Any other relevant Preferred Provider (Is there a local NHS provider?) Cost of treatment if known Clinical Effectiveness Strong Medium Weak Don’t Know Please indicate how strong you think the published evidence base is for this intervention for this condition Exceptionality How many patients with this condition you expect an average GP practice to see each year? Exceptionality Please describe any relevant clinical factors which make this patient’s case exceptional. Please address the following questions. How is this patient is: Clinically different to the general population of other patients with the same condition? Likely to gain a significantly greater health benefit from the intervention than might be expected for the average patient with the condition?
Any other relevant Preferred Provider (Is there a local NHS provider?) Cost of treatment if known Clinical Effectiveness Please indicate how strong you think the published evidence base is for this intervention for this condition Strong Medium Weak Don’t Know Exceptionality How many patients with this condition you expect an average GP practice to see each year? Exceptionality Please describe any relevant clinical factors which make this patient’s case exceptional. Please address the following questions. How is this patient is: Clinically different to the general population of other patients with the same condition? Likely to gain a significantly greater health benefit from the intervention than might be expected for the average patient with the condition?
IFR%20application%20form%20with%20IG%20statement%20-%20GP%2013%2014DEC.docx