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Winter 2020/21 Preparation for Fertility Services in Scotland

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Winter 2020/21 Preparation for Fertility Services in Scotland University of Dundee Coronavirus (COVID-19) Fertility Network UK; Martins Da Silva, Sarah; Kini, Suresh Publication date: 2020 Link to publication in Discovery Research Portal Citation for published version (APA): Fertility Network UK, Martins Da Silva, S., & Kini, S. (2020, Jan 12). Coronavirus (COVID-19): fertility services - winter 2020/2021 preparation plans. Scottish Government. 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Oct. 2021 This publication will be available in accessible HTML on the gov.scot website Winter 2020/21 preparation for Fertility services in Scotland October 2020 November 2020 V15 30 10 2020 Document No: Implemented: Key Changes Actioned Rev Date Description 1 MEMBERSHIP OF THE GROUP ...................................................................... 3 2 BACKGROUND.................................................................................................... 4 3 PREDICTED SITUATION ................................................................................... 4 4 EFFECT ON FERTILITY SERVICES................................................................ 5 4.1 Impact from other services: ............................................................................ 5 4.2 Shortage of staff ................................................................................................. 5 4.3 Pace of Restart.................................................................................................... 6 4.4 Impact on waiting times.................................................................................... 6 5 MITIGATION STEPS FOR FERTILITY SERVICES ....................................... 6 5.1 Flu vaccine:.......................................................................................................... 7 5.2 Prioritisation ........................................................................................................ 7 5.3 Patients with medical illness........................................................................... 8 5.4 Increasing capacity............................................................................................ 8 5.5 Cross working between clinics ...................................................................... 9 5.6 Communication with Primary care ................................................................ 9 5.7 Support for patients........................................................................................... 9 5.8 National and international guidance ........................................................... 10 5.9 Donor gametes.................................................................................................. 10 5.10 Waiting for elective surgery .......................................................................... 10 5.11 Self-funded patients ........................................................................................ 11 6 SUPPORT FOR STAFF .................................................................................... 11 7 SPECIFIC ISSUES............................................................................................. 11 7.1 Face coverings.................................................................................................. 11 7.2 Training ............................................................................................................... 11 8 ABBREVIATIONS.............................................................................................. 12 9 REFERENCES.................................................................................................... 13 10 APPENDIX 1: LETTER FROM HFEA TO ALL PRS ................................... 14 11 APPENDIX 2: TIERS........................................................................................ 15 Page 2 of 16 V15 30 10 2020 1 Membership of the group Fertility Network UK Gwenda Burns – Chief Executive Aberdeen Alison McTavish, Unit Manager, Quality & Business Manager and Nominal HFEA License holder, University of Aberdeen/NHS Grampian, Aberdeen Fertility Centre Abha Maheshwari, Lead Clinician, Consultant Reproductive Medicine and Person Responsible, University of Aberdeen/NHS Grampian, Aberdeen Fertility Centre Elizabeth Ferguson, Laboratory Manager, University of Aberdeen/NHS Grampian, Aberdeen Fertility Centre Dundee Sarah Martins da Silva, Consultant Obstetrician and Gynaecologist and Person Responsible, NHS Tayside, Dundee Assisted Conception Unit Suresh Kini, Consultant Gynecologist, NHS Tayside, Dundee Assisted Conception Unit Edinburgh Joo Thong, Lead Clinician, Consultant Subspecialist in Reproductive Medicine/Consultant Gynaecologist and Person Responsible, NHS Lothian, Edinburgh Fertility Centre Dave Wales, Quality Manager, NHS Lothian, Edinburgh Fertility Centre Daniel Collins, Laboratory Manager, NHS Lothian, Edinburgh Fertility Centre Glasgow Helen Lyall, Consultant Gynaecologist and Lead Clinician, NHS GG & C, Glasgow Assisted Conception Service Joanne Leitch, Lead Embryologist and Person Responsible, NHS GG & C, Glasgow Assisted Conception Service Scott Nelson, Professor of Obstetrics & Gynaecology, Nominal HFEA License holder University of Glasgow, NHS GG & C, Glasgow Assisted Conception Service Isobel Traynor, Lead Nurse Assisted Conception & Gynaecology, NHS GG & C, Glasgow Assisted Conception Service Scottish Government Sarah Corcoran, Team Leader, Maternal and Infant Health Branch, DCAF Louise McCue, Senior Policy Manager, Maternal and Infant Health Branch, DCAF Anthea Taylor, Policy Manager, Maternal and Infant Health Branch, DCAF NHS National Services Scotland Carsten Mandt, Senior Programme Manager, Scottish Perinatal Network Peer reviewed by: Dr Corinne Love, Senior Medical Officer/Maternal and Women’s Health, Chief Medical Officer Policy Division, Scottish Government This document should be read alongside the restart plan and the protocols set out there remain the case. Page 3 of 16 V15 30 10 2020 2 Background After the closure of all fertility clinics in March 2020 due to COVID-19, fertility services were given permission to resume in May 2020. Fertility services restarted in phase 1 of the recovery plan as it was acknowledged that it is an extremely time sensitive treatment (https://www.gov.scot/publications/re- mobilise-recover-re-design-framework-nhs-scotland/pages/9/). In addition, the sudden halt to fertility treatments was noted to have added to the distress already faced by these patients (Boivin et al., 2020). The data on COVID-19 and pregnancy are still emerging and more details are set out by Royal College of Obstetricians and Gynaecologists (RCOG) within Coronavirus (COVID-19), pregnancy and women’s health and United Kingdom Obstetrics surveillance system (UKOSS) COVID-19 in Pregnancy, with the former updated on a regular basis. Some risks have been identified in specific groups, but the data is largely reassuring. All four NHS tertiary clinics in Aberdeen, Dundee, Edinburgh and Glasgow have worked together with Scottish Government and the patient stakeholder group- Fertility Network, with twice weekly meetings to create uniform documents and policies with a Once for Scotland approachhttps://www.gov.scot/publications/covid- 19-fertility-treatment-scotland-plans-restarting-treatment-framework/. Whilst the initial COVID-19 surge occurred rapidly, with little time for service preparation, there is now an opportunity to prepare for the forthcoming winter, when it is anticipated that Fertility services may be affected again. NHS Fertility services were paused during the initial peak of the pandemic but have remained open during subsequent local lockdowns. This document sets out some of the issues that might occur in the event of a full lockdown again and how to ensure fertility centres provide services through any future local or full lockdowns, with appropriate measures being put in place in order support their patients in the most efficient and effective way and taking into account the COVID-19 Scotland’s Strategic Framework https://www.gov.scot/publications/covid-19-scotlands-strategic- framework/. Table 1 document sets out an example of prioritisation and Appendix 2 includes activity in Tiers as per the Framework. The intention and ambition of the Regulator, the Human Fertilisation and Embryology Authority (HFEA) is to avoid closure of licensed fertility services (letter from the HFEA Chief Executive, Appendix 1) and the Scottish Government is supportive of this in respect of NHS services as set out in this document. 3 Predicted situation As lockdown restrictions eased, it was predicted that there would be a resurgence of COVID-19 with local and/or regional outbreaks and this is indeed the current experience. There will be the usual winter NHS pressures including
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