People in Bury asked to share views on potential IVF policy changes

Author: Astrid Quinn

Patients and the public are invited to share their views on proposals to review Bury’s current policy in relation to commissioning In Vitro Fertilisation (IVF) services.

The consultation will run for six weeks from Monday 6th August to Sunday 16th September 2018.

Within the consultation document the CCG describes the reasons why it is considering changing its policy on commissioning IVF services, and seeks feedback from local people, stakeholders and health care professionals on a range of options.

An important part of the survey is to offer the opportunity for people to highlight if they feel the CCG has failed to consider something significant before coming to a decision.

IVF is one of several techniques available to help people with fertility problems have a baby.

NHS Bury CCG is one of only four CCGs in the country that provides IVF fully in line with NICE guidelines, including offering up to three funded cycles.

One cycle of IVF comprises an episode of stimulation of ovarian function which hopefully results in one to several eggs being harvested. After eggs are harvested, the best ones are fertilised and the most viable embryo is then implanted in the womb. Any other fertilised eggs that are viable are frozen. A cycle completes either with the birth of a baby or when all the viable embryos have been implanted, generally one at a time.

Bury’s projected spend for IVF in 2018/19 is around £320,000. The majority of CCGs in England offer one funded cycle.

Summarising the reasons why the CCG is considering changing its policy on commissioning IVF services:

• It has a duty to live within its financial allocation and to break even (balance the books) each year.

• Whilst the CCG has moved from being one of the most underfunded CCGs to starting to close the financial gap, challenges still remain.

• In recent years the CCG has been able to manage expected financial gaps through the use of non-recurrent (one off) monies, unfortunately these opportunities are now very limited and more radical solutions need to be identified to close the expected financial gap (deficit).

• The CCG has explored all areas of spend in relation to cost effectiveness, clinical outcomes and essential services.

• NICE fertility guidelines make recommendations about who should have access to IVF treatment on the NHS. However, the final decision about who can have NHS funded IVF in England is made by local CCGs whose criteria may be stricter than those recommended by NICE.

• In assessing the clinical and cost effectiveness of IVF, evidence shows that this falls as age increases, and falls with each unsuccessful cycle.

• The CCG is currently one of only four CCGs in the country that provides IVF fully in line with NICE guidelines, including offering up to three funded cycles.

• The majority of CCGs in the country provide one funded cycle of IVF.

• The CCG’s Clinical Cabinet and Governing Body consider that other types of healthcare should take priority over the current level of funding for IVF services

After reading a consultation document which includes information about the reasons why the CCG is considering changing its policy on commissioning IVF services, views can be fed in through a survey on a range of options. The options include continuing to offer up to three funded cycles of IVF; reducing provision to two funded cycles; reducing provision to one funded cycle and moving to providing zero funded cycles and therefore no longer funding IVF services.

Dr. Jeff Schryer, Chair of NHS Bury CCG said: “We know that infertility is a very difficult issue for those affected by it. As part of a review of all services that we plan and purchase, we have been faced with some very difficult conversations including considering whether IVF services should continue to be funded as they currently are.”

“Whilst the CCG Governing Body felt that other types of healthcare should take priority over the current level of funding for IVF services, it did not highlight a preferred option and instead wanted to consult on the full range of options with local people. The challenging financial situation we face means that maintaining the current level of provision of IVF would mean that we would need to consider other areas of healthcare in order to make the required savings.”

Feedback from the consultation period will help to inform the Governing Body to make a decision on the future provision of IVF in Bury at its meeting on 26th September 2018. The Governing Body meets in public and will publish the outcome of the consultation on its website, through social media and via the press and media.

How to get involved:

You can access the consolation document by following the link: https://security-eu.mimecast.com/ttpwp#/checking?key=bmV3c0BoaXRzcmFkaW8uY28udWt8ZGYwZGM4MjYtYmVmNC0zMjk4LWFlMDYtMGM2NjUxYjgyYzcy

The online survey is available here: https://www.surveymonkey.co.uk/r/3MCJ9TB

Requests for presentations to specific groups or meetings are welcome via email to buccg.communications@nhs.net