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Review exercise 2 - IFR process review
Download a PDF version of this review exercise
Once you have listened to our presentations on the legal and ethical aspects of local decision making and judicial review, reinforce your understanding and put some of the learning into practice by working through the following exercise.
This exercise could be used as a group exercise for IFR panels. It could also form part of an audit to ensure the PCT’s policies are robust and the panel are following the processes as set out in the PCT IFR policy.
It may also be helpful to familiarise yourself with the IFR policy health check in Supporting rational local decision-making about medicines and treatments: a good practice handbook.
Confidentiality: Whilst undertaking this exercise, please ensure patient confidentiality is maintained, as appropriate.
Take an IFR case previously dealt with by your trust. You will also need: a copy of your Trusts IFR Policy and the terms of reference of your IFR panel.
Assess the case and consider the following:
- Is there an appropriate paper trail? i.e. does the paperwork in the file flow and make sense?
- Is there a completed application or clinical letter which clearly outlines the appropriate information:
- Evidence or information regarding the exceptionality of the patient
- Clinical Evidence and the supporting documents
- Cost effectiveness evidence and the supporting documents
- The cost of the treatment
- Was there appropriate attendance at the IFR meeting? According to your IFR policy terms of reference were the group quorate for decision making purposes?
- Were appropriate minutes taken? Are they clear and easy to understand? Are they signed off by the chair?
- Were the patient and the clinician informed of the decision within the appropriate timescales? If the request was refused were they informed of the appeals process, how to access this and who to contact for information?
- In your opinion do you feel due process was followed for this case? Do you believe there are any areas which could be open to judicial review?
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