Commissioning policy for exceptional treatment requests - National ...
Commissioning policy for exceptional treatment requests - National ...
Commissioning policy for exceptional treatment requests - National ...
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<strong>Commissioning</strong> Policy <strong>for</strong> Exceptional Treatment Requests<br />
Appendix 7 – ETR Decision Report<br />
ETR<br />
Number<br />
Case No<br />
ETAP<br />
Decision<br />
Date<br />
Decision<br />
Outcome<br />
Decision<br />
Reasons<br />
1. Agree to fund<br />
2. Defer decision pending further in<strong>for</strong>mation/investigation<br />
3. Refuse to fund<br />
4. Service Development referred to :………………………..<br />
5. Refer to PEC<br />
TREATMENT REQUEST -<br />
Factors involved in considering the ETR decision:<br />
Does the patient meet PCT<br />
available referral criteria<br />
(Criteria score attached if applicable)<br />
Analysis of proposed<br />
<strong>treatment</strong> – documenting<br />
discussion around<br />
guidance available (eg<br />
NICE), effectiveness,<br />
efficacy and safety, MHRA<br />
approval recognition and<br />
VFM<br />
Analysis of alternative<br />
<strong>treatment</strong> and its cost and<br />
effectiveness and VFM<br />
discussion record<br />
Yes/No/Not applicable<br />
Likelihood and discussion<br />
record related to precedent<br />
setting and long term<br />
benefits/costs analysis<br />
Nature of the proposed<br />
<strong>treatment</strong>/intervention –<br />
discussion record regarding<br />
clinical case/s put <strong>for</strong>ward.<br />
Patient <strong>exceptional</strong><br />
circumstances taken into<br />
account – discussion<br />
record. Please note<br />
whether in<strong>for</strong>mation<br />
provided on an ETR Patient<br />
Additional In<strong>for</strong>mation Form<br />
was considered.<br />
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