ELMMB Forms

Request for a New Medicine or Change in Regimen

Any NHS healthcare professional working within the East Lancashire Health Economy

can request that the MMB considers an application to assess a new medicine, and

prioritise it against other competing requests.

Where a clinician is considering requesting an intervention for a patient that is not already

commissioned, but this patient represents the first of many, this will be considered only

as a Service Development. As such, the clinican should request the intervention for all

patients, The process for applying for a medicine to be reviewed as a service development

by the MMB can be found below with the application form for a 'New Product, or Change

of Regimen' and guidance relating to the governance arrangements of documents

submitted to East Lancashire Medicines Management Board.

New Product or Change of Regimen Request Form ELMMB .docx [rtf / 2.16MB] The form must be used for all requests - for drugs not currently used within the trust - new indications for established drugs - changes in practice/ regimen

Exceptional Cases

Where a policy not to fund a medicine is already in place

If an individual falls outside the range of services and treatments that the CCG has agreed

to commission then an Exceptional Funding Request can be made by a clinician, on behalf

of a patient, to fund healthcare. The responsibility for demonstrating exceptionality lies

with the requesting clinician and based on the information provided the CCG must decide

whether or not to support this view and agree to fund the request.

Should you wish to apply for exceptional funding please use the form

below.

Individual Funding Request Form 2020 [docx / 52KB] This form is an appendix to The Individual Funding Request Process. The full document must be considered before making an application on behalf of a patient to ensure that it is appropriate.