Funding drugs and other treatments

NHS Brighton and Hove has a duty to get best value from the money we spend on your behalf.  Most treatments are freely available on the NHS to anyone who needs them but sometimes we have to make choices around treatments which are exceptionally costly or where there is limited evidence of benefit.

We make these choices, using the best available evidence about the effectiveness and relative costs of different treatments.

Our Priorities Group is the principal group used by NHS Brighton and Hove to consider whether particular treatments should be made available to patients.

It develops and reviews policies which help the organisation decide what funding priority should be given to a particular treatment or other health intervention.

Its recommendations are then discussed by our Professional Executive Committee before a final recommendation is presented to our Board for approval.

The Priorities Group also:

• monitors how we spend money given to us specifically for interventions recommended by the National Institute for Health and Clinical Excellence (NICE) to make sure we comply with any directions given by the Secretary of State for Health.
• reviews recommendations from the South East Coast Health Policy Support Unit and decides how they should be implemented in Brighton and Hove.

The Priorities Group does not consider medicines and other pharmaceutical products; these are considered by our Prescribing Committee. Its recommendations also go to our Professional Executive Committee before a final recommendation is presented to Trust Board for approval.

Treatments that require prior funding approval

There are a small number of treatments we do not routinely fund.  This is normally because:

• there is little or no evidence that they are effective; or
• they are only effective in specific circumstances; or
• a cheaper, equally effective alternative is available; or
• the treatment is usually used for cosmetic rather than clinical reasons.

Our Individual Patients Funding Panel considers individual requests and decides whether or not to fund the requested treatment for each patient, and we have an appeals panel that considers appeals against Individual Patients Funding Panel decisions.

Details of:

• which procedures require this prior approval
• how to request funding
• how to appeal if a request for prior approval funding is turned down

are available in the Information for Health Professionals