Possibly Funding Decision reversal

I am a 41 year old living in Middlesbrough. I was referred though my GP for IVF on the NHS. I have previously had one cycle of IVF last year because the guidelines at the time (last year) excluded those after 40. I have seen a consultant twice at the hospital I was open and honest in order to give the best results as there were some issues with my IVF cycles that I didn't want repeating (I was advised that ICSI would be needed for myself if I have another cycle of IVF as fertilization did not take place last time). I now have two letters confirming my eligibility for IVF. After having a telephone conversation with an admin person whilst booking appointments id became apparent to her that I had had IVF previous. Now we have been called into the hospital with the lead consultant and I think they are going to revoke the decision

I will be questioning the competency of the Dr involved if this is the case and the reasons for her thinking I was entitled etc and I will be looking at my options possibly even going to a solicitor and getting legal advice

Have you ever come across this situation before ? Do you have any advice for me ? My appointment is at 1 pm today

Thanks

N

5 Replies

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  • Hello

    Was it a private round of IVF? I was told if I did this it was possible I wouldn't get IVF on the NHS. But, when I probed further they said this would only be the case if I didn't respond to the drugs during and, even then, they can of course tweak medication to achieve a better outcome in subsequent rounds.

    As long as there is a chance the round could succeed then I can't see why they should cancel it!

    But, if you do need to appeal there are draft letters on the Infertility Network UK website that you can use.

    Best of luck! x

  • It was private because at time the eligibility was 40 so I had little choice at that time being few months off 40... Then that change the criteria ... So we requested a referral I have two letters from one dr saying I'm eligible ... But today I was told that the dr was wrong and I'm not entitled . However the lead consultant said he will appeal to the Ccg on our behalf . I still feel hard done to considering I was told yes then no. It's like winning the big money lotto only to find you haven't as someone made a mistake X so down tonight im still paying off the private IVF loan x

  • That's really frustrating. Especially when you only went private as you didn't fit the NHS criteria at the time. What did they expect you to do?! It seems really unreasonable. Hopefully the consultant will resolve the funding issue with the ccg for you. It's good that he is on your side!

    Good luck. I hope it works out x

  • We were told by our fertility consultant we were eligible, then 3 months later when referral was at the fertility clinic, we were told we weren't due to my slightly raised fsh. The confusion was due to the guidelines being poorly written - I've read through them and I interpreted it the same as my consultant. I have appealed twice, once with a complaint, and the ccg are still saying I'm not eligible and won't admit there is anything wrong with their guideline. It's now in the hands of the health ombudsman and I am about to pay for my 2nd cycle privately. Understand the punch of thinking you are eligible then not, and we too are now loaned out. I would recommend getting the guidelines to check yourself - they can usually be found with a Google search. I wish lots of luck, but the appeals process is not a quick one. You may be in better luck than us due to the reasons around the guideline changing for you. Feels so unfair this postcode lottery and ccg's making their own rules. X

  • Thank you everyone I appreciate the well wishes... If the Ccg don't fund I will be complaining to the hospital as its their staff who got it wrong luckily I have a good friend who is a complaints manager in local government who is going to assist if needed ... Fingers crossed X

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