Individual Funding Requests (IFRs) were taking around four weeks to process in Barking and Dagenham, Havering and Redbridge (BHR). The system involved manual submission by clinicians and manual reconciliation by administrators.

The local CCGs were concerned about this delay, and about inaccuracies and variances in payments against their Procedures of Limited Clinical Effectiveness (PoLCE) policy.

We worked with them to develop a new prior approval process pathway, to ensure all treatment requests made by primary and secondary care clinicians are consistently reconciled and accounted for financially.

Referrals from primary care are now submitted through the (e-RS). The GP selects options on an electronic form, which is uploaded onto the NHS e-Referral Service NHS (e-RS). GPs also submit on behalf of opticians.

e-RS is not yet available for consultants to use as a referral tool, so they send completed e-forms direct to the prior approval team.

Anticipated full-year savings of £2.4m for 2017-18

The new pathway has enabled the BHR referral management team to provide clinicians with an outcome within 24 hours of submission.

This has enabled BHR CCGs to ratify all requests made by clinicians on behalf of BHR patients (where possible in advance of treatment). This has also led to a 75 per cent rise in the number of funding requests submitted by clinicians. We anticipate that these changes will yield a cost saving of £2.4 million for 2017/18.

It will also make sure services are focussed on effective delivery (in line with BHR’s PoLCE policy), meaning patients are more efficiently allocated the treatment they need.