Prior Approval Request (PAR)

A prior approval request is normally defined as a request for a patient to receive routine treatment outside of local services or established contractual arrangements. 

The prior approval route should only be used when all treatment options available within locally provided or contracted services have been exhausted, and it is clinically appropriate to consider accessing healthcare services elsewhere. 

Such a request will normally fall within one of the following categories: 

• Second opinion 

• Lack of local/commissioned service provision/expertise 

• Clinical continuity of care (considered on a case-by-case basis) 

• Transfer back to the NHS following self-funding in the private sector 

• Re-referral following a previous tertiary referral 

• Students 

• Veterans 

The Prior Approval policy does not apply to the following factors: (lifted from PAR policy)  

• Non-clinical factors (such as employment status) will not be considered when making decisions on prior approval requests. 

• Waiting time factors will not be taken into account when considering prior approvals as this will theoretically prioritise some patients over others who are in the same clinical position. 

• Patient choice. The NHS in Wales does not operate a system of patient choice. However, cross-border patients are able to choose their secondary care provider. Following submission of a fully completed Prior Approval application form, an independent panel of healthcare professionals and lay members will meet to consider the Prior Approval request and the clinical evidence. 

Please be aware: 

• Prior Approval funding does not cover healthcare travel costs. Go to the Get Help With NHS Travel Costs page on the Welsh Government website to find out if you are entitled to help with NHS travel costs.  

• Requests will not be considered for retrospective funding. 

• Personal details relating to the patient are always kept confidential.