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Researcher Guidance for Public Health and Social Care Excess Treatment Costs (ETCs)


Published: 01 December 2018

Version: 7.0 | February 2024

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Excess Treatment Costs (ETCs) are defined as the difference between NHS treatment costs and the costs of existing standard treatment. For the purposes of this guidance, non-NHS ETCs (or non-NHS intervention costs) are interventions or services that are outside of the remit of the NHS (often Local Authority commissioned) and not covered by existing arrangements for payment by service commissioners.

Whilst it is expected that as a matter of principle the organisation responsible for commissioning the intervention or service being researched should pay intervention costs or provide equivalent resources, where this has not been possible public health and social care research studies funded by non-commercial funders may be eligible for support from the Department of Health and Social Care (DHSC).

The DHSC and NIHR recognise that, in some situations, it is not always possible for the total costs of interventions under evaluation to be secured. For situations where reasonable steps have been taken to secure intervention costs, DHSC and NIHR are piloting interim arrangements to support non-NHS ETCs for research into public health and social care. A longer term policy is being developed for application during 2024.

The process for applying for non-NHS ETCs support for public health and social care research studies

The NIHR Public Health Research (PHR) and Research for Social Care (RfSC) pilot

To apply for non-NHS ETCs support for public health and social care studies funded by the NIHR PHR and RfSC Research Programmes, researchers are required to complete a proforma.

The proforma asks for various details about the intervention costs needed, including the level engagement of the commissioning organisation and any direct or in kind support. The proforma will be considered by the relevant NIHR Funding Committee and requests approved by the Programme Director.

Researchers can direct any queries about eligibility or request the proforma to the appropriate NIHR Research Programme by emailing:

Other NIHR programmes and non-NIHR funded studies

To apply for non-NHS ETCs support for public health and social care studies funded by other NIHR Research Programmes (e.g. HTA and HS&DR), or non-NIHR funded studies, the NIHR Clinical Research Network (CRN) Triage Helpdesk will continue to direct researchers to DHSC where they will be asked to complete a proforma to apply for non-NHS ETCs.

Please note that NHS public health and social care research studies that require the recruitment of individuals within an NHS setting (i.e. acute, ambulance, mental health, community or primary care) or an episode of care, will continue to be supported through the appropriate NIHR Local Clinical Research Network (LCRN).

Further information about all ETC processes can be found on the Excess Treatment Costs webpage or via

For further queries and guidance please email

Useful links

Online SoECAT guidance