Day in the life of a HFEA person responsible: “I feel a profound sense of satisfaction knowing that I am making a difference to patients' lives”

As medical director, person responsible, and a fertility specialist, my workday can vary greatly throughout the week. Every morning is different and presents its own challenges, as each patient is unique and individualised care is crucial. It’s important we take time to prepare and make sure our couples, individuals, and families have the time to ask questions and leave with an agreed treatment plan.

On a day where I am in theatre, my day starts at 8:00 am alongside a team of anaesthetists, theatre nurses/operating department practitioners, and embryologists. We first discuss the morning’s theatre cases to ensure the safe and smooth running of each procedure. The patients’ medical histories, responses, and any alerts are covered too. On these days, I can see between 10-12 couples, performing egg retrievals, embryo transfers, and occasionally surgical sperm retrievals. This aspect of my work is what I most enjoy, as I feel privileged to be part of each individual or couple’s fertility journey.

When consulting, I generally see around ten couples per day, which can include new patients for treatment planning, returning patients, or those who have experienced an unsuccessful cycle to discuss the next steps. During these appointments, I’ll discuss their medical histories, conduct investigations, and formalise a personalised treatment pathway. This may also involve counselling for those who opt for surrogacy, use donor eggs, sperm, or embryos, or undergo genetic testing of embryos.

Preparation for my day includes reviewing case notes, histories, and baseline tests. If I’m dealing with an unsuccessful cycle, I will revisit the embryology notes and may discuss the findings with the embryology team. Each patient has a 45-minute appointment, which can be set up as a face-to-face, video, or telephone consultation.

I hope that all the people who have received treatment with us, whether they have been successful or not, know that our team is always striving to do its best to support them.

The PR role

I stepped into the role of the person responsible for TFP Nurture in 2002 and have seen many changes since then. I’ve seen treatments modified, add-ons come and go, success rates change, and inspection processes evolve. When I first arrived in 2002, we carried out 180 treatment cycles, and this year we are set to perform more than 1,800 cycles.

The role of the PR is impossible for one person alone; it requires a team. While I may hold the title and be legally responsible in the eyes of the law, running a successful, safe and effective service relies on a multidisciplinary team. I depend on my general manager, nurse manager, lab manager and all the administrative team to ensure that the patient journey is as smooth and straightforward as possible.

Maintaining oversight of regulations, the consent process, storage, facilities, third-party arrangements and preparing for inspection every two years requires a team approach. The Quality Manager ensures all audits are in place and that the Self-Assessment Questionnaire (SAQ) is thoroughly answered to ensure the inspection goes smoothly.

To prepare for PR and leadership duties, I try to keep a structured approach. However, I also have an open-door policy for people to ask questions, seek advice and deal with administrative tasks that inevitably build up throughout the week.

I try to condense my administrative work into one dedicated session a week. This may require reviewing any reporting on incidents, analysing success rates, audits of practice, modifying standard operating procedures (SOPs), and occasionally addressing complaints.

During this time, I hope the PR team around me appreciate the experience I bring and views me as a positive role model, as well as a sensible source of advice and guidance.

At the end of the working day, I feel a profound sense of satisfaction knowing that I am making a difference to patients' lives. Being involved with fertility management and helping people complete their families is a massive privilege. Whether it’s transferring an embryo, providing counselling after an unsuccessful cycle, or meeting a baby who has come back to the unit, no two days are the same.

There is so much still to learn, develop and improve, so it is never boring. I am hugely proud of the team around me, and I know they share the same dedication to ensuring the best for every person who steps into the unit. If I were to start over again, I would not change a thing!

About the author:

James is a medical director at TFP Nurture Fertility and an RCOG subspecialist in reproductive medicine and surgery, with a focus on IVF and fertility management since 1993.

He completed his research and training in Oxford before moving to Nottingham, where he took up a consultant post and led the NHS Fertility service at QMC. His research focused on the development of endometriosis and the endometrium. He has extended his interest to become an experienced laparoscopic (keyhole) surgeon in endometriosis, adhesions, and fibroids.

James has authored or co-authored 30 papers and book chapters and has sat on the RCOG Subspecialty Committee. He further uses his expertise by leading subspecialty training in reproductive medicine in Nottingham, for training the next generation of specialist doctors in fertility.