2. What is the average cost of a cycle of an IVF cycle funded by the CCG and what does that include?

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1 Communications & Engagement Team 1st Floor North Point Cardinal Square 10 Nottingham Road Derby DE1 3QT Tel: Fax: Our ref: 340/16 Tuesday 26 July 2016 Re: Freedom of Information Act Request Thank you for your dated 14 July 2016 requesting information from NHS Southern Derbyshire Clinical Commissioning Group. I can confirm we do hold the information you require. You asked us to provide the following information: 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 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 fulfil? m. Do you fund fertility preservation for cancer patients and if so what budget is the funding taken from? 2. What is the average cost of a cycle of an IVF cycle funded by the CCG and what does that include?

2 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? 5. When will the CCG review its assisted conception policy? 6. Is the assisted conception policy available on the CCG s website? If so please provide a link to the policy. 7. Please could you provide me with a copy of your assisted conception policy? 8. Which MPs cover the boundaries of the CCG? 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 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? 13. In the last 12 months, how many women aged between has the CCG funded IVF treatment for? What does the CCG estimate this to have cost? 14. What advice has the CCG sought concerning the most cost and clinically efficient methods of setting up their tertiary infertility services? a. Where was this advice sought from? b. When was this advice sought? 15. I would also like to request permission to re-publish the data provided in a publically accessible document/web-format. I can provide the following information: The NHS Southern Derbyshire Clinical Commissioning Group IVF policy can be found on our Primary Care website here: All information requested in question one can be found within the policy. 2. What is the average cost of a cycle of an IVF cycle funded by the CCG and what does that include? 2700 for in vitro fertilisation (IVF) 2897 for Intra-cytoplasmic injection (ICSI) 800 for frozen embryo replacement (FER) Cost includes one course of IVF and or Intra-cytoplasmic sperm injection (ICSI), ovarian stimulation, egg collection, embryo transfer, drug therapy, follow up, frozen embryo storage, frozen embryo replacement (FER). 3. What providers does the CCG contract with to provide IVF services?

3 A list of providers is confirmed below: CARE Fertility Sheffield CARE Fertility Nottingham CARE Fertility Northampton NURTURE Cambridge IVF Oxford Fertility Unit 4. When was the current assisted conception policy developed? And who was consulted? As stated within the policy document, the IVF policy was developed in 2013 and was formally published on 1 April A list of individuals consulted on the drafting of the policy is included on page two of the document. 5. When will the CCG review its assisted conception policy? As stated within the policy document, the IVF policy will be reviewed in April Is the assisted conception policy available on the CCG s website? If so please provide a link to the policy. As stated above, the IVF/ICSI policy can be viewed on the NHS Southern Derbyshire Clinical Commissioning Group Primary Care website: 7. Please could you provide me with a copy of your assisted conception policy? As stated above, the IVF/ICSI policy can be viewed on the NHS Southern Derbyshire Clinical Commissioning Group Primary Care website: 8. Which MPs cover the boundaries of the CCG? The following MPs cover southern Derbyshire: Amanda Solloway Heather Wheeler Margaret Beckett Nigel Mills Patrick McLoughlin Pauline Latham 9. Has the CCG conducted any financial modelling on the cost implications of funding three full cycles of IVF? Yes, financial modelling on the cost implications of funding three full cycles of IVF was undertaken as part of the review of the IVF Policy undertaken during 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 NICE guideline?

4 NICE Guideline 156 makes a recommendation to CCGs to fund 3 cycles, the Guideline does not place a statutory duty onto the CCG to implement the recommendation. The Guideline also states under Recommendation 121: Inform people that the overall chance of a live birth following IVF treatment falls as the number of unsuccessful cycles increases. The recommendation was considered as part of the clinical and cost effectiveness of funding more than one cycle of IVF. The CCG has a responsibility to take account of priorities for funding all treatments and on the grounds of cost and clinical effectiveness it was agreed to fund one cycle of IVF. 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? The policy adopted by NHS Southern Derbyshire Clinical Commissioning Group is in collaboration with all Clinical Commissioning Groups within the East Midlands. 12. In the last 12 months, how many patients have applied for fertility funding (both successfully and unsuccessfully) through an Individual Funding Request? To date, no patient has applied for fertility funding through an individual funded request. 13. In the last 12 months, how many women aged between has the CCG funded IVF treatment for? What does the CCG estimate this to have cost? I can confirm between April 2015 and March women aged between had received NHS Southern Derbyshire Clinical Commissioning Group funded IVF treatment. The total estimated cost is 28, What advice has the CCG sought concerning the most cost and clinically efficient methods of setting up their tertiary infertility services? a. Where was this advice sought from? b. When was this advice sought? Monthly reports on the costs and the outcome of NHS funded IVF/ICSI treatments; the reports include a breakdown at Provider level so that CCGs can benchmark cost and clinical effectiveness across all IVF Providers who hold a NHS Standard Contract. CCGs can request further information on cost and clinical effectiveness from IVF Providers as part of the Service Conditions within the NHS Standard Contract at any time. 15. I would also like to request permission to re-publish the data provided in a publically accessible document/web-format. NHS Southern Derbyshire Clinical Commissioning Group grant permission to Fertility Fairness to republish the information provided above in a publically accessible document and/or web-format. I hope that the information meets your requirements. Should you have any further enquiries or queries about this response please do not hesitate to contact me. However, if you are unhappy with the way in which your request has been handled, you can raise any concerns you might have by contacting Helen Dillistone, Director of Corporate Development, at the following address: 1 st Floor North Point, Cardinal Square, 10 Nottingham Road, Derby, DE1 3QT. Telephone:

5 If you remain dissatisfied, you can apply to the Information Commissioner, who will consider whether NHS Southern Derbyshire Clinical Commissioning Group has complied with its obligations under the Act, and can require NHS Southern Derbyshire Clinical Commissioning Group to remedy any problems. You can find out more about how to do this, and about the Act in general, on the Information Commissioner s website at: Complaints to the Information Commissioner should be sent to: FOI/EIR Complaints Resolution, Information Commissioner s Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF.