Croydon couples will no longer be able to get IVF on the NHS as CCG draws up plan to save £5.7m

Couples struggling to conceive in Croydon will no longer be able to get fertility treatment on the NHS under plans drawn up by health chiefs to save money.

Croydon Clinical Commissioning Group (CCG) is planning to cut all provision of the treatment, among other measures, as it tries to save an extra £5.7 million after it was placed in financial special measures earlier this year.

Paula Swann, the CCG’s chief officer, told a Croydon Council meeting last week “we don’t believe it’s clinically effective”, while Dr Tony Brzecki, chairman of the CCG admitted the health body was “between a rock and a hard place”.

At the moment, the CCG funds one cycle of IVF or ICSI – where the sperm is directly injected into the egg – when a woman has had unexplained fertility for at least three years, up until the age of 39.

Each cycle of IVF costs the NHS about £5,000, and148 cycles are planned for couples in the borough this year, though demand is expected to grow.

But under the plans, which are are to go out for public consultation before being rubber-stamped by the CCG, no such treatments will be funded at all, save for individual applications granted on “exceptional” grounds, which must be made by a doctor.

The CCG said cutting the fertility treatments will save about £800,000 each year.

During a meeting of Croydon Council’s health and social care scrutiny committee last week, councillor Sean Fitzsimons, who said he had a course of IVF with his wife, said the move would have a “long-term emotional impact on people”.

“The issue that many couples have is that you sort of don’t know where you stand until you actually start going through the treatment, and the treatment gives you an idea of whether it’s a good idea to carry on or not.

“If you’re on a low income you may never get the money together to get a single cycle of IVF, just because it’s around £5,000 per cycle.

“It’s one of those ones where it’s very easy for people to say ‘well you know what it’s £800,000’. But I know from personal experience, and from talking to other people who didn’t have children that actually the impact of not having them, or not being able to go through this, has a very long term emotional impact on people.”

“Particularly as it’s almost an issue about how wealthy you are, it does have an adverse impact on people on low incomes, so I really am someone who really is very much opposed to us stopping this service.”

“For those that won’t have access to a service, and [having a child], that is a raison d’etre for being together and having a family, and that can be devastating,” he said.

It was not possible to affect other many other services, such as treatments for chest pains or cancer, to the same level with less of an impact on care, he added.

“There are a lot of sacred cows that we’re looking at. There is a process and a scoring and ranking scale we’ve gone through to reach these decisions.

“We’re between a rock and a hard place and we just do not know where else to go.”

A report before the committee acknowledged the biggest impact of the change would be on low-income Croydon residents without the means to fund fertility treatment privately.

It also said there would be adversely affect the quality of life of people who wanted fertility treatment.

Suggestions that Croydon residents would lose out in a postcode lottery of treatments were raised during that meeting, when councillor Andy Stranack asked health chiefs: “If we are cutting IVF and Bromley or Sutton aren’t, is there a danger that there’s a postcode lottery?”

In response, Ms Swann said there was already “quite a level of difference” in treatments available.

“In Croydon we currently provide one cycle of IVF and in Bromley they provide three cycles, and in some part of the country they don’t provide IVF at all,” she said.

“And what we’re proposing in Croydon, because we don’t believe it’s clinically effective, [is] that access to IVF will be through an individual funding request process.

“So already there are differences in the provision of healthcare and clearly we wouldn’t want to exacerbate those.”

Dr Brzezicki pointed out services are likely to become less of a postcode lottery across South London in the future as other CCGs face similar funding issues.

The CCG ruled out extending waiting times, reducing the number of planned new GP Hubs, cutting child and mental health services and reducing its investment in outcomes based commissioning, as money-saving moves.

But it will go ahead with cutting the Foxley Lane Mental Health Ward, which is currently run by the South London and Maudsley (SLaM) NHS Foundation Trust, in favour of mental health services that can be provided at patients’ homes.

It will also recommission some outpatient services to save money, and cut the provision of gluten free products, which it says are now far more widely available in shops for patients to buy themselves

The report states coeliac disease affects about 3,000 people in the borough, but people with other food allergies and intolerances do not get their food on the NHS.

Also due to face restrictions on prescription are Vitamin D supplements, skin creams and the provision of over-the-counter medications like paracetamol, cold and flu remedies and antihistamines.

It will also mean people requiring travel immunisations will have to pay for their jabs, which is already national NHS policy, though not enforced in the borough.

In total, Croydon CCG must make the extra £5.7million savings as part of an action plan drawn up for NHS England after it was already asked to cut £12.7 million from its £475.4 million budget.

Even with the savings, it is currently forecast to end the 2016/17 financial year with a £4.2 budget deficit.

The CCG says it is underfunded from central government, partly due to issues with Croydon’s changing demographics since funding formulae were drawn up, by about £18 million each year.


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