Prior Approval (PA)
Is a process that requires the referrer to obtain prior authorisation for patients who meet the criteria. If the patient demonstrably meets the criteria, please forward the application to the IFR Team for approval and await confirmation that funding is in place before a referral is made. If the patient does not meet the criteria for funded treatment, then a referral can be made to the Individual Funding Request Panel, but only if there is clear evidence that the patient’s clinical circumstances or condition are exceptional, i.e. there is something about the patient’s condition or circumstances that differentiate them on the basis of need from other patients with a similar diagnosis or condition and would justify funding being provided in an individual case when it is not routinely funded for others.
Please note any deviations from this policy, e.g. funding requests for a secondary care opinion only (where malignancy is not a concern), require Part C of the below application form completing and submitting to the Individual Funding Request team.
Funding requests from GP Practices can be accepted from Senior Clinicians, salaried GPs, Locum GPs or Practice Partners. Unfortunately we are unable to accept funding applications from other health professionals unless countersigned by a senior clinician or GP.
If you would like this policy in a different language or need it in another format, such as Braille, please contact the Patient Advice and Liaison Service on 0800 073 0907 or 0117 947 4477.
Continuous Glucose Monitoring Sensors (CGMS) are devices that allow for glucose values to be visible continuously, enabling immediate therapeutic adjustments on the basis of “real time” glucose results. CGMs can help patients with Type 1 Diabetes who experience severe hypoglycaemia, hypoglycaemia unawareness or have brittle diabetes to maintain safe blood sugar levels.
Continuous Glucose Monitoring Policy
Continuous Glucose Monitoring Sensors are not routinely funded by the CCG and are subject to this restricted policy.