List of Funding Policies

The policies are listed alphabetically on the ICB Policy Directory.

Alternatively, we have also listed the policies per specialty below and suggest that you check each section routinely to ensure there is not a policy applying to your referral before sending it off.

The funding policies do not limit referrals where there are safeguarding or cancer concerns. If any uncertainty, please call the EFR team on 0117 900 2244 before referring or email: bnssg.efr@nhs.net

Policies fall into 3 categories:

• Criteria Based Access (CBA) - these policies do not require prior approval but referrals must meet criteria and this must be clear in any referral. Referrals will be returned if criteria are not met in full.
• Prior Approval (PA) - these policies require that prior approval is obtained. A prior approval form specific to each policy is available on EMIS (resource publisher) and should be completed together with supporting evidence. A referral can be submitted simultaneously, and if PA criteria are met then the referral will be forwarded as requested.
• Exceptional Funding - these policies cover areas where there is no funding available except in exceptional circumstances. There are no specific forms for these policies and the generic form should be used (available as a templated in EMIS). See the Exceptional funding - NHS BNSSG ICB page for details 
• Exceptional Funding Request Application Form

Links below take you to the policy information and application form on the BNSSG ICB website.

Alternative Medicine

• Acupuncture
• Homeopathy Policy - Exceptional Funding Request
• Multiple Chemical Sensitivity (MCS) and Clinical Ecology / Environmental Medicine

Breast Surgery

• Breast Reconstruction Post-Cancer
• Breast Surgery (for Females)
• Breast Surgery (for Males)
• MRI Breast Screening
• Risk Reducing Mastectomy

Children & Adolescents

Unless otherwise stated, all policies apply to both adults and children. Please see the relevant specialty for further details of each policy. The main areas which have a separate policy for children are:

• Grommets – Surgical Referral for Children under 12yrs with Persistent Otitis Media with Effusion Policy - Criteria Based Access
• Grommets – Surgical Referral for Patients over 12yrs with Persistent Otitis Media with Effusion - Criteria Based Access
• Grommets - Elective Surgical Referral for Children under 16yrs with Recurrent Acute Otitis Media - Prior Approval
• Hydroceles – Surgical Removal – under 16 years of age
• Penile Conditions – Surgical Opinion and Treatment including Circumcision in Patients under the age of 16
• Polysomnography tests for Children - this policy has been removed (07/04/21) as commissioning now sits with NHS England. Please see the OSA in children page for further information.
• Speech and Language Therapy for Children with Voice Disorders in Secondary Care

Cosmetic surgery / treatment

• Abdominal Loose Skin & Soft Tissue Removal Policy - Exceptional Funding Request
• Botulinum Toxin Treatment Policy - this policy has been removed (07/04/21) and guidance is now available on the BNSSG Joint Formulary
• Breast Surgery (for Females)
• Breast Surgery (for Males)
• Correction of Chest Wall Deformity for Cosmetic Purposes Policy - Exceptional Funding Request
• Cosmetic Contact Lenses Policy - Exceptional Funding Request
• Cosmetic Surgery or Treatment
• Divarication of Recti Policy - Exceptional Funding Request - this policy has been removed (01/02/2024) and incorporated in the updated Abdominal Wall Hernia Repair for Patients 16 Years and Over CBA Policy
• Epididymal Cysts
• External Ear Surgery
• Facial Surgery and Treatment
• Female Genitalia Surgery Policy - Exceptional Funding Request
• Forefoot Surgery in Secondary Care
• Ganglion Referral and Removal via Sirona MSKI Teams only
• Hair Removal (Including electrolysis and laser therapy, also covering complex pilonidal sinus disease and para stomal disease) Policy - Prior Approval
• Hyperhidrosis Treatment
• Liposuction
• Skin Camouflage Services
• Skin Excision for Contouring including Buttock, Arm and/or Thigh Lift
• Strabismus or Amblyopia in Adults (Surgical Correction of)
• Tattoo Removal
• Testicular Prosthesis
• Wigs, Hairpieces and Hair Replacement Systems

