Clinical Policies Group, Evidence-based interventions & Individual Funding Requests

The Hertfordshire and West Essex (HWE) Integrated Care Board (ICB) Clinical Policies Group (CPG) is established to ensure clinical policies support the delivery of evidence-based, high-value, safe, equitable, cost-effective, and affordable care, in line with ICS strategic priorities and annual planning.

The Clinical Policies Group produce and maintain a set of Evidence Based Intervention (EBI) policies which describe procedures that are not routinely commissioned or are only routinely commissioned when certain clinical criteria (or thresholds) are met.

These local policies supplement the national Evidence-Based Interventions (EBI) programme, including the initial national statutory guidance published by NHS England (November 2018) and subsequent lists published by the Academy of Medical Royal Colleges. This national programme relates to the commissioning of interventions which are clinically inappropriate, or which are appropriate only when performed in specific circumstances. HWE ICB is committed to ensuring compliance to the national Evidence-Based Interventions program which is mandated by NHS England through the NHS Standard Contract.

Collectively, these EBI policies enable commissioners to prioritise those patients with the greatest capacity to benefit and to restrict procedures which have limited or no clinical benefit or are currently unaffordable.

To contact the Clinical Policies Group please email

Implementation of Evidence Based Intervention Policies

HWE ICB has processes to ensure the policies are complied with and EBI procedures are only undertaken for patients who meet the clinical criteria. These include:

Individual Funding Requests (IFR)

An IFR is an application for an individual patient to have a test or treatment that is not routinely funded, or where they do not meet the eligibility criteria set out in an EBI policy. A test or treatment may not be routinely funded because it has low clinical effectiveness, has limited evidence of effectiveness, is currently unaffordable or is not in line with local priorities. Individual Funding Request (IFR) applications should only be made where the patient demonstrates true clinical exceptionality. 

Prior Approval (PA)

Is a process in which clinicians demonstrate, by application to the EBI and IFR Team, how a patient meets the criteria set out within the relevant EBI policies, prior to referring to secondary or tertiary care and/or by consultants prior to listing for surgery. Prior approval is considered on a patient-by-patient basis by the EBI and IFR team. This ensures optimal clinical effectiveness and that the policy criteria are applied consistently to all patients.

Threshold Approval

Those procedures which are routinely commissioned by HWE ICB and are within agreed contracts but only for patients who meet the defined criteria set out within the relevant national and local Evidence-Based Interventions policies. Clinicians can proceed to treat the patients who meet the threshold criteria and prior approval is not required from the EBI and IFR team. Notification of compliance for audit is required according to contractual arrangements.

To contact the EBI & IFR team please email