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NHS denying women fertility treatment to save money, watchdog warns NHS denying women fertility treatment to save money, watchdog warns
(2 days later)
Women across Britain are being denied fertility treatment because NHS trusts are trying to cut costs, the government’s NHS care watchdog has warned. Women across England are being denied fertility treatment because NHS trusts are trying to cut costs, the government’s NHS care watchdog has warned.
Thousands of couples struggling to conceive are being subjected to unfair “postcode lotteries”, causing “widespread inequality”, experts have said.Thousands of couples struggling to conceive are being subjected to unfair “postcode lotteries”, causing “widespread inequality”, experts have said.
The National Institute for Health and Care Excellence (Nice) has said it is “unacceptable” that fewer than one in five commissioning groups are paying for the full number of IVF cycles recommended.The National Institute for Health and Care Excellence (Nice) has said it is “unacceptable” that fewer than one in five commissioning groups are paying for the full number of IVF cycles recommended.
Fertility groups have welcomed what they described as the “strongest call yet” from Nice to end the healthcare inequalities caused by local commissioners cherry-picking aspects of its guidelines.Fertility groups have welcomed what they described as the “strongest call yet” from Nice to end the healthcare inequalities caused by local commissioners cherry-picking aspects of its guidelines.
One in seven heterosexual couples are affected by infertility, while up to 5% of NHS referrals are from same-sex couples.One in seven heterosexual couples are affected by infertility, while up to 5% of NHS referrals are from same-sex couples.
The south of England is “arguably the worst” in the country for IVF provision, with a few exceptions such as Wiltshire, Gloucestershire and Swindon, according to research by Fertility Fairness, while the north of England, stretching from Cumbria to Newcastle, is the best.The south of England is “arguably the worst” in the country for IVF provision, with a few exceptions such as Wiltshire, Gloucestershire and Swindon, according to research by Fertility Fairness, while the north of England, stretching from Cumbria to Newcastle, is the best.
Those with fertility problems in the Vale of York are refused treatment altogether, while last month, Mid Essex clinical commissioning group said it would no longer provide fertility services except in “exceptional clinical circumstances”.Those with fertility problems in the Vale of York are refused treatment altogether, while last month, Mid Essex clinical commissioning group said it would no longer provide fertility services except in “exceptional clinical circumstances”.
More than half (52%) of commissioning groups offer just one cycle of IVF, the research found. The Nice quality standard says that the NHS should provide three full cycles of IVF treatment to women aged under 40 who have failed to get pregnant after two years of trying, and one full cycle of IVF for women aged 40-42 if certain criteria are met.More than half (52%) of commissioning groups offer just one cycle of IVF, the research found. The Nice quality standard says that the NHS should provide three full cycles of IVF treatment to women aged under 40 who have failed to get pregnant after two years of trying, and one full cycle of IVF for women aged 40-42 if certain criteria are met.
Prof Gillian Leng, deputy chief executive and director of health and social care at Nice, said that infertility can have a “devastating effect on people’s lives”, causing depression, severe distress and the break-up of relationships. She said it was “unacceptable that parts of England are choosing to ignore Nice guidelines”.Prof Gillian Leng, deputy chief executive and director of health and social care at Nice, said that infertility can have a “devastating effect on people’s lives”, causing depression, severe distress and the break-up of relationships. She said it was “unacceptable that parts of England are choosing to ignore Nice guidelines”.
A cycle of IVF can cost the NHS up to £3,000. Leng said she understood that the NHS faces financial constraints, but that infertility was a “recognised medical condition” and treatment of it is a “core” service.A cycle of IVF can cost the NHS up to £3,000. Leng said she understood that the NHS faces financial constraints, but that infertility was a “recognised medical condition” and treatment of it is a “core” service.
