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Statement from North East Lincolnshire CCG following IVF presentation to NELC Health Scrutiny Committee

Last year North East Lincolnshire CCG Council of Members (COM) agreed that with effect from the 7th August 2015, the CCG would move to funding one cycle of IVF, rather than three.

The  proposal was taken to COM for consideration because of the need for cost containment at a time of increasing financial challenge Prior to this, the CCG was one of only 18% of CCG’s in England who were funding three cycles; however, year on year IVF treatment costs were spiralling.

The COM decision reflected members’ desire to enable the available funding to support the maximum number of individuals to receive NHS funded IVF treatment. The decision was not based on any local view of clinical efficacy (national NICE guidance was accepted and taken into account), nor to provide a cost reduction.

COM requested that transitional arrangements be put in place for patients who were already receiving IVF treatment at the time of the decision. Patients, who were already receiving their first cycle on the 7th August 2015 could be offered a second and those patients who were already on their second at that time could be offered a third cycle. This decision meant that patients who had not yet started a cycle of IVF before 7th August 2015 would be offered one cycle in accordance with the amended policy.

North East Lincolnshire Clinical Commissioning Group was asked by the Health Scrutiny Panel to review the way it had applied its 2015 decision to move to funding one cycle of IVF. The CCG was also asked to reconsider the position of patients who were already on the care pathway when the decision was taken.

As a result, a review group was established by the CCG. The members of the group were Mr Mark Webb (CCG board chairman), Mrs Cathy Kennedy (Deputy Chief Executive), Mr Phillip Bond (lay board member), Michelle Barnard, Assistant Director for Women & Children’s Services, Councillor Jane Hyldon-King (lay board member, Deputy Leader of North East Lincolnshire Council and Portfolio Holder for Health), Mr Geoff Barnes (Deputy Director of Public Health), Dr Marcia Pathak (local GP and Clinical Lead for Women and Children’s services), and Mrs Pam Taylor (community representative for Women and Children’s services).

The review group’s report to Scrutiny can be obtained from North East Lincolnshire Council’s website and North East Lincolnshire Clinical Commissioning Group’s website. This highlights a number of lessons that have been learned in the application of this 2015 decision which will inform the way we apply or implement future decisions:

  • Each decision-making forum in the CCG will be tasked with ensuring that good practice in public and patient engagement is consistently applied to every significant service decision
  • Communication with individuals directly affected by a decision will be led (or assured more closely) by the CCG
  • There will be an extra emphasis on website and public information/awareness raising, especially where direct communication with individuals is problematic to achieve
  • Agreed service changes will be communicated to key stakeholders as rapidly as possible
  • The CCG document control policy has been amended to ensure that updated policy documents are made available on the website within a reasonable timeframe
  • New IT processes will ensure that out-of-date policies are not readily  accessible via search engines
  • Better processes will be established between the CCG and the Health Scrutiny panel

In regard to the position of patients already on the care pathway when the decision was taken, the group considered the transitional arrangements offered to individuals in two categories. Firstly, those patients who had not yet been referred to the specialist IVF provider (no transition arrangements had been offered to this group in the original decision). Secondly, those patients that had already been referred to the specialist IVF provider (transitional arrangements had been offered to this group in the original decision). In both cases, on balance, the review group concluded that the decision taken on transition arrangements was reasonable and appropriate. The rationale for this decision is set out in review group’s report to Scrutiny. However the review group identified there were lessons learned for the future including:

  • There will be explicit consideration of the most appropriate period of time that is to elapse between each service decision being taken and its effective date, to enable sound awareness-raising and communication

Should anyone affected by this decision wish to speak to somebody about this, they should contact the CCG Customer Care Team on 0300 3000 500 or by email to nelccg.askus@nhs.net.

ENDS


For further information contact the North East Lincolnshire CCG Communications Team on 03300 249301.

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