moving house - NHS fertility treatment and some advice please!

[sunnyg]

Hi all

We are in the process of moving house, and thus moving boroughs. However in the midst of all of this (oh the fun!) we have our first appointment at the fertility clinic (NHS - UCH London). Although this is only our first appointment, as I'm 34, TTC 1 for 2 years, I'm keen to make sure we don't waste another second. So my questions are:

1. The appointment is about a week after we've moved. Doubtful we'll have had time (or been able to get an appointment) to register at new doc in area. Do we need to tell/should we tell at the fertility clinic appointment we've moved?
   (We are moving from Islington PCT to Waltham Forest PCT)

2. If we do register with new doc in new area, how will this affect us in terms of already having started the process?

3. How can I found out which PCT offers better/more NHS fertility funding and waiting lists? (already know DH has low sperm count, and although yet to have first appointment my research and gut instinct tells me that either IVF etc may the only way forward for us)

Many thanks Ladies!

I remember seeing a website somewhere that had the rules for different areas. Might be worth a quick Google. Perhaps someone will come along with a link.

thanks for your response kat2504, have googled and googled but can't seem to find the info. I think I have found that the clinic we've got our appointment at (University College Hospital London - with partner unit CRGH) has in fact no waiting time for their fertility treatments (if I'm reading this right!) but I can't seem to find out what will happen when I move, in terms of still being able to go to this clinic or ?

Any more tips/advice would be much appreciated!

fertility friends used to have PCT type info on their website - worth a look there. Even if you have been for your first appt, the funding issue will need to be resolved before you can start any treatment. Not sure on the situation in London but up here in the North PCTs have contracts with specific hospitals to provide treatment. However any tests etc you have done can go with you if you need to move elsewhere.
Waiting times are also PCT specific, sorry.

Found this link, a bit out of date but may be useful

www.guardian.co.uk/news/datablog/2009/aug/06/fertility-problems-nhs

Hi sunnyg

I would call both PCTs and ask what the current policy on funding fertility treatment is. Although there are maps using old data that you can find using Google, lots of PCTs have changed their policies in the past 12 months (largely to save money). That said the Guardian table that kat2504 posted is the most useful one I've seen.

Technically, you can choose to go to any hospital so continuing to be seen at UCH shouldn't be a problem, if that is what you want. However, your funding for any treatment will still depend on the PCT you geographically live in.

For what it's worth, I'd go to the appointment and then look at registering with a GP in your new area. I think once you've been referred, you can't be un-referred so the hospital/and your old GP should just inform your new GP that you're under their care now.

Sorry to disagree with ladygee but certainly in my area you may not be 'unreferred' but if your PCT does not fund fertility treatment then that is that I'm afraid. They are under no obligation to pay for IVF unless you have already started a treatment cycle (but by that stage the hospital will have billed them anyway). You can't necessarily go to any hospital either - they will have contracts with specific hospitals and some things may not be included (eg freezing embryos). Agree with calling both PCTs to find out their policy. PCTs are very strict about fertility funding I'm afraid.

Hello,
I am in a similar boat - and I have re-directed my post so officially I still live in the old place. (It is not too far away and in the same county so I can still use my old doctor if needed.) I have an appointment with a consultant in November and after that I will look at moving. (I am hoping once we have a plan of action then moving shouldn't be too tough.)

Hi again Ladies
Many thanks for all of your responses. I've taken it all on board and done as much investigation as possible. Google is now officially my best friend. I've found out that the borough I'm moving has a waiting list of 6-8 months for nhs funded ICT at Homerton and you get 3 goes. Not great, but not too bad. Meet all of the criteria for NHS funding for IVF/ICSI except that of course once we do move (in the next few weeks) we'll need to be registered at local gp in the area for a year. I can't believe it, that is the only criteria we don't meet. In our current borough (Islington) finding out the funding criteria hasn't been so easy, in fact I'm now waiting for someone to 'email me the policy' as not obviously available on NHS Islington PCT website (they seem to be hiding it actually!). So once I have that, then I can find out which criteria we may meet. We have been registered with our current Islington GP for over a year now, so if the criteria is the same, then we'll meet that. BUT, what happens when we move, who knows?
As mentioned earlier we are due to have our first fertility clinic appointment in about 3 weeks, we will have just moved. At this point I doubt we'll even be able to register at a new GP and I'm reluctant to do that until I can find out how this might affect potential treatment. I know I might be getting ahead of myself, need to go to clinic appointment first, find out the treatment plan etc etc, but I would just hate to get all the way there and the find out that we couldn't undergo treatment just cause we have just moved! Any more advice would be great... someone out there must have gone through this too!

LIG1979 - what's your plan? Have you found out if your move will affect treatment and funding?

How does the Homerton compare in terms of success rates with UCH? if I recall correctly, UCH has one of the best success rates in Europe - they're all published on the HFEA website so you can compare yourself. I'd keep schtum and stay at UCH - you're not legally obliged to tell anyone you've moved!

