Three people in training session with teacher at a flipchart

IFR training & Support

Delivering training and operational support for your IFR team

The SPH team includes Consultants in Public Health Medicine (CPHM) who have experience of all aspects of the IFR process.

What we do

SPH can support your existing IFR processes. If your ICB already has good policies and processes in place to deliver IFR decisions, SPH can offer:

  • Triage of new IFR applications – to include clinical review of IFR applications, liaison with clinicians initiating requests on behalf of their patients, rapid searching for evidence on clinical and cost effectiveness of interventions, identifying cases which should be managed through other mechanisms, e.g. as a potential service development.
  • Support to IFR panels – to include preparation of case summaries, membership of IFR panels, help with drafting panel ‘decision letters’ and minutes, availability to respond to ‘urgent requests’ between meetings as required.
  • Input to IFR appeals – to include work up of cases requesting appeal, to clarify and appraise the grounds for appeal, and membership of appeal panels. We can provide cover for appeals panels/processes by a CPHM not involved in the initial IFR panel decision if this is required by your governance framework.

SPH can review your IFR policies and processes. We offer an in-depth review of existing policies and processes to include:

  • Process mapping
  • Audit to evaluate whether decisions are in line with existing policy at both IFR and appeal panel level
  • Feedback from those involved in the process and wider stakeholders re strengths and weaknesses
  • Assessment of robustness to legal challenge and any potential issues related to legality of existing policies
  • Policy re-drafting
  • Process re-design and implementation


Training and evidence reviews

We offer training for IFR teams, IFR and appeal panel members, commissioning managers and wider stakeholders and w undertake rapid evidence reviews of interventions identified through IFRs which need to be re-routed through the potential service delivery/ annual commissioning round route.
NHS Arden & GEM Commissioning Support Unit, provides additional transactional support for IFR services. Details can be found on their website:


Why choose SPH?

We have long-standing and current experience of providing public health input to the management of IFRs by ICBs via Consultants in Public Health Medicine supported by a team of evidence reviewers who can rapidly assimilate and appraise evidence on the clinical and cost effectiveness of healthcare interventions.
Please get in touch via our contact page.

Case Studies

Improving allocative value decision-making in the stroke pathway (STAR tool)

The Mid and South Essex stroke stewardship group wanted to better understand which of the interventions they delivered were high value and which were low value to inform decision-making on use of resources and investment. Arden & GEM’s Healthcare Solutions team provided training and support to enable the group to use the Socio-Technical Allocation of Resources (STAR) process in value based decision-making. As a result, the MSE stroke stewardship group has the insight needed to improve the allocation of their existing resources and improve outcomes for their patients. SPH were part of the project team, conducting a librarian review of economic evidence relating to cost-effectiveness of the stroke interventions to feed into the first workshop. This comprised a review of existing economic cost-effectiveness assessments (ideally by NICE as these are recognised as the guiding authority within the NHS). Where an economic assessment had not been undertaken then this was noted for further consideration. More detail here

Health Needs Assessment for Children & Young People

SPH carried out a Health Needs Assessment for a local authority that was recommissioning its Healthy Child Programme (HCP). The purpose was to review whether existing provision and service configuration of the HCP was meeting the needs of children and young people in the county, and to identify gaps and potential options for improvement. This is a preventative programme which includes Health Visiting and School Nursing Services, Family Nurse Partnership (FNP) Programme and healthy start vouchers and vitamins, linking with childhood immunisation services, community paediatrics, speech and language, services for children with a learning disability and complex needs and child and adolescent mental health services (CAMHS), among others. The HNA was carried out jointly by SPH and the local authority, with the epidemiological needs assessment and service description provided by the local authority. The report was compiled using a range of publicly available and locally collected epidemiological and service use data. In addition, SPH carried out a consultation of key corporate stakeholders as well as children and young people, their parents and carers. This included semi-structured interviews with key stakeholders in a range of organisations, a survey of a wider range of staff who work with children and young people and a survey of children and young people, their parents and cares which was distributed through the services.

Individual funding requests

SPH have provided public health support and advice for individual funding request (IFR) processes in London and the East Midlands. This included reviewing case summaries, attending panel meetings and undertaking rapid evidence work to support potential service developments as a result of patterns of cases identified in IFR panels. Producing evidence-based guidelines SPH were commissioned to produce evidence-based guidelines on screening for adult non-communicable diseases (diabetes mellitus, chronic kidney disease and cardiovascular disease), and on the implementation of new-born and antenatal screening for an international health organisation. SPH developed the guidelines using a three stage process, encompassing literature reviews to identify policies in other high-income countries and the evidence base underpinning those policies, surveys gathering the views of clinical leaders and two interactive clinical engagement events with clinical leaders.

Supporting Priorities Committees

Our work with Priorities Committees enables NHS commissioners to balance complex choices, backed up with independent evidence reviews and ethical frameworks. We provide an end-to-end service which includes the development of an ethical framework to inform the decision-making process, topic selection, evidence reviews, consultation with clinical specialists, operational support to priorities committees and drafting of clinical commissioning recommendations. We have also worked with commissioners around the country in developing and advising on setting up their own decision-making processes. We have experience of supporting commissioners in appeals against NICE guidance and in judicial reviews.