The Independent Review of the Individual Patient Funding Request (IPFR) Process – Written statement
17 January 2017
Vaughan Gething, Cabinet Secretary for Health, Well-being and Sport
I am pleased to publish the report produced by independent review of the NHS Wales Individual Patient Funding Request Process (IPFR).
All health boards use this process to decide whether or not an individual patient should have access to a treatment which is not routinely available.
This follows an IPFR review in 2014 and the implementation of its recommendations. I agreed the time was now right for a fresh review of the IPFR process, with a different emphasis. I announced this last July as part of the Compact to Move Wales Forward. Its aim was to focus on the number of panels and the clinical exceptionality criteria, taking into account the patient’s perspective.
I would like to take this opportunity to thank the review group them for their hard work and dedication in meeting a challenging timeframe for concluding their work. The combined expertise and experience of the group – Mr Andrew Blakeman (chair), Professor Peter Littlejohns, Professor Chris Newdick, Professor Phil Routledge, Dr Ben Thomas, Mr Irfon Williams and Mr Keith Cass MBE – has resulted in a report that blends compassion with the realities of making difficult, sensitive decisions. I am especially grateful to the review group for providing their insight and expertise free of charge and around their demanding schedules.
I note that the report endorses several aspects of the current IPFR process, and makes recommendations for further improvements. The review group has concluded that we should retain the current system of separate IPFR panels, given the costs and risks of changing the number of panels.
The review group has considered at length the complex issue of clinical exceptionality.
They conclude that the principle for making decisions at an individual patient level about access to a treatment should be based upon the level of expected clinical benefit and whether the treatment offers reasonable value for money. The review group makes several recommendations to replace “clinical exceptionality” and to strengthen the criteria used to make decisions at the individual patient level.
The patient perspective informs every page of this report, which is grounded in the evidence that the review group gathered so diligently. The 10 workshops held in Wrexham, Aberystwyth and Cardiff summarise the experiences and opinions of patients – who are hugely affected by going through the IPFR process – and of clinicians and other healthcare workers who work with it every day. The wealth of written evidence chronicles in some depth patients’ encounters with the IPFR process and how they feel about it as well as including thoughtful evidence from health charities, clinicians, health board staff and the pharmaceutical industry. A total of 68 contributors sent in written evidence, attended a workshop, or both. I thank them all for taking the time to share their experience and expertise.
I will now consider the report and its recommendations in more detail and will make a statement about the next steps shortly.