NHS funded treatments

The policies linked to this page were written prior to the start of the ICB on Friday, 1 July. They are in the process of being updated to reflect the change from CCG to ICB. During this process the information contained within them continues to be accurate and valid.

Some surgical procedures and treatments may not help patients in all circumstances. They can be painful and result in complications or harm that may outweigh any benefits. Sometimes, a safer, simpler alternative may be available. Therefore, surgical procedures should only be offered to patients who really need them.

As a result there are some surgical procedures and treatments that NHS commissioners do not normally pay for, or only pay for in specific circumstances.

NHS organisations across the country have developed criteria for accessing many common tests, treatments and procedures, to make sure that:

  • patients receive the right treatment, at the right time
  • treatments with no, or very limited, evidence of benefits to health are not used

In Kent and Medway, these criteria are listed in a document called the Referral and Treatment Criteria (RaTC) which:

  • contains policies on around 140 tests, treatments and procedures.
  • explains when each of these treatments can and can’t be used by clinicians to treat Kent and Medway patients.
  • helps clinicians identify patients most likely to benefit from particular treatments.

Whilst the quality of care given to patients is the most important factor for these policies, they will also help to free up time and resources that can be reinvested in patient care.

Policies included have undergone a rigorous review process by a group of doctors, pharmacists, commissioners and a member of the public from across Kent and Medway.

These policies help make sure the NHS offers treatments, based on the latest available evidence, fairly and consistently across Kent and Medway.

The NHS is committed to providing the most effective, fair and sustainable use of finite resources. NHS resources should be focussed on treatments that have been proven to be effective and appropriate.

Making sure that treatment and care is focused where it can make the biggest difference is a key part of getting the best use out of NHS resources. This is a key challenge for all NHS organisations. 

Exceptions to the criteria

There is no blanket ban on any of the treatments covered. If you do not meet the eligibility criteria for a particular treatment or the treatment is not normally funded, your doctor can make an individual funding request (IFR) if they think that you meet the criteria for ‘exceptionality’ or ‘rarity’.

For more information on individual funding requests, visit our individual funding requests page.

The main Referral and Treatment Criteria document does not cover fertility treatments, such as IVF.

Information on which fertility treatments are funded by the NHS and the eligibility criteria in Kent and Medway can be found on our clinical policies on fertility treatments page

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