NICE try… but is anyone listening

I’ve just spent a really interesting evening at a debate organised by Progress Educational Trust where the new NICE fertility guideline was up for discussion.  Titled ‘NICE try… but is anyone listening”, the debate was chaired by Dr Allan Pacey of the British Fertility Society which had sponsored the evening.  The debate focused on the fact that the 2004 guideline has still not been fully implemented in many areas, and questioned whether commissioners were really going to take any notice of the new guidance.   The evening started with brief presenatations from the panel of speakers.

First up was Dr Yacoub Khalaf, Director of the Assisted Conception Unit at Guy’s and St Thomas’ who explained how linking fertility funding to single embryo transfer had already successfully saved money overseas, and questioned why NICE was not able to use this kind of joined-up thinking. The second speaker was commissioner Peter Taylor, a fellow member of the NICE guideline development group.  Peter explained the commissioning process following on from the previous fertility guideline in 2004, and discussed how fertility commissioning decisions had often been down to arbitrary measures outside the guidance itself.  The final speaker was Dr James Kingsland, President of the National Association of Primary Care, who talked about the new clinical commissioning groups and how it will be up to the public to challenge them if they are making decisions about fertility treatment based on rationing rather than clinical care.

The debate which followed covered a range of topics, although there was some focus on the health economic models used by the NICE team and questions as to how reliable members of the audience felt these to be.  There was also discussion about the decision not to offer IUI to those with minor fertility problems, which one member of the audience felt was a mistake.  The decision to only offer one cycle of IVF to women between 40 and 42 was felt by many to be unfair.

For me, the quote of the evening came from Professor Peter Braude who questioned the fairness of the current system and noted that when it comes to fertility our health service is far from National: he made the point that we don’t make decisions about who should be immunised on the basis of their postcode, and questioned why we should do this when it came to fertility.

I think I’d agree with Peter Taylor’s concluding thought – that the new guideline may not be perfect, but it certainly isn’t that bad.  As a former patient, I’m really delighted that there is more up-to-date guidance to be followed, and that this advice will make it possible for people to access more cost-effective treatment more quickly if the guideline is followed.

 

afterword – The Fertility Show…

This weekend’s Fertility Show was very busy – more than 3,600 visitors over the weekend – and it was lovely to meet some of you and to find many old friends too.  The seminar programme this year was fantastic with really interesting topics addressed by some of the world’s leading experts in their fields and most of the talks appeared to be packed out.

There were quite a few clinics from the UK exhibiting at the Show, mainly from London and the South East, but they were rather outnumbered by their counterparts from overseas who have clearly realised that more and more people are considering travelling for fertility treatment.  There were fertility specialists from Spain, Russia, Latvia, Georgia, Italy, Barbados, the Czech Republic, Norway, Denmark, Greece, Sweden and across the USA from Florida to Chicago. I spoke to a number of people who were considering treatment overseas and they’d found it really helpful to have so many different clinics from around the world all gathered under one roof.  It can be very hard to distinguish between one and another when you’re only judging them on their websites and email communications, and the opportunity to meet staff face to face and get a feel for the clinics and what they can offer is quite unique.

For me, it was really good to see so many patient support organisations there too – Infertility Network UK, the Donor Conception Network, International Asherman’s Association, Klinefelter’s Syndrome Association, Fleur and the lovely team from Verity PCOS who must be congratulated on their purple theme which even went as far as a rather wonderful pair of handmade purple earings…

As it is National Adoption Week, it was heartening to see that a number of fostering and adoption agencies were represented too as this is an alternative route to parenthood that some may want to consider.

Everyone I spoke to who’d visited the Show had found it to be a beneficial experience.  I know some people do feel it is a rather commercial affair for a medical problem, but fertility treatment is a massive commercial industry. Personally, I think the opportunities a weekend at The Fertility Show can offer outweigh any such concerns.  If you’re not into fertility astrology or crystal therapy, you don’t need to spend time at the stands offering them. It’s a matter of picking and choosing the things that you want to know more about and making the most of the opportunities the weekend can afford.