Evidence Based Interventions (EBI) Programme

for Interventions Not Normally Funded (INNF)

The Evidence Based Interventions (EBI) programme for Interventions Not Normally Funded (INNF) on the NHS

The EBI programme is a national initiative led by the Academy of Medical Royal Colleges (AoMRC) to improve the quality of care for patients.

The EBI programme was developed in 2018 to assist with funding for surgical and non-surgical interventions that are not normally funded (INNF) within the NHS. You can find more information on the AoMRC website.

EBI principles

The EBI programme was developed in 2018 to help ensure a national approach to quality improvement takes place and that best practice is spread across the healthcare system. From the outset it had the following key principles:

Improve the quality of care for everyone.

Reduce the risk of harm to patients.

Minimise unwarranted variation in service provision.

Optimise the use of finite resources and ensure any money saved is spent on other, more effective treatments.

Why are some interventions not normally funded on the NHS?

The NHS strives to make best use of its limited resources and provide treatments that are safe and effective for patients whilst also being cost effective for the NHS.

Some interventions are not routinely available on the NHS because clinical evidence has shown that the clinical benefit of some interventions for most patients is small and there is little value to the patient or the NHS.

The NHS regularly reviews the clinical evidence of the interventions that it provides to ensure all patients benefit from treatment in the best possible way.

Our NHS Commitment to Somerset Patients

At NHS Somerset we are committed to making the best use of limited NHS resources to improve the health of Somerset’s population. We aim to provide the best and most effective interventions for patients with a clinical health need in a safe and cost-effective way so that all patients can receive:

‘The right treatment at the right time’

There are currently 70 surgical and non-surgical interventions that are not normally funded by the NHS available to patients in Somerset please see below for an A-Z list of available surgical and non-surgical interventions.

If you have a health condition that concerns you, you should contact your GP to discuss your health concern and if your GP or specialist clinician recommend an intervention not normally funded by the NHS as the best treatment option for you; they can request funding from the Evidence Based Interventions (EBI) Team at NHS Somerset.

The EBI Team at NHS Somerset administer all INNF funding requests received by GPs and specialist clinicians. The Team follow a robust and equitable local decision-making pathway to enable all patients with a demonstrated clinical healthcare need, to receive the treatment option recommended for them by their GP or clinician.

EBI description of service

NHS Somerset ICB commission 70 surgical and non-surgical Interventions Not Normally Funded (INNF) by the NHS, that cover a range of medical treatments for the population of Somerset.

Each intervention is underwritten by a clinical commissioning policy (CCP) to support clinically effective, safe, and cost-effective interventions for the Somerset population.

GPs, secondary care clinicians and healthcare practitioners can apply for funding of interventions on behalf of their patients, by completing and submitting an individual funding request application form to the EBI team at Somicb.ebisomerset@nhs.net

The EBI team follow a robust and equitable local decision-making pathway to enable all patients with a demonstrated clinical healthcare need ‘to receive the right treatment at the right time’.

EBI local decision-making pathway

EBI Decision-making Pathway

Pre-screening

To ensure the correct patient details and referring GP /clinician signature is provided in the application.

Screening

To assess the clinical evidence provided in the application against the relevant clinical commissioning policy criteria.

Clinical triage to the EBI Clinical Lead

To enable a more informed decision to be taken on a particular individual funding request as appropriate.

Clinical triage to the EBI Panel (EBIP)

EBIP Terms of Reference

Reconsideration by the EBI Panel

Right of Appeal

Appeals Panel Terms of Reference

Evidence Based Interventions (EBI) Treatment Pathways

Patients can access one of three referral to treatment pathways in Somerset for interventions not normally funded (INNF) by the NHS.

Prior Approval (PA) Pathway

Prior Approval (PA) funding requests require funding in place before a patient can receive a referral for a particular intervention. PA funding requests are subject to approval based on the set clinical commissioning policy criteria for each intervention.

PA Requests are administered in-house by the EBI team who follow a robust Individual Funding Request process that aligns with NHSE Standard Operating Procedures (SOP) for Individual Funding requests.

NHSE Standard operating procedures individual funding requests

Generic EBI Pathway

Generic EBI funding requests require funding in place before a patient can receive a referral for a particular intervention. Generic EBI funding requests are subject to approval based on clinical evidence to support ‘Clinical Exceptionality’.

A patient, who has a medical condition of which their clinical circumstances are exceptional when compared to a cohort of patients with the same condition, can be considered for referral on grounds of clinical exceptionality.

Please note. To eliminate discrimination for patients, social, environmental, workplace, and non-clinical personal factors cannot be taken into consideration. For more information see NHSE Commissioning Policy individual funding requests

Generic EBI Funding Requests are administered in-house by the EBI team who follow a robust Individual Funding Request process that aligns with NHSE Standard Operating Procedures (SOP) for Individual Funding requests.

NHSE Standard Operating Procedures individual funding requests

Criteria Based Access (CBA) Pathway