The NHS has a duty to spend the money it receives from the Government in a fair way, taking into account the health needs of the whole community. 
An Integrated Care Board’s (ICB) job is to get best value for this money by spending it wisely on your behalf. Demand for healthcare is growing, but there is only a set amount of money available to spend so difficult decisions sometimes have to be made. 
ICBs pay for local NHS health services and NHS England pays for highly specialised health services. ICBs have a legal duty to provide health services for patients in their area with the fixed amount of money they receive from the Government. They have a legal duty not to spend more than this. This means that some hard choices have to be made and not all treatments can be provided by the NHS. Treatments that are limited by the ICB are shown in their clinical commissioning policies. For the BOB ICB there are currently three sets of clinical commissioning policies for each geographical area. 

Buckinghamshire clinical commissioning policies  

Oxfordshire clinical commissioning policies 

Berkshire West clinical commissioning policies  

Work is on-going to develop single commissioning policies across the ICB from those developed by the predecessor clinical commissioning groups. The ICB knows that there will always be times when a patient would benefit from a particular treatment, not usually given by the NHS. To apply for this treatment, an Individual Funding Request is made (see below). The priority is paying for those medicines and treatments that are proven to work well, can demonstrate they improve peoples’ health, and offer good value for money. 


Individual Funding Requests 

An Individual Funding Request (IFR) is an application to fund healthcare which is not usually given by the NHS. These requests are considered by an IFR Panel who look at evidence of clinical and cost effectiveness, as well as equity for the whole population.  

The BOB ICB is happy to consider an IFR if the clinician believes there is a strong case for a specific patient on grounds of an exceptional health need. You can read about exceptional health needs in this guide: Exceptional Health Need – guide for patients and clinicians. 


For general enquiries please email 


To view the policies select a category from the list below.