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Why do IVF cycle protocols vary so much by CCG?

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29 January 2018

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A north of England clinical commissioning group (CCG) could offer prospective parents in south Cumbria just one IVF cycle, while its neighbouring CCG will continue to provide three.

Morecambe Bay CCG, which covers south Cumbria and parts of north Lancashire, is running a consultation on assisted conception.

The 12-week consultation is part of an ongoing review of all clinical policies in south Cumbria and Lancashire. It is likely to bring in the same assisted conception rules across Lancashire.

A north of England clinical commissioning group (CCG) could offer prospective parents in south Cumbria just one IVF cycle, while its neighbouring CCG will continue to provide three.

Morecambe Bay CCG, which covers south Cumbria and parts of north Lancashire, is running a consultation on assisted conception.

The 12-week consultation is part of an ongoing review of all clinical policies in south Cumbria and Lancashire. It is likely to bring in the same assisted conception rules across Lancashire.

Meanwhile, North Cumbria CCG is continuing to offer three IVF cycles and has no plans to change.

‘Difficult choices’

The two CCGs covering Cumbria split last April.

Morecambe Bay CCG said the changes were on the cards as it ‘has a limited budget and must make difficult choices.’

It will be holding open forum events for patients and other stakeholders to find out more.

The consultation document said it was limiting the number of cycles as ‘the CCG cannot offer unlimited treatments.’

It said: ‘Given the current pressure on NHS resources and the need to more adequately fund higher priority services (those which more clearly have a purpose of preserving life or of preventing grave health consequences), coupled with the decreasing effectiveness of IVF treatment units, means CCGs must make difficult choices and limit the funding available to services of this nature.’

If the proposals are agreed, it will offer one cycle to patients who have not already had treatment for assisted conception anywhere.

The cycle will be available to women aged 18 to 42 and they and their partners must be non-smokers.

The move also see a uniform lower age limit of 18 across Lancashire, as some CCGs currently have an age limit of 23, or no age limit.

It would also set a uniform upper age limit, compared with a range between 39 and 43, depending on the CCG.

If adopted, the new policy would also mean that both partners would have to be childless – the current policy in three quarters of  CCGs covering Lancashire.

The consultation ends on April 6.

'Each CCG has finite resources'

Dr David Rogers, Medical Director and Accountable Officer of NHS North Cumbria Clinical Commissioning Group (CCG), said: 'Each CCG has finite resources available to them which they must use to best meet the needs of the populations that they serve, and as you will be aware, there are huge pressures on NHS budgets, especially here in Cumbria. In light of this, there will be differences between certain policies that individual CCGs are responsible for putting in place.

'Following changes to commissioning boundaries in Cumbria, NHS North Cumbria CCG adopted the same policies that were in place for NHS Cumbria CCG. We are not in a position to comment on policies that have been changed by other CCGs.

'Commissioning policies are reviewed on a regular basis, and following this it is to be expected that policies between individual CCGs will differ, as each CCG uses its own budget to ensure the needs of its population are met.'

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