Reviewed and new policies are added to this website once they are approved by the CCG's Integrated Performance and Assurance Committee (known as IPAC) and ratified by the Cambridgeshire and Peterborough Clinical Commissioning Group Governing Body.
Note 1: All the CCG clinical policies are listed alphabetically and some are listed according to specialty group, eg the orthopaedic surgery selection drops down to reveal carpal tunnel, ganglion, hip replacement, knee replacement, etc.
Note 2: NHS England Specialised Commissioning Group (NHSESCG) - a link to the NHS England policies web page is available at the bottom of the policies drop down list. Please note you can access the following policies from this web page: Cochlear Implants, Bone Anchored Hearing Aids (BAHAs), etc.
Note to referring clinicians:
For interventions covered by a Lower Clinical Priority Policy (LCPP) it is necessary to secure approval of funding through the CCG Exceptional/IFR funding request process prior to referral for treatment. The referrer will need to demonstrate the patient's clinical levels of severity or demonstrate the patient's exceptionality.
Funding for the following policies may be sought by completing modified referral proforma rather than the Exceptional and IFR Request Form - instructions for completion are available on the proforma - please ensure referral proforma are completed electronically and submitted in Word format.
- Benign Skin or Soft Tissue Lesions
- Cosmetic/Aesthetic Surgery
- Laser Treatment for Skin Conditions
Lower Clinical Priority Policy - which drop down to select
| Lower Clinical Priority Policy Title | Drop down option |
|---|
| Benign Skin or Soft Tissue Lesions | Skin conditions |
| Bobath Therapy for Cerebral Palsy | Same option |
| Complementary and Alternative Therapies | Same option |
| Coloured Filters/Tinted Lenses for Reading Difficulties
| Same option |
| Cosmetic/Aesthetic Surgery | Same option |
| Extracorporeal Shockwave Therapy (ESWT) | Orthopaedic surgery |
| Functional Electrical Stimulation (FES) for the Treatment of Foot Drop of Neurological Origin Note: this intervention is now included in the Neurostimulation Position Statement. | Neurostimulation |
| Laser Treatment for Skin Conditions | Skin conditions |
| Open/Upright MRI | Same option |
| Reversal of Sterilisation | Sterilisation |
| Snoring – Surgical and Non Surgical Treatments | Merged with Surgery for Obstructive Sleep Apnoea Surgical Threshold Policy to become: Surgery for Obstructive Sleep Apnoea and Snoring |
For interventions covered by a Surgical Threshold Policy (STP) - if the patient meets the relevant policy surgical threshold criteria the referring clinician should complete the applicable sections of the referral proforma and send direct to the secondary care specialist - instructions are available on referral proforma -please ensure referral proforma are completed electronically and submitted in Word format.
Where the patient does not meet the surgical threshold criteria, treatment is considered a low priority and will only be commissioned by the NHS on an exceptional case basis. Funding through the Exceptional Cases process must be sought prior to referral to secondary care. The referring clinician should complete the relevant sections of the referral proforma and submit the proforma to the Exceptional Cases Team.
Surgical Threshold Policies - which drop down option to select
| Surgical Threshold Policy Title | Drop down option |
| Bariatric Surgery - Referral for | Bariatric Surgery |
| Bunions (Surgical Referral for Hallux Valgus) | Policy merged with Podiatry Services Policy. See Foot Care Interventions below. |
| Carpal Tunnel Syndrome | Orthopaedic surgery |
| Cataracts | Eye conditions |
| Chalazion | Eye conditions |
| Cholecystectomy for Gallstones | Same option |
| Chronic Hip Pain | Orthopaedic surgery |
| Circumcision | Same option |
| Dupuytren’s Contracture | Orthopaedic surgery |
| Dyspepsia - Management of in Primary Care and Referral for Endoscopy | Endoscopy |
| Eyelid and Brow Surgery | Eye conditions |
| Female Pelvic Organ Prolapse – Management of | Gynaecological conditions |
| Foot Care Interventions: Podiatry, Laser, Injections and Surgery | Orthopaedic surgery |
| Follow-up Cystoscopy for Non-muscle Invasive Bladder Cancer | Withdrawn – subject to NICE guidance |
| Ganglion | Orthopaedic surgery |
| Grommets & Adenoidectomy: Surgical Treatment of Otitis Media | Ear, Nose and Throat (ENT) |
| Haemorrhoids – Interventions for | Same option |
| Heavy Menstrual Bleeding (HMB) Management of | Gynaecological conditions |
| Hernia Surgery for Adults | Same option |
| Knee Arthroscopy for Chronic Knee Pain | Orthopaedic surgery |
| Low Back Pain – Surgery and Other Invasive Interventions | Orthopaedic surgery |
| Lower GI Endoscopy (Colonoscopy or Sigmidoscopy) | Endoscopy |
| Nasal Surgery for Obstruction or Deformity | Ear, Nose and Throat (ENT) |
| Primary Hip Replacement Surgery | Orthopaedic surgery |
| Primary Knee Replacement Surgery | Orthopaedic surgery |
| Radiofrequency Denervation | Orthopaedic surgery |
| Shoulder Pain - Management of (including referral for surgical assessment) | Orthopaedic surgery |
| Shoulder Replacement for Chronic Shoulder Pain | Orthopaedic surgery |
| Sterilisation | Same option |
| Surgery for Obstructive Sleep Apnoea and Snoring | Ear, Nose and Throat (ENT) |
| Temporomandibular Disorders – Management of (GP advice) | Dental and Orthodontic Policies |
| Tongue-tie – surgery for the treatment of | Same option |
| Tonsillitis – surgery for: Tonsillectomy and Adenoidectomy | Ear, Nose and Throat (ENT) |
| Trigger Finger | Orthopaedic surgery |
| Varicose Vein Interventions | Same option |
For interventions covered by Other Clinical Policies select the relevant policy to ascertain when prior approval is required - this will usually apply if a patient needs to receive treatment via a non commissioned pathway, requires out of area treatment or does not fit a particular group defined in a policy's criteria. Where funding is required an Exceptional/IFR funding request form will need to be completed.
Other clinical policies - which drop down option to select
| Policy Title | Drop down option |
| Assessment of Haematuria (presence of blood cells in urine) in Primary Care | Same option |
| Basal Cell Carcinoma Pathway | Skin conditions |
| Continuous Glucose Monitors | Same option |
| Earwax Removal – Referral for | Ear, Nose and Throat (ENT) |
| Familial Breast Cancer | Same option |
| Hydrotherapy | Same option |
| Hyperhidrosis - Management of | Same option |
| Lymphoedema Services | Same option |
| Neurostimulation | Same option |
| Obstructive Sleep Apnoea/Hypopnoea Syndrome (OSAHS) in Adults – Diagnostic Investigations | Same option |
| Oral Anticoagulation - Patient Self Management | Same option |
| Pain Relief Services | Same option |
| Photodynamic Therapy for Age-Related Macular Degeneration | Eye conditions |
| Podiatry Services | Policy merged with Surgery for Hallux Valgus (Bunions) Policy to form Foot Care Interventions. See above Surgical Threshold Policies. |
| Post-traumatic Stress Disorder | Same option |
| Stop Smoking Services (referral for Stop Smoking Services): ‘Stop Before Your Op’. | Same option |
When to apply for funding provides clarification to referring clinicians on when they should apply for funding to the Exceptional Cases Panel, relevant to policy type.
