Fertility Assessment and Treatment

  • Related keywords: IVF, ICIS, IUI, DONOR, DIUI, embryo transfer, sperm freezing, embryo hatching, cryopreservation.
  • Date: 1 Dec 2017
  • Who applies for funding: General Practitioner (GP), Consultant (CONS)

Referral Route:

Prior Approval (PA)

Is a process that requires the referrer to obtain prior authorisation for patients who meet the criteria. If the patient demonstrably meets the criteria, please forward the application to the IFR Team for approval and await confirmation that funding is in place before a referral is made. If the patient does not meet the criteria for funded treatment, then a referral can be made to the Individual Funding Request Panel, but only if there is clear evidence that the patient’s clinical circumstances or condition are exceptional, i.e. there is something about the patient’s condition or circumstances that differentiate them on the basis of need from other patients with a similar diagnosis or condition and would justify funding being provided in an individual case when it is not routinely funded for others. 

Please note any deviations from this policy, e.g. funding requests for a secondary care opinion only (where malignancy is not a concern), require Part C of the below application form completing and submitting to the Individual Funding Request team.

Funding requests from GP Practices can be accepted from Senior Clinicians, salaried GPs, Locum GPs or Practice Partners. Unfortunately we are unable to accept funding applications from other health professionals unless countersigned by a senior clinician or GP.

If you would like this policy in a different language or need it in another format, such as Braille, please contact the Patient Advice and Liaison Service on 0800 073 0907 or 0117 947 4477.

Criteria Based Access (CBA)

If the patient demonstrably meets the specific criteria for treatment, the patient can be referred directly via the appropriate Referral Service with a standard referral letter. If the patient does not meet the criteria for treatment then a referral can be made to the Individual Funding Request Panel but only if there is clear evidence that the patient’s clinical circumstances or condition are exceptional, i.e. there is something about the patient’s condition or circumstances that differentiate them on the basis of need from other patients with a similar diagnosis or condition and would justify funding being provided in an individual case when it is not routinely funded for others. Funding requests from GP Practices can be accepted from Senior Clinicians, salaried GPs, Locum GPs or Practice Partners. Unfortunately we are unable to accept funding applications from other health professionals unless countersigned by a senior clinician or GP.

If you would like this policy in a different language or need it in another format, such as Braille, please contact the Patient Advice and Liaison Service on 0800 073 0907 or 0117 947 4477.

For Patients:

No single fertility treatment is best for everyone. The treatment you are offered will depend on what is causing your fertility problems, the age of the prospective mother and your medical history.

Your GP will be able to carry out initial investigative tests before deciding to refer you for further Assessment at a General Infertility Clinic/Fertility Service.

Once you have been assessed, your consultant will apply for funding under the Fertility Assessment and Treatment Policy (see below). 

The IFR Team will advise you if funding is approved and you will be given details of the options available.  You will then be able to choose the clinic that is most suited to you to take your treatment forward.

Please note that the IFR Team will forward your referral to the clinic of your choice together with confirmation of funding approval.  You should not contact the clinic directly until the referral has been made.

 

For GPs:

Please refer to the Fertility Policy together with the GP Guidance document below. 

If you feel that your patient meets the CBA criteria please complete the Fertility Assessment Form and Preliminary Investigations Checklist and send to the General Infertility Clinic in the normal way.

Cover for GP Guidance - Assessment and Treatment of Couples with Fertility Problems

GP Guidance - Assessment and Treatment of Couples with Fertility Problems

This document has been produced by a fertility specialist detailing initial investigations that can be carried out in Primary Care prior to referral to Secondary Care.

Cover for Fertility Assessment Referral Form

Fertility Assessment Referral Form

This form should be completed by GPs and other clinicians who are referring patients to General Infertility Clinics for an initial assessment.

For Secondary Care:

Please refer to the Fertility Policy and the Fertility Treatment Referral and Funding Pathway below. 

If, following assessment, you feel that the patient meets the criteria to receive Licensed Fertility Treatment please complete the Fertility Treatment Funding Application Form below and send to the IFR Team at: IFR.BNSSG@nhs.net

Fertility_Treatment_Referral_Pathway

The following documents have been updated from 1st December 2017 and replace all previous versions.  Please remove old documents from your records.

Cover for Fertility Assessment and Treatment Policy

Fertility Assessment and Treatment Policy

Fertility Assessment and Treatment is not routinely funded by the CCG and is subject to this restricted policy.

Cover for Fertility Treatment Funding Application Form

Fertility Treatment Funding Application Form

This form must be completed by the Fertility Service to refer patients who meet criteria to receive Licensed Fertility Treatment.  Please send completed forms to the IFR Team.

Immigration health surcharge - removal of assisted conception services

Amendments to the NHS (Charges to Overseas Visitors) Regulations 2015 were introduced into Parliament on 19 July 2017.

As a result, from 21 August 2017, assisted conception services will no longer be included in the scope of services available for free for those who pay the immigration health surcharge.

We are in the process of updating our fertility policy and will include this requirement. Further information about the regulations can be found on the Legislation.gov.uk website

What we do and don't fund