Four clinical commissioning groups which were planning to cut costs by reducing the number of IVF cycles they fund will now face an increased bill, after rowing back on the decision.
The four CCGs in north and west Kent and Medway, which had proposed to reduce their number of funded cycles from two to one, have now cancelled that plan. In addition, they have agreed to commission services using donated eggs and sperm. These services open up IVF to lesbian couples and heterosexual couples unable to use their own genetic material.
Kent County Council’s health overview and scrutiny committee was told the policy on donated genetic material was being reexamined after a complaint it effectively excluded same-sex couples from fertility treatment. CCGs nationally have also been warned policies which discriminate against same-sex couples could be unlawful.
It is not clear why the four CCGs decided not to continue with plans to halve the number of funded cycles.
Had West Kent, Medway, Swale and Dartford, Gravesham and Swanley CCGs reduced the number of cycles, it would have led to a disparity between the east of Kent and the rest of the region, despite a merging of all of the area’s eight CCGs being mooted for next year.
The original decision to cut cycles was made to save money. Adam Wickings, joint chief operating officer for West Kent CCG, told the HOSC in November 2017 that the CCGs were “committed to being honest about the drivers behind the change, notably the requirement to find savings”.
The four east Kent CCGs – Ashford, Canterbury and Coastal, South Kent Coast, and Thanet – will also fund IVF and other fertility services with donated genetic material. The move is expected to potentially increase the yearly spend on IVF across Kent and Medway from £1.7m to around £2.3m.
The CCGs also want to commission new providers. Current contracts with BMI Chelsfield Park in Orpington and Care Fertility in Tunbridge Wells have expired, although the CCGs have continued to commission services with these providers. A third provider – BMI Chaucer in Canterbury – withdrew in 2017, leaving people in east Kent with long journeys to access services.
The CCGs risked a legal challenge from potential providers if they did not go out to procurement, according to governing body papers for Medway CCG, which is leading on procurement.
Although the CCGs are not currently reducing cycles, the procurement will state the number of funded cycles “may” reduce at some time in the future, if some or all CCGs decide to go out to consultation. Some of the CCGs have already been through pre-consultation engagement on a possible reduction and found those who responded “mostly disagreed”.
A report to Swale CCG’s governing body last month suggested a consultation on reducing the number of funded cycles could still go ahead. “There is likely to be a further delay before the policy review relating to the number of IVF cycles recommences, whilst a consultation timeline is agreed,” it said.