An existing child from a previous relationship…

Is it fair that in so many areas couples are denied access to NHS fertility treatment because one of them has a child from a previous relationship? I’ve spoken to so many people who are affected by this recently, and it causes great distress – particularly where the existing “child” may be a young adult or teenager who has little or no contact with the couple concerned. It seems to be increasingly common for CCGs to restrict treatment in this way – often citing the fact that so many others do as their excuse.  What do you think? Is this just a way of rationing treatment, or do you think it’s a fair way of deciding who should get NHS funded IVF ? I’d be interested to know your views…

 

 

Funding U-turn at Vale of York

Just last month, Vale of York CCG was being widely praised for finally agreeing to fund a limited amount of fertility treatment for the first time, so it was a huge shock when it suddenly announced yesterday that it wasn’t going to be able to do it after all. What was perhaps even more of a shock was the financial justification for this – that funding one IVF cycle for 110 people was apparently going to cost them £2 million.

It does raise serious questions about financial planning when a CCG changes tack like this in such a short space of time – and there’s also the matter of how one cycle of IVF for 110 people ends up costing £2 million – that’s more than four times what it would be at most fertility clinics,

Infertility Network UK and the National Infertility Awareness Campaign have condemned the proposal – Susan Seenan, Chief Executive of Infertility Network UK and Co-chair of the National Infertility Awareness Campaign (NIAC) said:   “The announcement by Vale of York CCG today to go back on their commitment to reinstate funding for fertility treatment is quite simply appalling.  To raise the expectations of those patients in the area who need fertility treatment and then within one month smash their hopes is completely irresponsible.

We would like to see the figures they have used to justify their decision – suggesting that offering one cycle to patients would cost as much as £2million per year simply doesn’t add up if they are talking about treating 110 patients. Deferring the reinstatement of funding for another year will simply add to their cost pressures as they try to deal with the backlog.  National guidance set by NICE recommends offering up to three cycles for  those eligible, based on both cost as well as clinical effectiveness, and there is no reason for patients who have a clinical need for a treatment recommended by NICE to be targeted yet again by a CCG which has for many years consistently failed them.”

 

Are you getting NHS funding for fertility treatment?

It’s good to see that pressure is mounting for the NICE guideline to be followed – and for all those who are eligible to have three full cycles of fertility treatment funded by the NHS. The BBC were running a story this morning about calls for proper funding in Cornwall, and it follows a stream of coverage after NICE made it clear that commissioners should be mindful of the guidelines, which are based on what is both clinically and economically effective.

Infertility Network UK campaign on this as part of the National Infertility Awareness Campaign.  If you are in London and the South East and are having problems accessing treatment, do contact me via I N UK at katebrian@infertilitynetworkuk.com

Funding for fertility

It’s good to see that pressure is mounting for the NICE guideline to be followed – and for all those who are eligible to have three full cycles of fertility treatment funded by the NHS. The BBC were running a story this morning about calls for proper funding in Cornwall, and it follows a stream of coverage after NICE made it clear that commissioners should be mindful of the guidelines, which are based on what is both clinically and economically effective.

Infertility Network UK campaign on this as part of the National Infertility Awareness Campaign.  If you are in London and the South East and are having problems accessing treatment, do contact me via I N UK at katebrian@infertilitynetworkuk.com

NHS funding for fertility

It is good news that NICE is working to reinforce last year’s fertility guideline, and is pushing to end the postcode lottery which has blighted so many people’s access to fertility treatment. NICE released draft standards today about this – a finalised version will be published after consultation in October. You can see the press release from NICE here.

For too long, fertility treatment has been seen as some kind of optional extra by some commissioners, despite very clear guidance from NICE on what they should be offering. The NICE guidelines are based on what is both clinically and cost effective, and are all about ensuring best practice. Despite this, many commissioners have set their own rules on how many cycles to offer, and have invented criteria to limit access to treatment. I was shocked when I was in touch with one clinical commissioning group recently to discover that their justification for denying treatment to a woman whose partner had a grown up child from a previous relationship appeared to be based on the fact that this was mentioned as a reason for rationing treatment on the NHS Choices website.

