FOI Summary Issue: IVF Policy. This information relates to Bristol Clinical Commissioning Group

Transcription

1 FOI Summary Issue: IVF Policy This information relates to Bristol Clinical Commissioning Group 1. According to your current IVF treatment policy: a. How many cycles of IVF do you offer to eligible patients? b. Do you fund a full cycle of IVF, as defined by NICE, which includes replacement of all frozen embryos? If not how many frozen embryo transfers do you fund? c. What is your upper and lower age limit that female patients must meet in order to qualify for treatment? d. Do you fund one full cycle of IVF for women aged in line with the 1 Taken directly from our fertility policy ( - For the purposes of this policy, the commencement of IVF/ICSI cycle is defined as commencement of ovarian stimulation by fertility services, or if no drugs are used, when an attempt is made to collect eggs/oocytes. Any patient who completes this step, regardless of the outcome, is deemed to have had one full cycle of IVF/ICSI. Therefore if a cycle is abandoned for clinical reasons this is still counted as the fresh cycle that the couple are entitled to. One frozen cycle using frozen embryos will follow a fresh cycle if deemed clinically appropriate. Patients will not be eligible for further NHS funded investigation and fertility treatment following completion of this cycle. See answer above. The prospective mother must not be older than 18 weeks before her 40th birthday at referral as no female patient will be placed on the waiting list for secondary care fertility assessment within 18 weeks of their 40th birthday. No lower age limit exists. No. Page 1 of 7

2 NICE guidance? e. Do you have an age criteria that male patients must meet in order to qualify for treatment? If so, please state what the criteria is. f. What must the smoking status of patients be? g. What weight requirement exists (i.e. BMI)? h. How long do couples need to be trying to conceive before becoming eligible for treatment? i. Is there a minimum period that the couple need to have been in a relationship before becoming eligible for treatment? j. What eligibility criteria do you apply in relation to existing children that either one or both partners may have? k. What policy is in place (if any) for the use of Single Embryo Transfer? l. Do you fund fertility treatment for same sex couples, and if so what eligibility criteria do they have to fulfill? The prospective father is aged up to 55th Birthday. Non-Smoker The prospective mother s body mass index (BMI) must be between 19 and 29.9 kg/m2 2 years. The couple have been in a stable relationship for at least two years. At least one partner must have no living offspring/children to qualify for funding. This includes genetic and legally adopted children and offspring who are adults but does not include foster children or step children. If the couple adopt a child or become pregnant naturally during assessment or treatment the couple are no longer eligible for fertility assessment or treatment. Our policy offers patient one single embryo transfer and one frozen. Yes. Same general principles for all patients and Section C - Investigation, Assessment and Advice on Fertility Issues for Same Sex Couples (For review and consideration by the GP at time of Referral to fertility services) In order to access services to Page 2 of 7

3 investigate and assess issues with fertility, couples must meet all of the following criteria: 1. The couple have been in a stable relationship for at least two years. 2. Same sex couples may be assessed if self funded insemination on at least ten nonstimulated cycles over a period of two years has failed to lead to a pregnancy or oncology treatment is likely to compromise the fertility of the prospective mother. NHS funding is not available for access to donor insemination facilities for fertile women or surrogacy. 3. Either a. both partners have fertility issues ie blocked fallopian tubes or anovulation, or b. where only one partner is sub-fertile, where possible, the partner who is fertile should try to conceive before proceeding to interventions involving the sub-fertile partner. 4. Recurrent miscarriage is not an indication for patients to access fertility services although they may be referred for gynaecological investigations and treatments if appropriate. 5. At least one of the partners must be registered with a GP in the BNSSG area. 6. The couple must not have previously received a cycle of NHS funded fertility treatment to the level outlined in this policy. 7. Patients who have previously self funded unsuccessful fertility treatment are eligible for NHS funded fertility treatment as long as they meet the criteria within this policy. Outcomes from previous fertility treatment will be considered as part of the clinical assessment and patients should be aware that multiple failures to conceive through fertility treatment is indicative of poor conception success rates. 8. The prospective mother must be a non-smoker as confirmed in their primary care records. Patients who are smokers should be referred to smoking cessation services and be able to demonstrate that they are non-smokers prior to assessment. Partners of prospective mothers who smoke should also be offered a referral to smoking cessation services in order to improve their health and support their partner. 9. The prospective mother s body mass index (BMI) must be between 19 and 29.9 kg/m2. The evidence is clear that obesity negatively impacts upon successful natural conception and fertility treatment. Prospective mothers with a BMI of 30 and above should be offered a referral to weight management services in order to reduce their weight prior to assessment and treatment by fertility services. 10.Where the prospective mother is aged between 37 and up to 18 weeks before her fortieth birthday, her BMI must be between 19 and 35 kg/m2 prior to referral for assessment. Prospective mothers with a BMI above 29.9 in this age group should be referred to weight management services at the same time as being referred to fertility services in order assist her to lose weight and aid fertility. 11.The partner of a prospective mother who has undertaken NHS funded fertility treatment, whether successful or not, will be deemed to have received their entitlement to NHS funded fertility treatment upon completion of this cycle in line with heterosexual couples and will not be eligible for a Page 3 of 7