BTW if yove got male factor issues you're probably looking at ICSI so you need to compare the live birth rate for ICSI for your age group for both clinics. Good luck!

Sorry, I can see now that my last paragraph was a bit ambiguous, freelancescientist. I meant that once sunnyg knew what the criteria was for the new PCT and, if you met that criteria, then I would go to the appointment regardless and take it from there.

The treatment policies and options are so complex. We were able to choose from any hospital when we were referred. We made our decision based on success rates and waiting times. It means we're at a hospital further away from home (in another county) but it was the best choice for us. But you're right, different hospitals/clinics all provide slightly different options.

Sunnyg - I don't know the geography but if it turns out that the only criteria you don't meet is having been with your GP for a year, might it be feasible to stay with your current GP? GPs can keep patients on their register even if they are out of the area (for instance, you can register with a practice near to where you work rather than where you live) but they have to agree to this and assure the PCT they are able to take care of you.

It's such a minefield, I hope you get it all sorted. Good luck.

Sunnyg, I retired from MN six months ago but still lurk. When I saw your post I joined again under a different name so I could let you know of my experiences .

We used to live in Islington and started our infertility investigations at the time. The GP did basic day 3 and day 21 tests and sperm analysis via the local hospital and then referred us to UCH for further investigations as DH's sperm were slow (not low, just lazy!)

I got the policy on fertility treatment from the PCT at the time (2008) and it stated that on referral from the GP, UCH will carry out investigations and, if appropriate and necessary, offer up to three IUIs. If these didn't work then UCH would refer the couple to IVF Hammersmith for up to two fresh cycles (IVF OR ICSI).

PCTs buy fertility contracts with hospitals/clinics and it is not always the nearest one and can be split (i.e. when we did it investigations and IUI were done at UCH and IVF was done at the Hammersmith Hospital!). Unless you have seen it on the policy or actually spoken to the PCT do not assume that if the investigations and IUI happened at UCH then IVF, if you need it, would happen there too. The IVF clinic at UCH is actually a private one called Centre for Reproductive and Genetic Health (CRGH). I am currently there as a private patient and can certainly recommend them; they have some of the best embryologists in the business and a customised approach to IVF dependant on your personal diagnosis.

As for your timing in terms of the move, I would organise the re-direction of mail and hold off registering with a new GP until your investigations/treatment at UCH are well underway. I know this is naughty but, the mere fact that you have got the appointment means that the PCT has already committed the money for you and your initial treatment (investigations and IUI). If these do not deliver your much wanted baby and the consultant starts talking about IVF (we had a meeting with her between IUI 2 and 3) then say that you have recently moved and are under a new GP and PCT hence the criteria may change. Get a copy of all your notes so that when you register with your new GP and he starts mentioning investigations you can prove you have had them all done and are ready for the IVF referral straight away.

One of the things I regret not doing during my NHS funded IVF cycles was to try to do a private one whilst I waited. It depends what the PCT policy is, some will strike you off the list you did a self funded cycle whilst on the waiting list, others do not mind. Start saving now if you possibly can and if you do face a need for IVF but a year long waiting list for the Homerton then you could do a private one at a clinic of your choice whilst waiting if your PCT lets you.

I have only had experience of UCH for IUI and ICSI at the Hammersmith and CRGH so I am unable to comment on how good or bad the Homerton is. There is a great website called Fertility Friends where the posting boards are clinic specific so you could visit and read up what people say about it. Remember that if you are on an NHS cycle you cannot normally choose a clinic or timescale and the PCT/clinic with the contract will dictate everything and you have to go with their flow.

Sorry for the essay, assisted conception is such an overwhelming subject that I know I was very grateful at the time for anyone with information on it. If you would prefer to PM me with any questions please do

Good luck, it is a real adventure but has resulted in so many dreams coming true for so many people that it is certainly worth it!!!!

Ladygee, you were so lucky to be able to choose the clinic that you wanted for NHS funded IVF. The PCTs I have lived under in London would have never agreed for us to do it us they had to protect their contracts. Glad to see that they are not all like that!

Hi All
GMTS thank u so much for your detailed response. It's given me some food for thought. Have now obtained policy from Islington PCT, which is dated May 2008. This says if the fertility investigations warrant it we may be offered up to six cycles of IUI and then if that not successful then 2 cycles of IVF/ICSI. I think I will take your advice and go to our first appointment(in 2 weeks time) organize mail redirection and then take it from there. I hope we can get out investigations underway and get some kind of treatment plan in place and then we can deal with the issue of having moved. DH will still be working in the area and very close to our current gp so maybe that will be good enough for them to let us stay registered with our current gp. Gosh it really is a minefield. All the best to u all, hope all is going well at UCH GMTS!
Many thanks again!

Good to hear that you now have the policy (obviously extended the number of IUIs after we were under them) and you are going ahead with your initial appointment at UCH. All the best of luck with IUI and the move!