1. Clinical Thresholds and IFR Panel Referral Process
Procedures of Limited Clinical Value
GP reviews patient against clinical criteria
Patient does not meet clinical criteria but GP refers for exceptionality
Patient meets clinical criteria for non-routinely commissioned procedure
Patient does not meet clinical criteria *
GP refers for advice from Secondary Care
Procedure refused on NHS GP provides feedback
Refer to
IFR Panel *
GP refers to Secondary Care with completed PLCV check-list & referral letter
Consultant reviews patient against clinical criteria *
IFR Panel approve procedure
IFR Panel does not approve procedure and patient notified
Secondary Care Agreement that Patient meets clinical criteria , procedure is carried out
Patient does not meet clinical criteria and is discharged and GP notified
GP refers to Secondary Care with IFR Approval
Patient does not meet clinical criteria , consultant applies to IFR panel for approval on grounds of exceptionality
IFR Panel approve and the procedure is carried out *
IFR panel don’t approve, letter to the patient and discharge (if appropriate)
* Check-point