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Croydon CCG stops funding IVF treatment to save £800 000 a year

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j1403 (Published 20 March 2017) Cite this as: BMJ 2017;356:j1403
  1. Matthew Limb
  1. London

Campaigners fear that a hospital fertility centre could close after NHS commissioners in Croydon became the first in London to stop routine funding of in vitro fertilisation (IVF) treatment.

The NHS Croydon clinical commissioning group (CCG) said that it had taken the decision to help save over £800 000 a year, although 77% of people who responded to its consultation had opposed the closure. Agnelo Fernandes, a Croydon GP and the CCG’s assistant clinical chair, said, “This is one of the hardest decisions of my professional career, and I wish we were not in the position of having to make it.”

Croydon Health Services NHS Trust said that the future of the service at Croydon University Hospital was now “uncertain,” as the CCG was its main commissioner.

A trust spokesperson said, “Croydon CCG has made a very difficult decision, but the impact cannot be underestimated. Our IVF service has treated thousands of women.

“The CCG has made a commitment to continue funding patients already on our waiting list. However, as of 14 March 2017, the CCG will only consider IVF funding applications from GPs or consultants for those with exceptional clinical circumstances.”

A campaign group, Fertility Fairness, said that Croydon had become the fifth CCG in England and the first in London to stop routine IVF funding, following on from Basildon and Brentwood CCG, North East Essex CCG, South Norfolk CCG, and Mid Essex CCG.

Steve Reed, Labour MP for Croydon North, said this meant that the fertility unit at Croydon University Hospital could close and cause “heartbreak” for couples forced to seek private treatment.

“Croydon CCG should rethink their decision, and the government should step in and give our NHS the funding it needs to maintain services,” he said.

NHS Croydon CCG’s governing body decided on 14 March to fund IVF and ICSI (intracytoplasmic sperm injection) “only for those with exceptional clinical circumstances.” Asked about the future of the fertility clinic, a CCG spokesperson told The BMJ, “In response to the concerns regarding potential clinic closure, we have provided a list of alternative providers of IVF, which can be found in our governing body papers.”

Fernandes commented, “This is a very emotional subject—and that is shown in the majority objection we have had to this proposal through the consultation. However, it is our role to look at the entirety of health needs across the borough, and we have a statutory duty to prioritise the limited resources we have available to us.”

Emily Symington, a GP member of the CCG, said that the decision would be reviewed in a year’s time. “I think we owe it to the people who will be affected by this decision to do everything we can in the other areas of our financial savings plan so that, in the future, we hope to be financially able to reinstate this funding,” she said.

Croydon CCG had been funding around 150 cycles of IVF a year, costing over £800 000. The group was offering one IVF cycle to couples, compared with the three cycles recommended in national guidance. Croydon CCG has said that it needs to save almost £36m in 2017-18, about 6% of its £482m commissioning budget for local health services.

The CCG and Croydon Health Services NHS Trust were both placed in financial special measures in 2016, although these were lifted from the trust earlier this year.

Sarah Norcross, co-chair of Fertility Fairness, said it was “shocking” that Croydon CCG had disregarded public opinion and that the action would be devastating for people unable to have a baby without medical help. The campaign group’s updated 2016 audit of England’s CCGs indicated a move to “sustained disinvestment in NHS fertility services in England.”

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