For Commissioners

Collaborative Commissioning (England)

Doctor-holding-piggy-bankFertility Fairness is keen to assist commissioners wherever possible, in order to help them commission fertility services effectively and efficiently. Our 2011 patient survey found that whilst more than half of GPs were perceived to hold the necessary information of infertility and the treatment options available to provide an effective service, a significant number still lacked this vital knowledge.

As the ‘gatekeepers’ of NHS services, it is essential that GPs are well informed when it comes to the causes of, and treatments available for, infertility. Lack of information in this area of medicine has, at times, contributed towards to a lack of interest at commissioner level. If commissioners do not address this knowledge gap, there is a danger that fertility services could become marginalised.

GPs play a leading role on CCG governing boards and they are expected to commission a number of services of which fertility is just one. They are directly responsible for managing around 60% of the total NHS budget, which they must ensure covers the health needs of their entire local population. Consequently, commissioners are placed under enormous pressure to allocate funding appropriately.

Recognising this challenge we recommend the following – that commissioners:

  • Always seek to collaborate with neighboring CCGs in order to save on procurement costs and minimise variations in access
  • Always consult service users in the run up to any change in policy
  • Always consult with medical staff in the primary, secondary and tertiary care setting before making a change to a policy
  • Always use the 2013 NICE guideline as the basis for local policies
  • Challenge the cost per cycle quoted by providers and compare to other regions when procuring tertiary fertility services
  • Publish all details regarding their assisted conception policy on their CCG website (even if the policy is in the process of being updated)
  • Communicate proposed changes to GPs working in the community well in advance of the change taking place

And in so far as is possible:

  • Notify Fertility Fairness and Fertility Network UK of a change in policy or an upcoming consultation via our contact page.

2013 NICE Guideline NHS England Commissioning Factsheet Infertility Network UK
Collaborative 3 Cycle Policy Example Compare your CCG  

Measuring provision and increasing transparency (England)

Fertility Fairness will be issuing Freedom of Information requests to your CCG on an annual basis. We do this to compare provision across the country.

The reason we have to do this is that many CCGs do not publish their assisted conception policies on their website. Sometimes a policy is published online, but it can be ‘lost’ amongst a variety of other policies and this is often very confusing for patients who deserve to know what their local level of provision is. Fertility Fairness therefore urges commissioners to publish all information relating to their assisted conception policy even if it is in the process of being updated.