Priority setting: managing individual funding requests
In undertaking priority setting, one of the key challenges for primary care trusts (PCTs) is how to strike the right balance between providing services that meet the needs of the majority and accommodating the differing needs of individual patients.
Commissioning by its very nature focuses on the larger scale. As a result, it cannot be undertaken in a way that meets all needs of all patients in any one clinical group or address the specific needs of patients with less-common conditions. Therefore, PCTs will always need an individual funding request (IFR) process to consider making additional NHS funds available for the atypical or uncommon patient.
Decision making is compounded by the fact that legitimate demands for healthcare will always exceed PCT budgets. There have always been individuals whose need for healthcare has not been met by the NHS and this will inevitably continue in the future. Indeed, unmet need is an unfortunate feature of all healthcare systems. So, how should a PCT decide which individual patients should have their requests for special consideration funded? These are some of the most difficult decisions a PCT will have to face.
This report explores this area of decision making and provides some good-practice points in relation to managing individual funding requests and dealing with clinicians and patients
