Policy number: MSEICB 084
Policy name: Female Sterilisation (operative occlusion of the fallopian tubes)
Status: Group Prior Approval
Effective date: 1 April 2023
Next review date: 1 April 2024
Mid and South Essex ICB commission Female Sterilisation on a restricted basis.
Sterilisation is an irreversible method of contraception. The surgery involves blocking or sealing the fallopian tubes, which link the ovaries to the uterus, thus preventing the eggs from reaching the sperm and becoming fertilised. As this procedure is invasive and usually requires general anaesthetic it comes with associated health risks. There are many methods of contraception accessible in the ICB, some of which may be as or more clinically effective, and that are associated with lower acute health risks.
Counselling: the patient must be aware that the procedure is permanent but has a failure rate, that reversal is not funded on the NHS (unless there are Exceptional Clinical Circumstances), and other forms of LARC have a similar success rate, with lower risk profile.
Vasectomy, tubal occlusion and other methods of contraception should be discussed with all patients requesting sterilisation irrespective of their gender. Individuals should be made aware that some LARC methods are as effective as sterilisation and may confer non contraceptive benefits. They should be advised that vasectomy is safer, quicker to perform and is associated with less morbidity than laparoscopic sterilisation.
Where an individual patient’s BMI is above 35, this will be reviewed carefully at surgical assessment, and options for appropriate weight management may be considered prior to a decision on surgery.
Patients will be eligible if BOTH the following are confirmed:
- The patient is certain that their family is complete, or they have a medical condition making pregnancy dangerous, and that they never want children in the future
- Contraception: there is an absolute clinical contraindication to Long-Acting Reversible Contraception (LARC) or has severe side effects to the use of LARC or declines a trial of LARC after counselling from a healthcare professional experienced in fitting these devices.
Patients not meeting the above criteria will not be funded unless there are clinically exceptional circumstances.
Individual funding requests should only be made where the patient demonstrates clinical exceptionality.
Further information on applying for funding in exceptional clinical circumstances can be found on the ICS’ website.
A downloadable version of this document is available below: