Get the best from your NHS
NHS funding for individuals
Individual funding requests (IFRs)
Every year NHS Brighton and Hove receives money from the Government to pay for health care for local residents.
Our job is to get best value for this money by spending it wisely on your behalf. Difficult choices sometimes have to be made because demand for health care is growing, new (and often expensive) treatments become available all the time, and we only have a set amount of money available to spend.
Our priority is to pay for those medicines and other treatments that:
- are clinically effective;
- demonstrably improve people’s health; and
- offer good value for money.
As a result there are some treatments we do not normally fund, or only fund in certain circumstances.
The PCT's IFR Policy describes the process the panel follows, and what information the panel requires when making decisions.
- Download the IFR policy
- Patient leaflet updated
- You require 'Prior Approval' from the PCT before your Consultant can proceed with treatment. These conditions often have defined clinical criteria which you will need to meet before funding for that treatment will be agreed. You can find further details of what these procedures are, and any criteria that exist by visiting the prior approvals section of this website.
Your Consultant or GP can advise you if they think your clinical circumstances meet the PCT's criteria for funding. Please note that the PCT can only accept requests for funding treatment or procedures from your Consultant or GP.
NHS continuing healthcare
NHS continuing healthcare is the name given to a package of care which is arranged and funded solely by the NHS for individuals outside of hospital who have ongoing healthcare needs. You can receive continuing healthcare in any setting, including your own home or a care home. NHS continuing healthcare is free, unlike help from social services for which a financial charge may be made depending on your income and savings.
In your own home, this means that the NHS will pay for healthcare (e.g. services from a community nurse or specialist therapist) and personal care (e.g. help with bathing, dressing and laundry). In a care home, the NHS also pays for your care home fees, including board and accommodation.
Who is eligible?
Anyone assessed as having a certain level of care needs may receive NHS continuing healthcare. It is not dependent on a particular disease, diagnosis or condition, nor on who provides the care or where that care is provided.
If your overall care needs show that your primary need is a health need, you should be eligible for NHS continuing healthcare. Once eligible for NHS continuing healthcare, your care will be funded by the NHS but this is subject to review, and should your care needs change the funding arrangements may also change.
Cancer drugs fund
NHS South East Coast, the strategic health authority for Kent, Surrey and Sussex, has been allocated £3.9m by the Department of Health to set up a regional cancer drug fund. This interim fund is to support improved access for patients to cancer drugs that can extend or improve quality of life, ahead of the Government’s longer term plans to improve access to drugs in 2011/12 and to change the way the NHS pays for branded drugs in 2014.
The allocated funding is for the period between the 1 October 2010 and the 31 March 2011. We are putting in place a process to ensure that the money is spent as fairly as possible. We are also designing the process to be simple, as we recognise the importance of making timely decisions.
Funding treatment abroad
Case law from the European Court of Justice (ECJ) on patient mobility under Article 49 of the EU Treaty means that patients are able to seek any healthcare (including private care) in another European Economic Area (EEA) Member State, and, as long as they are entitled to the treatment in question under their home healthcare system, they are eligible to have their costs reimbursed.
Further information is available below:
- Healthcare abroad policy (420kb Word file)
Applications for funding can be made using the:
- Cross Border Request Form Final (230kb Word file)
Further information and resources
- The national framework for NHS continuing healthcare and NHS funded nursing care (July 2009)
- Public information leaflet on NHS continuing healthcare
- Policy on NHS continuing healthcare and panel terms of reference
Contact us
NHS Funded Healthcare Team
Level 3, Lanchester House
Trafalgar Place Brighton BN1 4FU
Direct Line: 01273 574814
Confidential Fax: 01273 574830
email: nhsfundedcare@bhcpct.nhs.uk
The NHS Funded Healthcare Team working hours are Monday to Friday (excluding Bank Holidays) 9am to 5pm.