4 m. Do you fund fertility preservation for cancer patients and if so what budget is the funding taken from? further NHS funded treatment with their partner. 12.The prospective mother has not been sterilised in the past even if it has been reversed and the sterilisation is the cause of the fertility problems. 13. Both members of the couple must accept joint legal responsibility for any child produced through fertility treatment. Yes it is commissioned as part of the cancer treatment pathway. N/A 2. What is the average cost of a cycle of an IVF cycle funded by the CCG and what does that include? 3. What providers does the CCG contract with to provide IVF services? 4. When was the current assisted conception policy developed? And who was consulted? 14/15 prices Covers - IVF / ICSI Full Cycle including FET North Bristol NHS Trust December 2014 Bristol Centre for Reproductive Medicine. Public Health 5. When will the CCG review its assisted conception policy? Due for renewal December 2017 but may be sooner subject to NICE guidelines/ publications and ongoing secondary care feedback. Page 4 of 7

5 6. Is the assisted conception policy available on the CCG s website? If so please provide a link to the policy. Yes Section D 7. Please could you provide me with a copy of your assisted conception policy? Section D 8. Which MPs cover the boundaries of the CCG? Karin Smyth Charlotte Leslie Kerry McCarthy Thangam Debbonaire 9. Has the CCG conducted any financial modelling on the cost implications of funding three full cycles of IVF? 10. If the CCG does not follow the NICE guideline, have they published the reasons why they do not follow the guideline? If so, what are the reasons for not complying with the No. No Page 5 of 7

6 NICE guideline? 11. In the last 12 months, or at the time of the last consultation on the IVF policy, has the CCG considered collaborating with other CCGs on the fertility policy? 12. In the last 12 months, how many patients have applied for fertility funding (both successfully and unsuccessfully) through an Individual Funding Request? NHS Bristol, NHS North Somerset and NHS South Gloucestershire CCG s [BNSSG] have limited resources to fund fertility treatments and have therefore targeted the limited funds specifically in order to allow couples in a stable relationship, a chance to conceive. Given the limits on resources, provision of treatments under this policy are aimed at patients with a realistic clinical opportunity of having a child. Bristol collaborates with North Somerset, South Gloucestershire and Somerset CCGs 38 IFRs requests received 7 IFRs requests Funded 29 IFRs requests Not Funded 1 Waiting Info 1 closed and no further information has been received 13. In the last 12 months, how many women aged 1 between has the CCG funded IVF treatment for? What does the CCG estimate this to have cost? 3, I would also like to request permission to republish the data provided in a publically accessible This information is licensed under the Open Government Licence v1.0. To view this Page 6 of 7

7 document/web-format. licence, visit or write to the Information Policy Team, The National Archives, Kew, Richmond, Surrey, TW9 4DU. Any enquiries regarding this publication should be sent to: or write to FOI Manager, Bristol CCG, South Plaza, Marlborough Street, Bristol, BS3 5AQ When you use this information under the Open Government Licence, you should include the following attribution: Bristol Clinical Commissioning Group, published 9 th July 2015 The information provided in this response is accurate as of 9 th July Page 7 of 7