provide to the general population are based on medical evidence. This means providing treatments where these are beneficial and not harmful, and ensuring treatments are provided in the right place and at the right time.
In today’s times of financial constraints there is a need to improve value by focusing on reducing or stopping the commissioning of procedures of limited or lower clinical value on the basis of available current medical evidence.
The Primary Care Trust has identified a range of treatments for individual patients that will either; not normally be funded (low priority procedures) or commissioned, have criteria based access and/or will require prior approva. The access criteria for these treatments are listed below.
If your GP or clinician has seen you and said that the treatment that you need has been classed as low priority then it is unlikely that your treatment will go ahead.
If your clinician or GP considers that you are “clinically exceptional” then there is a mechanism for them to apply for funding. If your GP or clinician wishes to apply for funding as an individual case, they would need to make a case for exceptionality and this would need to be assessed by our Individual Patient Treatment Request Panel which meets monthly. However such exceptional cases are extremely rare and would number a few each year.
The fact that a treatment is likely to be effective for a patient is not, in itself a basis for exceptional circumstances. In order for funding to be agreed, there must be some unusual or unique clinical factor about the patient that suggests that they are:
Exceptionality means that there are clear clinical reasons why the individual would be expected to benefit more from this procedure than the general population with the same condition, for whom this procedure is considered low priority and is therefore not normally funded. Evidence to support clinical exceptionality can only be submitted by the applying clinician and cannot be accepted directly from patients.
In deciding whether your case is exceptional your clinician or GP should follow the guidelines in our Joint Policy for Commissioning Individual Treatments-see link on right.
For a list of all treatment policies follow the clinical policies page link on right.
