Agenda item

This report sets out an overview from NHS Kent and Medway Integrated Care Board on the changes made to the NHS Funded IVF fertility treatment offer for Kent and Medway residents, which took effect from 1 April 2026.

Estimated time: 45 minutes

Discussion:

The Chief Executive (CE) of NHS Kent and Medway Integrated Care Board (ICB) introduced the report and apologised for failures in the process of engagement around the fertility services review, acknowledging that both Medway HASC (this Committee) and the Kent Health Overview and Scrutiny Committee (HOSC) should have been consulted at the beginning of the process. The ICB had therefore taken the decision to re-instate the previous IVF offer, backdating that decision to the 1 April 2026, and would re-open dialogue and consultation in relation to the proposal. He also wanted to use the opportunity to work with other ICBs across the South-East to potentially create more parity and fairness across the landscape in terms of the eligibility criteria, which differed across the region. He also emphasised the financial difficulties and the £200m deficit the ICB was trying to address, hence the need to make difficult decisions.

The Deputy Chief Medical Officer explained that in the climate of limited funding, the proposals had been developed to maximise successful outcomes. He also explained that of the 28 women that had been accepted for fertility treatment in the year 2025-26, had those changes been in place during that period, six would have no longer been eligible. 

Members then raised a number of questions and comments, which included:

·         Mitigations for future engagement – in response to what mitigations had been put in place to avoid a future error in the engagement process, the ICB CE described the broader organisational issues inherited since he joined the ICB in 2025, including cultural issues, a major headcount reduction, the significant financial deficit position and a need to reset commissioning processes.

·         Commissioning intentions – the ICB CE explained that he intended to share with the Committee in the summer, the ICB’s commissioning intentions which would outline its considerations for commissioning decisions that the Committee could then have early sight of and comment on. He also referred to the Memorandum of Understanding between the Committee and NHS bodies which was being developed, which would help to reaffirm expectations of relationships.

·         Lack of detail – Members expressed their frustration of the lack of information within the report, including financial modelling. It was explained that estimated average savings from the changes had been approximately £900k by reducing the number of cycles from 2 to 1 and approximately £480k by reducing the upper age limit from 40 to 38.

·         Retrospective eligibility - Concern was raised about how many women had been denied treatment since 1 April, who would now be eligible and how they would be notified, along with women less easy to identify, who had not been in the formal system but may have been working to prepare for it, such as losing weight in preparedness and had not pursued an application because they had believed they were no longer eligible under the new criteria. In response the ICB confirmed this was their immediate priority. They did not believe at this stage that anyone had been directly impacted by the decision but they were working on a communication strategy to ensure a wide reach and were contacting all fertility providers.

• Wider cost of proposals – reference was made to the potential wider cost implications of the proposals, such as poor mental health of families who would be denied treatment under the new criteria, who would have otherwise been eligible. It was explained that understanding further the views of those with lived experiences was vital which had been one contributory factor to re-opening the engagement process. Reference was also made to the falling birth rate and the negative impact the proposals would have on addressing that national issue.

Decision:

The Committee noted the submission from the ICB, as set out at Appendix 1 to the report and the SV questionnaire, as set out at Appendix 2 of the Supplementary Agenda and determined that the proposal did constitute a substantial variation or development in the provision of health services in Medway because of the lack of consultation and lack of information in the report.