What funding requests for treatments for ultra-orphan diseases it regards as being exceptional.

It is a matter for individual clinical decision in discussion with each patient as to the most appropriate treatment in each case.
Treatment(s) for people with rare diseases may be available locally, regionally, nationally and/or in some cases via UK specialised services through National Services Division of NHS National Services Scotland. Decisions regarding the provision of NHS services are a matter for NHS boards.
As far as medicines are concerned, the Scottish Medicines Consortium (SMC) appraises all newly licensed, prescription only branded medicines for clinical and cost-effectiveness and publishes advice for NHS boards. The SMC operates independently from the Scottish Government and NHS boards are expected to follow SMC advice.
Where a medicine has not been recommended for use within the NHS in Scotland by the SMC, NHS boards are not expected to make it routinely available. However, decisions regarding the provision of NHS services are a matter for NHS boards and all NHS boards have arrangements for clinically-led consideration of SMC “not recommended” medicines, including orphan medicines, for individual patients. The process for such consideration is known as Individual Patient Treatment Requests and clinicians are responsible for clinical decisions regarding the care of individual patients.