Dermatology

• Benign Skin Lesions
• Desensitizing Light Therapy in the Management of Severe Polymorphic Light Eruption - This policy has been reviewed in December 2021 and the decision was taken to remove it.
• Hyperhidrosis Treatment
• Laser Hair Removal for Pilonidal Disease - Policy retired on 01/08/2023. Criteria added to commissioning policy for Hair Removal (including electrolysis and laser therapy). 
• Skin Camouflage Services
• Skin Excision for Contouring including Buttock, Arm and/or Thigh Lift
• Tattoo Removal
• Wigs, Hairpieces and Hair Replacement Systems

Endocrine & Metabolic Medicine

• Continuous Glucose Monitoring - this policy has been removed (07/04/21) as a new pathway is available via the BNSSG Formulary
• Hyperhidrosis Treatment
• Weight Management Service – Tier 3 and Tier 4 Service

ENT

• Adenoidectomy
• Benign Skin Lesions
• External Ear Surgery
• Facial Surgery and Treatment
• Grommets – Surgical Referral for Children under 12yrs with Persistent Otitis Media with Effusion Policy - Criteria Based Access
• Grommets – Surgical Referral for Patients over 12yrs with Persistent Otitis Media with Effusion - Criteria Based Access
• Grommets - Elective Surgical Referral for Children under 16yrs with Recurrent Acute Otitis Media - Prior Approval
• Laryngeal or Voice Box Surgery
• Microsuction for Ear Wax, Discharge or Debris Removal in Secondary Care
• Nasal Treatment – Non Cosmetic for All Ages
• Speech and Language Therapy for Children with Voice Disorders in Secondary Care
• Snoring – Surgical Intervention for Simple Snoring
• Temporomandibular Jaw Motion Rehabilitation Devices & Mandibular Advancement Devices Policy - Exceptional Funding Request
• Tongue-Tie Division Surgery
• Tonsillectomy – All Ages
• Uvula Removal

General Surgery

• Divarication of Recti Policy - Exceptional Funding Request - this policy has been removed (01/02/2024) and incorporated in the updated Abdominal Wall Hernia Repair for Patients 16 Years and Over CBA Policy
• Surgical Treatment of Haemorrhoids Policy - Criteria Based Access
• Abdominal Wall Hernia Repair for Patients 16 Years and Over Policy - Criteria Based Access (This policy includes Divarication of Recti)

GI & Liver

• Alfa Pumps for the Removal of Ascites due to Liver Disease - Policy retired on 01/08/2023.
• Anal Skin Tag Removal
• Gallbladder Removal in Adult Patients – Over 18 years
• Surgical Treatment of Haemorrhoids Policy - Criteria Based Access
• Radiofrequency Ablative Therapy for the Treatment of High Grade Dysplasia in Barrett’s Oesophagus - Policy retired on 01/08/2023.
• Laparoscopic Ventral Mesh Rectopexy and Stapled Transanal Rectal Resection (STARR)
• SpyGlass® Direct Visualisation Cholangioscopy in Complex Hepatopancreatobiliary (HPB) Disease - Removal of policy on 01/08/2023.
• Weight Management Service – Tier 3 and Tier 4 Service

Gynaecology

• Diagnostic Dilation and Curettage (D&C) in Women <40 yrs with Menorrhagia - Policy retired on 01/08/2023.
• Female Genitalia Surgery
• Female Sterilisation & Reversal Policy - Prior Approval
• Infertility Assessment and Treatment
• Hysterectomy for Menorrhagia
• Intrauterine Coil Insertion and Removal in Secondary Care Policy - Criteria Based Access
• Reversal of Vasectomy or Female Sterilisation - Policy retired on 01/08/2023. Policy criteria has been added to the Female Sterilisation policy.

Infertility

• Infertility Assessment and Treatment

Neurology

• Closure of Patent Foramen Ovale for Migraine
• Drop Foot; Surface Orthotic Functional Electrical Stimulation for Dropped Foot of Central Neurological Origin

Oncology

• One-Step Nucleic Acid Amplification (OSNA) as an Intra-Operative Diagnostic Method for Detecting Metastasis in Breast Cancer -  This policy was reviewed and deemed to be no longer needed and was therefore removed on 01/04/2023.

