Sussex CCGs fertility services – response to Coronavirus

COMMUNICATION

Suspension of Fertility services across the Sussex CCGs until routine service resumes.

COVID-19 is a new illness that can affect lungs and airways. It is caused by a virus called coronavirus. The disease has taken on pandemic proportions, leading to extraordinary measures being introduced across the world.

On 16 March 2020, the Prime Minister set out the new national position on the response to the ongoing situation in relation to Coronavirus pandemic, which can be read here.

The National Health Service (NHS) put in measures with the aim of freeing up the maximum possible inpatient and critical care capacity to support patients that will be affected by the Covid situation. These include restrictions on elective surgical and outpatient work, plans for utilising medical and nursing staff from other areas and recalling retired medical staff.

The situation is fast evolving and recent announcements from the prime minister emphasise the need for social distancing. “Everyone must stay at home to help stop the spread of coronavirus.

This includes people of all ages – even if you do not have any symptoms or other health conditions.

You can only leave your home:

  • to shop for basic essentials – only when you really need to
  • to do one form of exercise a day – such as a run, walk or cycle, alone or with other people you live with
  • for any medical need – for example, to visit a pharmacy or deliver essential supplies to a vulnerable person
  • to travel to and from work – but only where this is “absolutely necessary”

Sussex CCGs’ priority as commissioners is to keep patients and staff safe, following national and local guidance. We want to ensure that we work effectively for the wider NHS system. It is important that we consider issues around treating patients throughout the coronavirus pandemic.

On 24th March 2020, the Human Fertilisation and Embryology Authority (HFEA) UK’s independent regulator of fertility treatment and research using human embryos published an open letter to fertility patients. In this letter, the chair of HFEA stated that they had written to all UK licensed clinics to tell them that they expect them to follow the guidance from the medical and scientific experts in the UK fertility sector, the British Fertility Society and the Association of Reproductive and Clinical Scientists. Their advice is that clinics should plan to stop treatments over the next three weeks, allowing patients to complete any cycle they have started.

There is no access on GP sites and GPs are at the heart of fertility services including initial investigations. Fertility services are reliant on accessing surgical procedures for example, hysteroscopy, and laparoscopy, and as routine surgery has been stopped this makes it untenable to provide a safe service. In addition, the need for unnecessary travel for patients has to be minimised.

After careful consideration, including acknowledgement of the potential impact of fertility treatments on NHS services, which are likely to be stretched in coming months Sussex CCGs are suspending all new fertility referrals.

Referrals already accepted into the system that have appointments pending will be deferred until routine work recommences. These include referrals to fertility local commissioned service (Fertility LCS GPs).

We recognise that this is a difficult time for all and hope that you will understand that this decision is needed at this challenging time.

Our Fertility providers will continue to follow national and professional guidance. Fertility Clinics will operate in line with Human Fertilisation and Embryology Authority (HFEA) and should follow professional UK guidance from the British Fertility Society and Royal College of Obstetricians and Gynaecologists on treating patients throughout the coronavirus pandemic.

We will put in place measures for the following groups:

  • Patients who are approaching 40 years of age an appropriate extension will be approved
  • Those who have started treatment and cannot complete the cycle because of coronavirus will not lose their cycles
  • Any patient that needs to freeze eggs /sperm due to cancer treatment will be assessed on a case-by-case basis. We will draft a pathway for patients to be able to access during the coronavirus period
  • For those who are already referred to our commissioned specialist tertiary providers the advice from Human Fertilisation and Embryology Authority is that clinics should plan to stop treatments over the next three weeks, allowing patients to complete any cycle they have started. Our specialist tertiary centres will maintain dialogue with patients, they may consider changing face-to face consultations to phone or video calls and may recommend freezing of embryos for those due to receive second cycle of treatment
  • We will review the need to repeat tests when service reactivates

Advice and support

We are closely monitoring the fast evolving situation and will respond as appropriate taking into account national guidance as well as medical and scientific experts in the UK fertility sector (the British Fertility Society and the Association of Reproductive and Clinical Scientists)

The commissioned fertility specialist tertiary providers have information on their websites for patients.

At primary care level, the CCG staff will work together with GP practices to respond to queries in the interim. We have pulled together a list of helpful organisations including fertility specific charities and counselling services to sign post patients to.

Links to useful organisations

Useful telephone numbers

  • Sussex Mental Health Help Line – 0300 5000 101 – Available Monday to Friday 5pm to 9am, and 24 hours at weekends and Bank Holidays. The Sussex Mental Healthline is a telephone service offering support and information to anyone experiencing mental health problems including stress, anxiety and depression. The service is also available to carers and healthcare professionals. You do not need an appointment.
  • Samaritans – 08457 90 90 90 – Available 24/7 Samaritans provides confidential non-judgmental emotional support for people who are experiencing feelings of distress or despair.
  • No Panic – 0808 808 0545 (freephone) 10am – 10pm Support for sufferers of Panic Attacks, Phobias, Obsessive Compulsive Disorder, and General Anxiety Disorder

Date: 3rd April 2020