FREEDOM OF INFORMATION ACT 2000 Birmingham CrossCity CCG Ref: FOI/ IVF Funding Policy

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1 Our Ref: FOI/ th August 2014 Bartholomew House 1 st Floor 142 Hagley Road Birmingham B16 9PA Tel FREEDOM OF INFORMATION ACT 2000 Birmingham CrossCity CCG Ref: FOI/ IVF Funding Policy Thank you for your request received 18 th July You requested information regarding IVF funding policy.. Your request for information has now been considered. I will answer your queries below: I am a Birmingham resident (B17 postcode) and am writing to request that you send me a copy of the CCG s current policy for IVF funding. In addition, I have noted that a revised policy went out for consultation earlier in the year. Please can you also share a copy of this policy and advise when it will be effective from? Please see attached Birmingham Cross City CCG s commissioning policy for infertility services. The revised policy is still in draft form and has not been finalised at the time of writing. Once approved and finalised it will be available on our website site. We are therefore applying section 22 of the FOI Act 2000 which is, Information intended for future publication. I hope this completes your request. Kind regards Donna Dallaway Senior Information Governance & Compliance Manager If you are unhappy with the way your request for information has been treated, you can request a review by contacting: Paul Sherriff Assistant Accountable Officer / Head of Corporate Services Birmingham CrossCity CCG Bartholomew House, 142 Hagley Road Birmingham B16 9PA If you further remain dissatisfied with the handling of your request following the trusts review, you have the right to appeal to the Information Commissioner at: The Information Commissioner s Office Wycliffe House, Birmingham CrossCity Clinical Commissioning Group Chair: Dr Gavin Ralston

2 Water Lane, Wimslow, Cheshire, SK9 5AF. Tel: or Website:

3 South Birmingham Primary Care Trust Heart of Birmingham Primary Care Trust Commissioning Policy for Infertility Services within Birmingham For Birmingham Primary Care Trusts 1

4 Commissioning Policy for Infertility Services within Birmingham Primary Care Trusts Patient Eligibility All requests for funding of fertility treatment will be assessed according to the relevant law and guidance in this area. Decisions will be made according to the individual circumstances of each request. The following criteria will be taken into consideration when a decision as to funding is being made: Defining Infertility Infertility should be defined as follows: One or both partners having been diagnosed as having some pathology that will significantly reduce the probability of natural conception Or Failure to conceive after regular unprotected sexual intercourse for 2 years in the absence of known reproductive pathology (unexplained infertility). Treatment should be offered as appropriate to the cause of infertility e.g. couples with unexplained infertility may be offered intrauterine insemination prior to being offered IVF in line with NICE guidelines. Single women who are infertile as defined, and same sex couples where one or both partners falls within the definition of infertility, may be considered for treatment in accordance with NICE guidelines and as above. IVF In line with NICE Guidance, couples referred for fertility treatment, after demonstrating a failure to conceive for a period of 3 years duration, should be offered up to 3 stimulated cycles of IVF treatment. Guidance states that PCTs should move towards offering 3 cycles and so for 2007/08, Birmingham East and North will be offering 1 NHS funded cycle this will be reviewed on an annual basis. (2008 this one cycle is inclusive of a frozen embryo transfer) 2

5 Maternal Age Funding will be provided for women in the age range 23 to 39 at the time of treatment, i.e. 23 at the time of treatment and up to the 40 th birthday. Referrals into the service should be made in appropriate time to ensure that treatment can take place by the woman s 40 th birthday. Maternal Weight To secure funding and to be accepted onto the waiting list, women should have a body mass index (BMI) in the range 19 to 30 inclusive. There is clinical evidence to demonstrate that a BMI within this range improves pregnancy rate. BMI must remain within the stated range at the time of treatment. Living Children There should be no living children, which include children from previous relationships. Once accepted for treatment, should a pregnancy leading to a live birth occur, the couple will no longer be eligible for NHS funded treatment. Previous assisted conception treatment Couples will not be eligible for NHS funding under the following circumstances: The couple have at any time previously received an NHS funded cycle The couple have undergone three cycles of treatment, whether NHS or privately funded. Sterilisation If either partner has undergone sterilisation and this is the cause of infertility in the couple then the couple will not be eligible for NHS funding. Funding will not be provided for reversal of sterilisation procedures. Smoking Status Funding for assisted conception will not be approved for couples where either partner smokes as smoking is proven to reduce fertility and is harmful during pregnancy. HFEA Code of Practice Couples not conforming to the HFEA s Code of Practice ( Code ), will be excluded from having access to NHS funded assisted fertility treatment. Same sex couples 3

6 Same sex couples will be assessed in line with the criteria as laid out in defining infertility in treatment centres in accordance with the Code. Treatment centres must have clear and unambiguous criteria for the assessment of all couples requesting treatment. Registered General Practitioner Couples must be registered with a Birmingham GP. Initial GP Assessment and Referral An initial assessment of a couple s sub fertility should be undertaken by their GP. This should include lifestyle advice in compliance with NICE recommendations, for example on BMI, smoking cessation, occupational hazards, alcohol and caffeine consumption and prescribed, over the counter and recreational drug use. For example: - Couples should be informed that the consumption of more than one unit of alcohol per day reduces the effectiveness of assisted reproduction procedures, including in vitro fertilisation treatment. - Couples should be informed that maternal and paternal smoking can adversely affect the success rates of assisted reproduction procedures, including in vitro fertilisation treatment. - Couples should be informed that caffeine consumption has adverse effects on the success rates of assisted reproduction procedures, including in vitro fertilisation treatment. In cases where couples meet all of the commissioning criteria, couples may be eligible for NHS funded specialist infertility treatment, i.e. Intra-Uterine Insemination (IUI), Ovulation Induction (OI), Tubal Surgery, In-Vitro Fertilisation (IVF), Intra-Cytoplasmic Sperm Injection (ICSI) and Gonadotrophin Therapy. In this instance they should be referred, using the attached form, to a Consultant Obstetrician and Gynaecologist at the following Trusts: - Heart of England Foundation Trust NHS Trust - Good Hope Hospital NHS Trust - Birmingham Women s Hospital Trust - Sandwell & West Birmingham NHS Trust A range of diagnostic tests will be undertaken within these Trusts. Following clinical investigation, individuals will be referred to a tertiary centre for the most appropriate fertility treatment. Exceptions For exceptional circumstances, your GP may contact the relevant PCT Individual Cases process. If you have any queries relating to this policy please contact your local Primary Care Trust 4

7 South Birmingham PCT Eastern Birmingham PCT North Birmingham PCT Heart of Birmingham PCT September

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