Clinical Policies Directory TNRF1: Musculoskeletal (MSK)
These pages provide a web friendly version of the Treatments not routinely funded one policy (CLIN02 Treatments Requiring Individual Funding Applications TNRF1).
Go to Policies and Processes page (Clinical policies section) of this website to read the full policy.
Pain management procedures
Cervical and thoracic facet joint injections (spinal injections for pain)
Overview
A cervical or thoracic facet joint injection involves injecting a small amount of local anaesthetic (numbing agent) and/or steroid medication, which can anesthetize the facet joints and block the pain.
Thresholds and eligibility
Facet Joint Injections or Medial Branch Block Injections for chronic pain in the cervical or thoracic spine will not be routinely funded.
Resources
Treatments not routinely published policy (TNRF1)
Additional information
If a clinician is able to demonstrate that their patient’s individual clinical circumstances are clearly different to those of other patients, they have the option of submitting an Individual Funding Request (IFR) application to the Effective Commissioning Initiative team at NHS Surrey Heartlands via the Blueteq database.
Simply put, the consideration is whether it is fair to fund their patient’s treatment when the treatment is not available to others.
Epidural Injections for non-radicular pain (spinal injections for pain)
Overview
An epidural injection contains a steroid medicine, usually together with a local anaesthetic. These injections are also called epidural steroid injections. The liquid is injected into a gap called the epidural space, which surrounds your spinal cord. To be non-radicular means that the back pain is local and does not involve nerve root irritation.
Thresholds and eligibility
This procedure is not routinely funded.
Resources
Treatments not routinely published policy (TNRF1)
Additional information
If a clinician is able to demonstrate that their patient’s individual clinical circumstances are clearly different to those of other patients, they have the option of submitting an Individual Funding Request (IFR) application to the Effective Commissioning Initiative team at NHS Surrey Heartlands via the Blueteq database.
Simply put, the consideration is whether it is fair to fund their patient’s treatment when the treatment is not available to others.
Lumbar facet joint injections (spinal injections for pain)
Overview
A Lumbar Facet Joint injection is an injection of local anaesthetic (numbing medicine) into one or more of the small joints located along the side of each vertebrae on both sides of the spine in the lower part of the back.
Thresholds and eligibility
For patients with chronic non – specific low back pain and those with sciatica will not be routinely funded.
Resources
Treatments not routinely published policy (TNRF1)
Additional information
If a clinician is able to demonstrate that their patient’s individual clinical circumstances are clearly different to those of other patients, they have the option of submitting an Individual Funding Request (IFR) application to the Effective Commissioning Initiative team at NHS Surrey Heartlands via the Blueteq database.
Simply put, the consideration is whether it is fair to fund their patient’s treatment when the treatment is not available to others.
Occipital Nerve Stimulation (ONS) for management of medically intractable migraine, medically refractory cluster headaches and facial pain (treatment for chronic and severe headaches)
Overview
Occipital nerve stimulation is a surgical procedure that may be useful in the treatment of chronic and severe headache disorders, such as chronic migraines, that do not respond well to other therapies.
Thresholds and eligibility
This procedure is commissioned by NHS England.
Resources
Treatments not routinely published policy (TNRF1)
Additional information
This procedure is commissioned by NHS England.
Platelet rich plasma injections: autologous blood injections (treatment using a patient's own blood cells to accelerate healing in a specific area)
Overview
A platelet-rich plasma (PRP) injection is an orthopaedic therapy that uses a patient's platelets to accelerate the healing of damaged joints, ligaments, tendons, or muscles. Your plasma contains proteins that help your blood clot as well as support cell growth.
Thresholds and eligibility
This procedure will not be routinely funded for any MSK conditions.
Resources
Treatments not routinely published policy (TNRF1)
Additional information
If a clinician is able to demonstrate that their patient’s individual clinical circumstances are clearly different to those of other patients, they have the option of submitting an Individual Funding Request (IFR) application to the Effective Commissioning Initiative team at NHS Surrey Heartlands via the Blueteq database.
Simply put, the consideration is whether it is fair to fund their patient’s treatment when the treatment is not available to others.
Orthopaedic procedures
Extracorporeal shockwave therapy (Treatment that involves delivery of shock waves to injured soft tissue)
Overview
Extracorporeal shockwave therapy is a non-invasive, out-patient alternative to surgery for those with many joint and tendon disorders.
Thresholds and eligibility
This procedure is not routinely funded.
Resources
Treatments not routinely published policy (TNRF1)
Additional information
If a clinician is able to demonstrate that their patient’s individual clinical circumstances are clearly different to those of other patients, they have the option of submitting an Individual Funding Request (IFR) application to the Effective Commissioning Initiative team at NHS Surrey Heartlands via the Blueteq database.
Simply put, the consideration is whether it is fair to fund their patient’s treatment when the treatment is not available to others.
Magnetic resonance therapy (MRT) for knee osteoarthritis (Magnetic therapy for knee pain)
Overview
Magnetic resonance therapy (MRT) for knee osteoarthritis involves placing a magnetic resonance device over the knee to stimulate cartilage to heal and relieve the symptoms of osteoarthritis.
Thresholds and eligibility
This procedure is not routinely funded. Clinicians wishing to undertake MRT should do so in accordance with IPG 702 and for research purposes only.
Resources
Treatments not routinely published policy (TNRF1)
Additional information
If a clinician is able to demonstrate that their patient’s individual clinical circumstances are clearly different to those of other patients, they have the option of submitting an Individual Funding Request (IFR) application to the Effective Commissioning Initiative team at NHS Surrey Heartlands via the Blueteq database.
Simply put, the consideration is whether it is fair to fund their patient’s treatment when the treatment is not available to others.
Subacromial shoulder decompression (surgery for shoulder impingement)
Overview
Subacromial decompression is an operation on your shoulder to treat a condition called shoulder impingement, which causes pain when you lift your arm.
Thresholds and eligibility
This procedure is not routinely funded.
Resources
Treatments not routinely published policy (TNRF1)
Additional information
If a clinician is able to demonstrate that their patient’s individual clinical circumstances are clearly different to those of other patients, they have the option of submitting an Individual Funding Request (IFR) application to the Effective Commissioning Initiative team at NHS Surrey Heartlands via the Blueteq database.
Simply put, the consideration is whether it is fair to fund their patient’s treatment when the treatment is not available to others.