The release of the draft standards follows a court ruling that Clinical Commissioning Groups cannot just decide not to follow NICE guidance without good reason after a woman who was due to have chemotherapy was denied NHS funding for egg freezing.

For too long our national health service has been far from national when it comes to funding for fertility – let’s hope it’s finally time for a change.

The truth about IVF funding

We have known that NHS funding for fertility treatment is patchy, despite last year’s NICE guideline which recommended that three full cycles of treatment should be provided for eligible women who were 39 and under.  Now, the first survey to look at how funding is working since the NHS system changed and Clinical Commissioning Groups (CCGs) were brought in has revealed the truth about what is really happening on the ground.

The comprehensive audit carried out by the National Infertility Awareness Campaign (NIAC) shows that 73% of CCGs fell short of the NICE guideline recommendation of providing 3 full cycles of IVF/ICSI to eligible couples. Of those that funded treatment, around 49% only offered one cycle of treatment, around 24% offered two cycles and 24% offered three cycles

Since April 2013, Clinical Commissioning Groups (CCGs) have been responsible for commissioning fertility services, replacing Primary Care Trusts (PCTs).  Apparently some CCGs are currently reviewing their policies on assisted conception, but many are ignoring NICE guidance and using social criteria set in place by PCTs to ensure that the number of people who qualify for treatment is limited.

Clare Lewis-Jones, chair of NIAC said: “It is now nearly 10 years since the original NICE guideline was published and yet here we are, in 2013, still facing a situation whereby the level of service is determined by postcode. Sutton and Merton, along with the CCGs covering the former North Yorkshire and York PCT, have all chosen to follow the policy of their predecessor PCTs, and are consequently offering no funding for IVF. 

 This report gives a snapshot of IVF provision across England during the summer of 2013; sadly many patients will find they are no better off than in 2011 when the last national audit of this kind was carried out. NICE’s retention of the three cycle recommendation in its updated guideline in February 2013 should send a clear signal to commissioners as to the level of service patients should receive.

Whilst we are pleased to highlight areas of best practice in our report, we are incredibly disappointed to learn that since we carried out the research several CCGs in the East of England have carried out a review of their services and are now considering a reduction in the number of cycles from the recommended three to two. Not only is this contrary to the NICE guideline and detrimental to the desired outcome of the treatment, but it also means we can no longer confidently hold up the region as a shining example to others.

 I acknowledge the fact that CCGs are still finding their feet but this should not prevent commissioners from acting on NICE’s latest guideline – which should serve as the basis for all future funding discussions at a local level. I hope they will use the information contained within this report to inform their thinking.”

NICE guidelines are based on not only what is clinically effective, but also what is cost effective, and it seems extraordinary that so many CCGs should be choosing to completely ignore them. We are meant to have a NATIONAL health service, but when it comes to fertility it’s still your postcode that is going to dictate whether or not you qualify for treatment.

 

End to the postcode lottery for IVF in Scotland

It’s fantastic news that in Scotland access to IVF treatment is to be standardised to put an end to the postcode lottery for fertility patients.  With new investment, people who need help to conceive across the country will know exactly where they stand and what they can expect to receive.  Although for the time being they will only be offered two cycles of treatment rather than the three cycles recommended by the NICE, the initiative also aims to reduce waiting times.  Criteria used to assess eligibility will be standardised so the same rules will apply to everyone, no matter where they live.

Of course this move is to be applauded, but it’s high time that the rest of the UK followed suit.  In England, there are huge regional variations in NHS-funded treatment which are unfair and quite wrong – in many cases, commissioners have seemed to make up the rules as they go along. It is completely crazy that access for treatment for a medical condition is determined entirely by where you live – and a situation that we can only hope will not be allowed to continue for much longer.