Interim Individual Commissioning Decisions Panel (ICDP)

The Interim Individual Commissioning Decisions Panel (ICDP) has been established by Cambridgeshire & Peterborough ICB to provide a clear, fair, and transparent way of managing exceptional commissioning cases that fall outside our usual policies, contracts, or statutory responsibilities.

The ICDP exists to ensure that no individual falls through the gaps when commissioning responsibilities are unclear, while protecting system integrity and ensuring decisions are fair, ethical, and well-governed.

When to Refer to ICDP

The ICDP should only be used when:

  • A person has a clear health-related need not covered by existing funding routes (e.g. CHC, Section 117, block contracts, PHBs, or Local Authority social care).
  • Continuation of care is required after a specialist or tertiary intervention, but responsibility is unclear or disputed.
  • A commissioning gap, dispute, or urgent risk exists, and all other statutory/contractual options have been ruled out.

Important: The ICDP is not the route for Individual/Exceptional Funding Requests (IFRs) for treatments not routinely commissioned. Those must go via the existing IFR process.

Referral Process

  • Who can refer? Only ICB-employed staff, with sign-off from their line manager or senior lead.
  • How to refer? Complete the ICDP Referral Form with all supporting documentation. ICDP Referral Form and send it to cpicb.icdp@nhs.net.
  • Triage: A triage panel will review referrals to confirm suitability, request further details if needed, or redirect if another route is more appropriate.

All referrals to the ICDP are first reviewed by the Triage Panel, which acts as a gateway to ensure only appropriate and fully evidenced cases proceed to the main panel. The triage process checks that all statutory and contractual funding routes (e.g. CHC, Section 117, IFR, Local Authority, PHB, NHSE) have been explored and ruled out, that referral forms are complete, and that cases fall within the ICDP’s scope. Where information is missing or another pathway is more suitable, cases are either returned with feedback or redirected. The Triage Panel does not make funding decisions but ensures that only eligible, well-prepared cases are escalated for full ICDP consideration.

Text: Flowchart - From Referral to Decision: Referral:• ICDP Referral Form • ICDP Referral Form Completion Guide for Referrers • Quick reference Guide (when to refer to ICDP or other Panels)

Decision-Making

The ICDP panel brings together expertise from clinical, commissioning, finance, contracting, and quality teams. Decisions are guided by:

  • Impact on the individual – safety, dignity, wellbeing.
  • Clinical appropriateness – assessed health need within NHS scope.
  • Responsibility – all statutory and policy options ruled out.
  • Value and affordability – proportional and evidence-based.
  • Equity and consistency – fair and transparent.
  • System impact and risk – timely decisions to avoid harm or escalation

Triage Process

Initial Check ®  Scope & Relevance ®  Evidence Review ®  Decision at Triage ®  Feedback & Record

When you submit a referral to the Interim Individual Commissioning Decisions Panel (ICDP), it goes through the Triage Panel first. Here’s what happens:

  1. Initial check – The Triage Panel confirms the referral is complete, signed off by your line manager/senior lead, and uses the correct ICDP form.
  2. Scope and relevance – The case is checked against ICDP’s remit to ensure it genuinely falls outside existing statutory, policy, or contractual funding routes (e.g. CHC, Section 117, IFR, Local Authority, PHB, NHSE).
  3. Evidence review – The panel checks that all sections of the form are filled in and that sufficient clinical and commissioning evidence has been provided.
  4. Decision at triage –
    • If the case is suitable, it is escalated to the full ICDP panel.
    • If the case is incomplete, more information will be requested.
    • If the case is out of scope, it will be redirected to the correct pathway.
  5. Feedback and record – The outcome is shared with the referrer, and a log is maintained of all triaged referrals for learning and governance purposes.

Governance and Escalation

  • The panel has delegated authority for individual decisions of up to £20,000 per case in any twelve months.
  • Cases above this threshold are escalated to the Chief Nursing Officer, Chief Medical Director, and/or Chief Financial Officer (or equivalent), as appropriate.
  • It is to be noted that governance arrangements will become formalised as CPICB transition into Central East ICB. 

Supporting Documentation

*The following documents support the ICDP process; please contact the ICDP Administration Team should you require any further support: cpicb.icdp@nhs.net

  1. ICDP Terms of Reference
  3. ICDP Referral Form
  4. ICDP Decision Making Template
  5. ICDP Referral Form Completion Guide (For Referrers)
  6. Decision Making Guide Notes for ICDP Panel
  7. Quick Reference Guide (when to refer to ICDP or other panels)
  8. Understanding Commissioning Responsibilities