Agenda item

Stuart Jeffery (Chief Operating Officer, NHS Medway CCG) and Adam Wickings (Joint Chief Operating Officer, NHS West Kent CCG) were in attendance for this item.

(1)       Mr Jeffery advised the Committee that Medway CCG was the lead CCG for IVF and all assistive reproductive technologies (ART) in Kent.  He introduced the report which outlined proposals for a review of the service.  Mr Jeffery explained that the review outlined was undertaken as part of the CCG’s standard review cycle but also because it had become evident that the service offer provided by Kent and Medway was different to that offered in rest of the country, notably that Kent and Medway were offering two cycles of therapy when other health areas only offered one or fewer.  He also noted that it had recently been identified that the current policy may have discriminated against same sex couples, which was an issue the CCG was keen to address as soon as possible.  He advised that the report set out the process, timeline and planned consultation work as part of the review, which would latterly involve bringing the proposals back to the Committee for further consideration in due course.

(2)       Steve Inett, Chief Executive, Healthwatch Kent, extended an offer to support stakeholder engagement to assist the CCG with capturing public views and identifying potential issues.  He also queried how the CCGs were planning to align ongoing service changes to ensure effective consultation.  Mr Jeffery, explained that consultation planning was ongoing and that stakeholder engagement was planned, with potential for agencies to be employed to support this work.  Mr Wicking noted the large scale of the Kent and Medway area and that it contained a significant range of different population and stakeholder groups.  He also explained that work was undertaken by the Commissioning Support Unit (CSU) to try to plan and programme in consultation and engagement activity so that the schedule was not overwhelming or confusing for stakeholders.  Mr Jeffery reassured the Committee that the planned consultation work would involve using professional organisations to support obtaining a representative sample of views.

(3)       Responding to questions regarding the proposed reductions, Mr Jeffery explained that each cycle included one frozen embryo and one fresh embryo.  This meant that the current two cycle approach involved four embryos and it was proposed that this drop to two, in line with wider practice nationally. 

(4)       Responding to a question regarding the planned provision for patients who may require ART in order to conceive as a result of injury or trauma, Mr Jeffery advised the he would confirm the full policy details and provide the information in due course.

(5)       Mr Jeffery reassured the Committee that there was no appetite in the CCG to completely remove ART provision but there was a recognition that it was appropriate to review and change the way it was provided.  As per the early stage proposals, it had been assessed that a reduction from two cycles to one cycle of treatment was appropriate.  Mr Wickings also commented that the CCG was basing the proposals on the best expert advice and that while it would not choose to implement such reductions, there were many difficult decisions to be taken and in light of the financial challenges, not saving money in one area would mean having to save money in other areas of medicine.  Responding to further comments, Mr Wickings advised that the CCGs were aware of the sensitivity of the subject but was committed to being honest about the drivers behind the change, notably the requirement to find savings while still maintaining critical care issues.

(6)       Mr Jeffery advised the Committee that the information provided represented the plans as far as they had been developed and that the CCG’s policy unit was still working to finalise the proposals to be put out to consultation.  He assured the Committee that the detailed proposals would be provided in January, when the CCG would also ask the Committee to advise on whether the matter should be considered as a substantial variation of service.

(7)       Responding to questions regarding service variations across the county, Mr Wickings explained that CCGs had been striving to operate on a Kent and Medway wide basis when planning service changes.  He clarified that this approach was positive but not always possible as each CCG has authority to make its own decisions.  He was hopeful, however, that the majority of Kent and Medway CCGs would make similar decisions around this service, preventing problematic service variations around the county.  Mr Jeffery commented that the planning and development of the policies did involve significant engagement and discussion with a range of CCGs and that this often encouraged greater consistency.

(8)       RESOLVED that the Committee:

(a)       notes that a review of the Assistive Reproductive Technologies (ART) policy is being undertaken by the Kent & Medway CCGs;

(b)       requests that the proposed revised policy is presented to the Committee in January in order for it to make a determination about the proposals constituting a substantial health service development or variation.