FINANCE: A financially challenged primary care trust has lifted the bar it placed on IVF services, despite continuing to overspend at a rate of £600,000 a month.

The board of the NHS Bury, which reported a year-to-date deficit of £4.3m at the end of January, last week agreed to reinstate the assisted conception services it suspended in September.

It has also agreed to consider, alongside others in the north east sector of Greater Manchester, the possibility of relaxing qualification thresholds they had placed on cataract treatments and hip and knee replacements.

The PCT’s board said it would instead be introducing a new package of measures to achieve financial recovery, which would affect all elective procedures.

According to its 2011-12 financial plan, “thresholds across all areas of elective activity” will be introduced that will be decided by emerging commissioning consortia.

A statement released by NHS Bury said in the coming financial year “all non-emergency referrals will go through a strict ‘gateway’, where independent GPs will ensure that procedures meet the appropriate criteria”.

IVF and assisted conception would now be dealt with according to National Institute for Health Clinical Excellence guidelines – which recommend up to three cycles be offered to eligible couples – and “will be subject to the same strict gateway process”.

In September, the financial plan said the commissioner was overspending at a rate of £1.3m a month. By January it had reduced this to a rate of £600,000 a month, which was maintained in February.

But the addition of new cost pressures, plus the requirement on all PCTs to set aside “contingency funds” and to generate a surplus next year, means Bury estimates it will have to make savings of £25.6m next year to break even.

NHS Bury was one of a number of PCTs –including NHS Warwickshire, NHS Surrey and NHS South West Essex – that announced last year they were suspending funding for IVF and other procedures deemed as low priorities in order to bolster their financial position, such as cataracts and tattoo removal.

The changes in IVF availability sparked a letter in January from NHS deputy chief executive David Flory calling for PCTs to abide by the NICE guidance.