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Funding Prioritisation

Contact Us - Health

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This page provides information on how HSC makes decisions concerning the funding of services and treatments.

  • How to search the downloads

    • On this page we have included an A-Z document which contains funding statements on specific treatments.  To search for a specific treatment please open the document and hold down the 'ctrl' and 'f' key to open up the search or 'Find' bar.  Once the search bar is visible type in the word you would like to find within the document.
    • G1033A is also a large document.  It has a contents page towards the beginning of the document.  However you can also search the document for specific words or word combinations using the 'Find' function in the same way as described above.
  • A-Z List of Funded and Non Funded Treatments

    • The A-Z of treatments document contains statements about what HSC will and will not fund.  The list does not cover every treatment and if you have any queries about what is covered by the States then in the first instance ask your doctor.  Your doctor can always contact Health and Social Care if they are uncertain about the funding position.
    • Some of the statements are too large to be included in the A-Z document but can be seen in the download section as separate policies.
  • Individual Funding Requests

    • Health and Social Care has responsibility for funding certain elements of health care.  The HSC is not able to meet every health care need and as such has made decisions about what treatment and services to fund and not fund based on available resources and competing demands.  The HSC is striving to make available on this website which treatments are funded and which are not.
    • What are the options for patients and clinicians if a treatment is not funded? 
    • HSC recognises that there will always need to be a process for considering and making additional funding available for the individual needs of a patient. The HSC has an Individual Funding Request Process to perform this function.
    • The following points set out some of the key guiding principles for our Individual Funding Request Panel:
    • key points
      Clinical needYour hospital consultant must provide evidence about your clinical need when submitting your application using their clinical judgement
      Evidence of clinical and cost effectivenessEvidence is required to demonstrate the clinical and cost effectiveness of the treatment, drug, operation or referral. The proposed treatment must be the most cost effective option that meets your clinical needs
      ExceptionalityThere must be an exceptional reason as to why you need to be treated over and above other patients with similar conditions, for whom treatment is not available.  In the case of experimental treatments, the Panel need to consider whether there are grounds to make a treatment available outside of a clinical study
    • Clinical trials
    • The Individual Funding Request Panel also considers requests to enter patients into clinical trials when HSC funding is required.  However, given the current financial climate the funding of clinical trials is relatively low priority.
    • What is the role of the Individual Funding Request Panel?  
    • The role of Individual Funding Request Panel is to consider applications for funding for treatments, on a case-by-case basis that fall outside existing contracts.
    • How can I access the service and have an application considered?
    • To access the Individual Funding Request process, your clinician will need to make an application on your behalf.  They should only do this if they are of the view that exceptional circumstances do apply in your particular situation.  They may therefore decline your request to make an application.
    • Applications should be submitted by clinicians to the Individual Funding Request Panel via our generic email address: Individualfundingrequests@hssd.gov.gg
    • Can I challenge a decision made by the funding panel? 
    • The decision of the Individual Funding Request Panel cannot simply be challenged because you or your clinician disagrees with the outcome.
    • If you consider the Individual Funding Request Panel did not follow its own policy or processes, you can ask the HSC to review its decision.
    • If there are grounds for appeal, then an Individual Funding Request Review Panel will be convened.  The Review Panel checks:
      • That the funding panel considered all the evidence provided by your clinician correctly
      • Whether new evidence has emerged that was not available at the time your request, which might alter the funding decision
      • That the funding panel acted in accordance with the applicable HSC policies
  • Prioritising funding for Health and Social Care

    • Health and Social Care (HSC) is responsible to the States of Guernsey for the health and social well-being of the people of Guernsey and Alderney.  These responsibilities include:
      • Promoting, protecting and improving personal, environmental and public health;
      • Preventing or diagnosing and treating illness, disease and disability;
      • Caring for the sick, old, infirm and those with disabilities; and
      • Providing a range of social services to all age groups including ensuring the welfare and protection of children, young people and their families and ensuring that the best interests of the child will be a primary consideration.
    • The HSC receives an annual budget to carry out these responsibilities.  However the need and demand for health and social care exceeds funding available to meet that need.  The States of Guernsey is not unique in facing these issues; they are challenges faced by all countries regardless of how care is funded and to what level.  As a result, the HSC will need to continue to make difficult choices between competing needs.  This necessarily results in a restriction of treatments and services that are made available.  This may mean limits are placed on:
      • What services and treatments are available;
      • Who can receive a treatment or a service by limiting access to those who are most likely to benefit the most;
      • How much care is provided to patients for example number of physiotherapy sessions;
      • The quality of the care that is provided; and
      • Limits on the choice of provider.
    • There are challenges ahead in terms of funding care and the HSC aims to further develop its decision making with respect to the patient and public engagement on these issues but this will take time.  The first step is to make more transparent the decisions that are being taken.
  • Key policy to support the decision making

    • G1033: Priority setting in Health and Social Care is the policy which underpins all the decisions of the HSC which commit funding.  This includes decisions relating to individual funding requests.
    • The first part of this policy sets out the guiding principles, decision rules and policy statements which guide those making funding decisions within HSC.
    • The second part deals with the operational aspects of decision making.
    • HSC is a constantly evolving environment which means these policies are continually reviewed and challenged to ensure they are up to date.

Downloads

A to Z List of Funded and Not Funded Treatments G1029: Fertility services G1031: Gender reassignment services G1059: Funding the Consequences of Private Testing G1062: Breast surgery G1070: Reimbursement for living kidney donors G1002: Individual funding requests Individual funding request application form Individual Funding Request Leaflet G1033: Priority Setting in Health and Social Care

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