Leng said: “Some parts of England are doing very well in offering the full Nice-recommended number of IVF cycles for all eligible women up to the age of 42. This is particularly true in the north, in areas like Northumberland, Oldham and Cumbria.Leng said: “Some parts of England are doing very well in offering the full Nice-recommended number of IVF cycles for all eligible women up to the age of 42. This is particularly true in the north, in areas like Northumberland, Oldham and Cumbria.
“Others are still to introduce a cycle of IVF for women between the ages of 40 and 42, but have at least committed to providing three full cycles of IVF to women under 40 years old, such as Camden and Gloucestershire. “But many areas are not even doing this.”“Others are still to introduce a cycle of IVF for women between the ages of 40 and 42, but have at least committed to providing three full cycles of IVF to women under 40 years old, such as Camden and Gloucestershire. “But many areas are not even doing this.”
The quality standard also identified key areas where improvements were needed, including GPs referring women for specialist consultation if they have not conceived after one year of trying, and giving those who face certain cancer treatments the option of egg or sperm freezing.The quality standard also identified key areas where improvements were needed, including GPs referring women for specialist consultation if they have not conceived after one year of trying, and giving those who face certain cancer treatments the option of egg or sperm freezing.
Susan Seenan, co-chair of Fertility Fairness, formerly the National Infertility Awareness Campaign, said: “There are clear guidelines, based on cost and clinical effectiveness, and it is simply not acceptable for the CCGs to refuse to follow them, or to trade off provision for those under 40 in order to fund treatment for a small number of eligible women over 40. We hope that the quality standard will reinforce the need for those CCGs which are currently ignoring the guideline to rethink their approach to treating infertility as a matter of urgency.”Susan Seenan, co-chair of Fertility Fairness, formerly the National Infertility Awareness Campaign, said: “There are clear guidelines, based on cost and clinical effectiveness, and it is simply not acceptable for the CCGs to refuse to follow them, or to trade off provision for those under 40 in order to fund treatment for a small number of eligible women over 40. We hope that the quality standard will reinforce the need for those CCGs which are currently ignoring the guideline to rethink their approach to treating infertility as a matter of urgency.”
Allan Pacey, the chair of the British Fertility Society, said: “During my time as the BFS chairman, it is disappointing to see that there has been no improvement in the funding available for assisted conception services in England. Some areas such as Mid Essex are worse off now compared with a few years ago, suffering from reduced or even complete withdrawal of funding. By cherry-picking aspects of guidelines to fund services of their choice, local commissioners fly in the face of what Nice is all about. Their guidelines must be taken as a whole if we are to deliver the best and most cost-effective use of NHS resources.”Allan Pacey, the chair of the British Fertility Society, said: “During my time as the BFS chairman, it is disappointing to see that there has been no improvement in the funding available for assisted conception services in England. Some areas such as Mid Essex are worse off now compared with a few years ago, suffering from reduced or even complete withdrawal of funding. By cherry-picking aspects of guidelines to fund services of their choice, local commissioners fly in the face of what Nice is all about. Their guidelines must be taken as a whole if we are to deliver the best and most cost-effective use of NHS resources.”
Sally Cheshire, chair of the Human Fertilisation and Embryology Authority (HFEA), welcomed the announcement. She said: “While always mindful that we are not a cost regulator either for public or private IVF provision, the nature of our work nevertheless means that we are always profoundly aware of funding issues, and the strength of feeling and very real impact NHS funding decisions have on women and men who are desperate to start a family but who simply can’t afford private treatment.”Sally Cheshire, chair of the Human Fertilisation and Embryology Authority (HFEA), welcomed the announcement. She said: “While always mindful that we are not a cost regulator either for public or private IVF provision, the nature of our work nevertheless means that we are always profoundly aware of funding issues, and the strength of feeling and very real impact NHS funding decisions have on women and men who are desperate to start a family but who simply can’t afford private treatment.”
• This article was amended on 24 October 2014. Because of an editing error, an earlier version referred to Britain in the first paragraph where England was meant.