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This NHS Continuing healthcare and NHS-funded Nursing Care leaflet is a guide for individuals who may be in need of ongoing care and support from health and social care professionals as a result of disability, accident or illness, and explains the process used to determine whether the individual is eligible for care funded entirely by the NHS.

For more information and how to apply for Continuing Health Care in your area of Cumbria call:

  • Allerdale & Copeland: 01900 324 246
  • Carlisle & Eden: 01228 608 325
  • South Lakeland & Furness: 01539 797 871

Summary Care Record – your emergency care summary leaflet

The NHS in England has introduced the Summary Care Record, which will be used in emergency care. The record will contain information about any medicines you are taking, allergies you suffer from and any bad reactions to medicines you have had, to ensure those caring for you have enough information to treat you safely. Healthcare staff will ask your permission before they look at your record, except in certain circumstances for example if you are unconscious.

As a patient you have a choice:

  • Yes I would like a Summary Care Record – Let the Practice reception know when you register and a Summary Care Record will be created for you.
  • No I do not want a Summary Care Record – Let the Practice Reception know when you register and you will not have a summary care record created. I would like more time to consider – Let the Practice Reception know you would like more time to consider your options.

For more information, telephone the dedicated NHS Summary Care Record Information Line on 0300 123 3020 or visit the website at www.nhscarerecords.nhs.uk, where you can find information in other formats and languages.

You can choose not to have a Summary Care Record and you can change your mind at any time by informing your GP practice.

If you are the parent or guardian of a child under 16 and feel that they are old enough to understand, then you should make this information available to them.


Please note:Individual Funding Requests (IFRs) are administered by a Commissioning Support Officer, North of England Commissioning Support Unit on behalf of NHS North Cumbria Clinical Commissioning Group.

Please see the leaflet: Information for patients on how Individual Funding Requests (IFRs) are considered by the NHS in the North East of England and Cumbria

An Individual Funding Request (IFR) is an application to provide healthcare funding for a patient that currently falls outside the usual treatments and care routinely provided by the NHS. This usually relates to patients with rare conditions, or for more experimental treatments where there is very little evidence.

The request may be for any type of healthcare, a service, a piece of equipment/aid or a specific treatment or medicine. The request for funding is considered by the IFR Panel which consists of GPs, Pharmacist, and contracting manager.

Why does a GP or Consultant have to apply for IFR?

If an individual falls outside the range of services and treatments that NHS Cumbria Clinical Commissioning Group (CCG) has agreed to commission, then an Individual Funding Request can be made by a clinician, on behalf of a patient, to fund healthcare. All Individual Funding Requests will be considered against agreed criteria or on the basis of evidenced exceptionality. The responsibility for demonstrating exceptionality lies with the requesting clinician and, based on the information provided, NHS Cumbria CCG will decide whether or not to support this view and agree to fund the request.

What are exceptional circumstances?

Exceptionality is defined as: The patient, or their circumstances, is significantly different from the general population of patients with the condition in question and the patient is likely to gain significantly more benefit from the intervention than might normally be expected for patients with that condition.


An application for an IFR is made online by the patient’s clinician with guidance available to advise them how to complete this correctly. They will obtain the patient’s consent for relevant health records to be shared with members of the IFR panel. The online system details a number of treatments that list the clinical criteria a patient needs to meet for funding to be approved. If the patient does not meet the clinical criteria the requesting clinician needs to describe if the patient has any exceptional clinical circumstances.

What is the referral process?

Once an online application has been submitted, requests are measured against existing eligibility criteria or any exceptional reasons put forward to support the request. Further information may be requested from the requesting clinician if required. The IFR panel normally meets every four weeks to consider cases and to make decisions. The clinician will be notified of the outcome via email and the clinician is responsible for communicating the decision to the patient. The target timescales for decision making are:

• 25 working days or less from receipt of request with all relevant information to panel decision
• 10 working days or less from IFR panel decision to written confirmation (standard requests)
• 5 working days or less from receipt of request with all relevant information to written confirmation of panel decision (urgent requests only)

What are the criteria for IFR?

The most current copy of the criteria can be found by accessing the attached link https://ifr.sotw.nhs.uk/signin. Patients are encouraged to contact their doctor or clinical representative to discuss their eligibility against the criteria in place.

Where to get further information?

In all cases, patients are encouraged to discuss their clinical condition and the options available with their doctor or clinical representative.


Commissioning responsibility for a number of services, including bariatric surgery, adult highly specialist pain management.

Pre-Implantation Genetic Diagnosis (PGD) has moved to specialised commissioning teams.

Specialised services are commissioned under contract with nominated providers, therefore referrals should be sent directly to them for assessment.

For further information please refer to:

NHS England Clinical Commissioning Polices or Statements
Manual of Prescribed Services
Identification Rules

Bariatric surgery – referral information for Tier 3 intensive weight management programme:

Northumbria Bariatric Surgery referral form
Referrals to the Aintree Weight Specialist Management Service

If the provider considers that the referral constitutes an IFR within NHS England Prescribed Services, they should apply for funding approval via: https://nescg.not.nhs.uk . The application will be considered by Cumbria, Northumberland, Tyne and Wear NHS England Area Team which is responsible for the operational management of IFRs for prescribed specialised services for provider organisations in the North of England region.

To make an application:

Register on the online IFR referral system at https://ifr.sotw.nhs.uk . The guidance document on the website explains how to do this.

You will be requested to confirm that patient consent has been obtained on behalf of your patient for relevant health records to be shared with members of the IFR team.  You can use the Patient Information Explicit Consent Form to record that consent has been given.

To clarify eligibility criteria visit Value Based Clinical Commissioning Policies. A copy of the policies can be found on the website.

If you need assistance on using this system please contact your Individual Funding Request Administrator at NECSU.IFRCumbriaadmin@nhs.net

Submitted requests are triaged against existing eligibility criteria or to consider whether there are exceptional reasons put forward for the funding request.  If insufficient information is provided, further information will be requested from the clinician.  The IFR panel normally meets every four weeks to consider the cases and make decisions.  The referrer will be notified of the outcome by email which will provide a link to the on-line referral.   The clinician is responsible for communicating the decision to the patient.   The target timescales for decision making are:

25 working days or less from receipt of request with all relevant information to panel decision

10 working days or less from IFR panel decision to written confirmation (standard requests)

5 working days or less from receipt of request with all relevant information to written confirmation of panel decision (urgent requests) 


IFR’s for Specialised Services

If the provider considers that the referral constitutes an IFR within NHS England Prescribed Services, they should apply for funding approval via: https://nescg.not.nhs.uk

The application will be considered by Cumbria, Northumberland, Tyne and Wear NHS England Area Team which is responsible for the operational management of IFRs for prescribed specialised services for provider organisations in the North of England region.

North of England Commissioning Support Unit on behalf of  NHS North Cumbria CCG

Commissioning responsibility for a number of services, including:

bariatric surgery,

adult highly specialist pain management

Pre-Implantation Genetic Diagnosis (PGD)

has moved to specialised commissioning teams.  

Specialised services are commissioned under contract with nominated providers, therefore referrals should be sent directly to them for assessment.

For further information please refer to:

NHS England Clinical Commissioning Polices or Statements

Manual of Prescribed Services

Bariatric surgery – referral information for Tier 3 intensive weight management programme (bariatric surgery)

o   Northumbria Bariatric Surgery referral form

o   Referrals to the Aintree Weight Specialist Management Service