Evidence Based Interventions (EBI)
When we spend money on health and care services for the people of Bath and North East Somerset, Swindon and Wiltshire, we take into account the needs of the whole population.
The demand for our services is always greater than the money we have available, so it is not possible for us to fund every available treatment. This means we sometimes have to make difficult decisions regarding which treatments are routinely provided.
BSW ICB has a set of policies and procedures in place in order to reduce variation of care provision across England, follow the principles of good medical practice and limit the number of procedures of limited clinical value (PLCV).
We refer to the NHS Evidence-Based Interventions Programme (EBI) for guidance. Its aim is to manage and prevent avoidable harm to patients, to avoid unnecessary operations, and to free up clinical time by only offering treatment on the NHS that is evidence-based and is clinically effective.
Our Evidence Based Intervention Clinical Policies listed below outline whether an intervention is not normally funded (INNF) or whether the intervention has a clinical criteria threshold to access treatment and is therefore either criteria based access (CBA) or prior approval (PA) is required. It is the responsibility of the clinicians and referrers to ensure patients meet the policy criteria before referring or commencing treatment.
We know, however, that there are times when you could benefit from a particular treatment that is not usually funded by us. Your GP or Consultant may make a request on your behalf for such a treatment if they feel there are exceptional clinical circumstances related to your case. This request is called an Exceptional Funding Request (EFR).
View If I pay for private treatment, how will my NHS care be affected?
View the BSW ICB - Exceptional Funding Requests, Prior Approval & Criteria Based Access Policy
View the Statement on European Cross Border Health Care
View advice for Getting as fit as possible for surgery
View the General Principles for Funding Approval
View the BSW CP091 - Management of patients moving in and out of BSW
View the Medicines Management Team Advisory Summary for Private Treatments
Bath and North East Somerset, Swindon and Wiltshire ICB Funding Policies
For a small number of treatments, individual policies for each locality still apply. View locality-specific policies for BaNES, Swindon and Wiltshire.
BSW Prior Approval Application Form | Generic form if there is no specific procedural form available for the condition in question |
BSW Exceptional Procedures Application Form | Generic form for all exceptional procedural requests. Please use the form below for medicines, devices or drug related requests, as the level of information requested on this form will not be sufficient for the committee to make an informed decision |
BSW Exceptional Medicines Application Form | Generic form for all exceptional medicine, device and drug related requests. |
Condition |
Funding Criteria |
Abdominoplasty / Apronectomy policy | Indication Not Normally Funded- Exceptional Funding Required |
Adenoidectomy (Under 18) policy | Criteria Based Access |
Aesthetic Surgery policy | Indication Not Normally Funded- Exceptional Funding Required |
Assisted Conception (IVF) policy | Prior Approval |
Preservation of Fertility policy | Criteria Based Access |
Blepharoplasty and Ptosis (18 and over) policy | Prior Approval |
Body Contouring | Indication Not Normally Funded- Exceptional Funding Required |
Botulinum Toxin for Anal Fissure policy | Criteria Based Access (1st Treatment)
Prior Approval (Subsequent Treatment) |
Botulinum Toxin for Bladder Dysfunction policy | Criteria Based Access |
Botulinum Toxin for Focal Spasticity policy | Prior Approval |
Botulinum Toxin for Other Treatments policy | Various Specific Criteria |
Breast Reconstruction (Post Cancer & Risk Reduction) policy | Exceptional (Secondary Care Specialists Only) |
Breast Surgery Cosmetic policy | Indication Not Normally Funded- Exceptional Funding Required |
Brow Lift Surgery policy | Indication Not Normally Funded- Exceptional Funding Required |
Bunions (Surgical) policy | Prior Approval |
Carpal Tunnel Syndrome (Inc. Revision Surgery) policy
Carpal Tunnel Syndrome (Inc. Revision Surgery) application form |
Prior Approval (Required for Secondary Care Referrals) |
Cataracts policy | Criteria Based Access |
Chalazion Treatment policy | Prior Approval |
Cholecystectomy policy | Criteria Based Access |
Chronic Fatigue Syndrome policy | Indication Not Normally Funded- Exceptional Funding Required |
Circumcision policy | Prior Approval |
Complementary & Alternative Therapies policy | Indication Not Normally Funded- Exceptional Funding Required |
Diabetes CGM Adults & Children policy | Criteria Based Access |
Diastasis of Recti policy | Indication Not Normally Funded- Exceptional Funding Required |
Discectomy policy | Criteria Based Access |
Dupuytrens Surgery policy | Prior Approval |
Eye – Ectropion Surgery policy | Prior Approval |
Eye – Entropion Surgery policy | Criteria Based Access |
Exogen® (Low-intensity Pulsed Ultrasound for Fracture Healing (LIPUS) policy | Indication Not Normally Funded- Exceptional Funding Required |
Female Genital Cosmetic Surgery policy | Indication Not Normally Funded- Exceptional Funding Required |
Functional Electrical Stimulation for Drop Foot (FES) policy | Criteria Based Access |
Ganglia policy | Prior Approval |
Grommets in Adults & Children policy | Criteria Based Access |
Haemorrhoids policy | Criteria Based Access |
Hair - Wigs, Hairpieces & Hair Transplant / Replacement policy | Indication Not Normally Funded- Exceptional Funding Required |
Heavy Menstrual Bleeding (Menorrhagia) policy | Criteria Based Access (For Secondary Care Referrals)
Indication Not Normally Funded- Exceptional Funding Required (For Dilation & Curettage) |
Hernia in Adults policy | Criteria Based Access |
Hip and Knee Replacement policy | Criteria Based Access |
Hirsutism policy | Indication Not Normally Funded- Exceptional Funding Required |
Knee Arthroscopy policy | Criteria Based Access |
Micro Suction (18 & Over) - Management of Earwax policy | Criteria Based Access |
Nasal Surgery – Septoplasty, Septorhinoplasty & Rhinoplasty policy | Various Criteria |
Nasal Surgery - Chronic Rhinosinusitis policy | Criteria Based Access |
Open MRI policy | Prior Approval |
Pinnaplasty policy | Indication Not Normally Funded- Exceptional Funding Required |
Reversal of Sterilisation policy | Indication Not Normally Funded- Exceptional Funding Required |
Shoulder Pain Management policy | Various Criteria |
Skin Lesions (Benign) policy | Prior Approval |
Skin Lesions (Basal Cell Carcinoma) policy | Policy Statement |
Snoring (18 & Over) policy | Indication Not Normally Funded- Exceptional Funding Required |
Spinal Pain (Neck & Lower Back) policy | Various Specific Criteria |
Tonsillectomy (Children & Adults) policy | Prior Approval
Criteria Based Access (Peritonsillar Abscess - Quincy) |
Trigger Finger Release (18 & Over) policy | Prior Approval |
Varicose Veins policy | Prior Approval |
Locality Specific Policies
BaNES Policies
Please note: RUH tier 3 Weight Management is now open to direct referral for all of the BSW geography
Swindon Policies
None listed.
Wiltshire Policies
None listed.