Ophthalmology

• Blepharoplasty and/or Brow Lift Policy - Prior Approval
• Cataract Referral for Assessment of Surgical Treatment Policy - Criteria Based Access
• Chalazia Removal Policy - Criteria Based Access
• Cosmetic Contact Lenses Policy - Exceptional Funding Request
• Ectropion and Entropion Surgery Policy - Criteria Based Access
• Laser Eye Surgery for Refractive Error Policy - Exceptional Funding Request
• Multi-focal (non-accommodative) Intraocular Lenses in Treatment of Adults with Cataracts Policy - Exceptional Funding Request
• Raised Intraocular Pressure Policy - Criteria Based Access
• Strabismus or Amblyopia in Adults (Surgical Correction of)
• Vitreous Floaters

Oral & Maxillofacial

• Facial Surgery and Treatment
• Temporomandibular Jaw Motion Rehabilitation Devices & Mandibular Advancement Devices Policy - Exceptional Funding Request

Orthopaedics

• Carpal Tunnel Syndrome Surgery Policy - Criteria Based Access
• Chiropractic Assessment and Treatment - Exceptional Funding Request
• Dupuytren’s Contracture Release in Adults
• EXOGEN Ultrasound Bone Healing System Policy (Patients 18 Years & Older - Prior Approval
• Forefoot Surgery in Secondary Care
• Ganglion Removal Policy - Prior Approval via Sirona MSKI Teams only
• Hip Surgery (open or arthroscopic) for Pain including Femoroacetabular Impingement
• Hip Replacement Surgery (including Referral for Surgical Assessment of Osteoarthritis)
• Ingrown Toenail Treatment in Secondary Care Policy - Criteria Based Access
• Knee Arthroscopy and Irrigation
• Knee Replacement Surgery (including Partial and Total Knee Replacement with or without Patella Replacement or Resurfacing)
• Management of Low Back Pain and Sciatica in over 16s
• Selective Dorsal Rhizotomy Post Operative Physiotherapy
• Shoulder Impingement Surgery for Subacromial Pain
• Shoulder Replacement
• Spinal Surgical Opinion – Referral for Assessment
• Syndactyly – Surgical Correction of the Fingers
• Trigger Finger

Pain Management

• Acupuncture
• Myalgic Encephalomyelitis / Chronic Fatigue Syndrome Referral for Adults Policy - Criteria Based Access
• Management of Low Back Pain and Sciatica in over 16s
• Referral to Secondary Care Pain Services Clinics For Assessment And Treatment Policy - Criteria Based Access

Radiology

• Open MRI Scanner

Respiratory

• Assessment Referral & Treatment of Obstructive Sleep Apnoea / Hypopnoea Syndrome (OSAHS) Policy - Criteria Based Access
• Polysomnography tests for Children - this policy has been removed (07/04/21) as commissioning now sits with NHS England. Please see the OSA in children page for further information.

Rheumatology

• Direct Access to DXA Scanning to Help Target Treatment in Adults at Potential Risk of Osteoporotic Fracture - Policy retired on 01/08/2023.

Screening

• MRI Breast Screening
• Population Screening Outside of National Screening Committee Guidelines

Thoracic Surgery

• Correction of Chest Wall Deformity for Cosmetic Purposes Policy - Exceptional Funding Request

Urology

• Epididymal Cysts
• Extracorporeal Shockwave Therapy (ESWT) Policy - Exceptional Funding Request
• Hydroceles – Surgical Removal – under 16 years of age
• Hydroceles in Patients over 16 years of Age
• Penile Conditions – Surgical Opinion and Treatment including Circumcision in all Male Patients Over the Age of 16
• Penile Conditions – Surgical Opinion and Treatment including Circumcision in Patients under the age of 16
• Percutaneous Tibial Nerve Stimulation (PTNS) for Urinary Incontinence in Adults
• Prostatic Urethral Lift (UroLift® System)
• Reversal of Vasectomy or Female Sterilisation - Policy retired on 01/08/2023. Policy criteria has been added to the Female Sterilisation policy.
• Testicular Prosthesis
• Vasectomy and Reversal Policy - Criteria Based Access / Exceptional Funding Request

Vascular

• Varicose Veins Surgery

Misc (Guidance documents)

• Elective Treatment in Northern Ireland, Scotland, and Wales Policy - Exceptional Funding Request
• Funding for Post Clinical Trial or Innovation Treatment Policy - Exceptional Funding Request
• Management of Patients Moving In/Out of BNSSG ICB Policy - Exceptional Funding Request
• Treatments Partially Commissioned by other Commissioners Policy - Exceptional Funding Request