There is no National Institute for Health and Care Excellence (NICE) guidance on the use of the ioIAMD lens. Where NICE guidance does not exist on a particular treatment, it is for local National Health Service commissioners to make funding decisions based on an assessment of the available evidence and on the basis of an individual patient’s clinical circumstances.

NHS commissioners are required to have in place clear and transparent arrangements for local decision-making on the funding of treatments and for considering exceptional funding requests.

If a patient’s local clinical commissioning group, decides, on the basis of rational, proper consideration of the evidence, that a treatment should not be provided which the patient and their doctor have requested, patients must be provided with the reasons for that decision in writing.

The Government has been clear that restricting access to services on the basis of cost alone is wrong and compromises patient care. Commissioning decisions should be made on the basis of the available evidence of clinical and cost effectiveness.