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iVF Funding

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Nina1202 Wed 08-Jan-20 22:00:22

Good evening,

Thank you for taking the time to read my post.

Background
In July 2018 my husband and I went through successful ICSI treatment on the NHS. Unfortunately, our son was born at 24 weeks at passed away on the same day. We were referred for fertility treatment as there was a problem with my husband.

We have lived in our local area for over 3 years, but I did not change GP until I got pregnant as our current GP wanted to see the IVF cycle through. When I got pregnant, the GP advised me to register with a local GP to where I live. This was in August 2018. My husband however did not register with a local GP until July 2019 as he has not had any significant medical issues that required him to use the GP.

Issue
We are now in a position where we are ready to try again for another baby. The fertility nurse at our local hospital put through an application for NHS funding and we were declined. The reason being that my husband had not been registered with a local GP for over 12 months. The funding policy states:

The reason for rejection is that the person with the identified fertility problem must be registered with a local CCG GP and live within that boundary for 12+ months. Your partner was registered with a local CCG GP and lived within that boundary since 17/7/19.

The guidelines also state that ‘if unregistered, their usual place of residence is within the local CCG boundary. The period of residence must be a minimum of 12 months.’

Unfortunately, my husband does not meet the CCG’s definition of unregistered. Their definition of unregistered is not being registered with any GP at all and means he should have be deregistered from our old GP once we moved.

I did get a letter from our old GP stating that I had not used them for a significant period of time and presented this to the CCG. However they said, even though this is the case, the NHS digital system still shows my husband as registered with the previous GP up until he registered with the new one in July 2019.

My husband has said we should go private even though it will be financially challenging. However each private cycle we undertake will lead to a loss of an NHS funded cycle and if the cycle is unsuccessful, it will come at a cost of about . This could mean if unsuccessful, we lose approximately £7k-£9k. We are fortunate that the area we live in will offer 3 cycles funded by the NHS.

Assistance need:
1)Can anyone provide any advice or guidance on how I can appeal or escalate this decision to receive funding. I think it is unfair and we should qualify for funding as we have lived in the area for over 3 years. This feels like an administration point, and the matter should be looked at more practically.
2)If we were to take the private option, and if unsuccessful, would we be able to prevent the NHS knowing about this cycle to preserve one of our funded cycles?
3)How would I be able to get my digital NHS record changed/ updated to reflect the timelines from when I stopped using my old GP.

Apologies for the lengthy post, and thank you for your help in advance.

Nina

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