Criteria Based Access (CBA)
If the patient demonstrably meets the specific criteria for treatment, the patient can be referred directly via the appropriate Referral Service with a standard referral letter. If the patient does not meet the criteria for 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. 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.
Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. In most cases, gallstones do not cause any symptoms and do not need to be removed. However, patients who suffer with symptomatic gallstones and who meet the policy criteria may be referred to Secondary Care to have their gallstones removed.
Occasionally, patients with asymptomatic gallstones may also have them removed, but only in specific circumstances - please see the Asymptomatic Gallstones section in the Policy.
Laparoscopic Cholecystectomy for Gallstones is not routinely funded by the CCG and is subject to this restricted policy.