• Four CCGs want to look at reducing number of cycles offered but four don’t
  • Split comes after the eight CCGs agreed to work together
  • Policies on donated sperm and eggs also likely to change

Eight clinical commissioning groups which were meant to work together under a single accountable officer are split on one of their first major commissioning decisions.

The CCGs across Kent and Medway currently have a uniform policy on commissioning IVF, paying for two cycles of treatment – involving one fresh and one frozen embryo transfer per cycle – but not for the use of donated eggs and sperm.

The CCGs have been considering lowering this to one cycle but allowing the use of donated genetic material, which would benefit same sex couples and other couples with some forms of infertility.

However, four of the CCGs – those in East Kent – have now said they do not wish to go ahead with any moves to change the number of cycles. Of the others, Medway has already carried out pre-consultation engagement, Swale, and Dartford, Gravesham and Swanley, are currently doing the same and West Kent has said it will do so but has not started.

The differing approaches are already creating concerns this will lead to a postcode lottery in the county with some areas offering more cycles than others. A report to Kent County Council’s health overview and scrutiny committee warns of the potential for reputational damage and the need to work through the implications of such a split with NHS England.

In April, the CCGs announced they were to share an accountable officer – Glenn Douglas – and would work together as a single strategic commissioner.

Funding treatment with donated genetic material could wipe out some of the savings from reducing the number of cycles. However, the report to the HOSC says that NHS Medway – the  lead commissioner – believes the policy on donated gametes needs to change to meet the requirements of legislation such as the Equality Act. This policy will be addressed separately to the number of cycles.

A spokesman for the CCGs said: “Although covered by the same sustainability and transformation partnership, the individual CCGs across Kent and Medway maintain their own decision making rights, which is why they are not all proposing the same changes.

“In east Kent, the CCGs are about to embark on a major public consultation regarding the reconfiguration of hospital services that will require substantial clinical and managerial leadership. The outcome of the consultation will inform the future direction of NHS services in east Kent. Therefore, the CCGs agreed that running a second concurrent public consultation on IVF at this stage would be distracting.

“It is important people understand that no decisions have been made and a formal consultation is yet to begin.”

Over the last few years, many CCGs have restricted access to IVF with around 60 per cent now funding only one cycle.

NHS England did not respond to a request for a comment.

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