Effective Use of Resources

The NHS belongs to us all. It is there to improve our health and well-being, support us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover to stay as well as we can to the end of our lives.

To make sure that we can provide the best care for the maximum number of people it is vital that we make every penny count.

This means funding treatments that have been demonstrated to work and where there is a high likelihood of benefit and a low likelihood of harm. Carrying out operations that are not of great health benefit uses up resources that could be spent on really making a difference elsewhere. 

As happens in other parts of the country, we may decide that a treatment or procedure should not be routinely funded because

  • There is only limited or no evidence of its effectiveness (whether it works or not).
  • It is considered a low priority for funding, (for example, cosmetic surgery) compared to other treatments (for example, dementia or stroke care).

The Effective Use of Resources (EUR) Treatment Policies below lists those procedures that are not funded or where funding will only be made available if specific criteria are met.  Work is also taking place across Greater Manchester to review the EUR policies contained within this list, as well as to develop new policies. This work will help to ensure that people across the whole of Greater Manchester are able to access these treatments in a fair and equitable manner.

It is important to remember that, while the NHS does not want to carry out operations which have little health benefit in general, there may be overwhelming health benefits for an individual patient. In these cases, a doctor, on behalf of a patient, will explain the exceptional circumstances and request that these are considered through the EUR process, where it will be decided if the NHS will carry out the operation. The EUR process will make decisions on an individual case by case basis. The EUR process for requesting funding on an individual patient basis is detailed in the Greater Manchester EUR Operational Policy below. This process is applied consistently by all Clinical Commissioning Groups in Greater Manchester.   The Terms of Reference for our Individual Funding Request Panel can also be found below.


General Practitioner (GP) - If you would like to discuss making an individual funding request (IFR), you should contact your General Practitioner, who may do this on your behalf.

Effective Use of Resources (EUR) Team for Greater Manchester
EUR process or funding requests:

EUR policy development:


Bolton CCG EUR Treatment Policies (includes criteria / funding mechanisms / funding request forms – for specific GM policy funding request forms please see end column in list)

PbR Excluded Drugs List

PbR Excluded Devices List

Greater Manchester EUR Operational Policy

Bolton CCG Individual Funding Request Panel – Terms of Reference

Bolton CCG Process Review Panel – Terms of Reference

Seeking Medical Treatment Abroad

As an NHS patient, you have the right to receive treatment anywhere in the European Economic Area (EEA), provided that the treatment is funded by the NHS. Our EUR policies above also apply to treatment accessed in Europe.  Further information regarding accessing medical treatment in Europe can be found on the NHS Choices website.

Treatments which are not the funding responsibility of CCGs in England

There are a number of treatments and conditions which are funded directly by NHS England, which means that CCGs in England are not responsible for funding the care for patients related to that particular treatment or condition.  Further information regarding the treatments and conditions funded by NHS England can be found on their website.

NHS England Manual (contains NHS England’s 143 Prescribed Specialised Services)

NHS England Drugs List

NHS England’s Specialised Services Key Documents

NHS England’s Specialised Services IFR Processing System for the North of England

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