The latest figures released by Fertility Fairness earlier this week about funding for IVF treatment have been described as “shocking” by the President of the Royal College of Obstetricians and Gynaecologists, Professor Lesley Regan.
Commenting on the fact that so few clinical commissioning groups (CCGs) are currently following national guidance and that the number which have completely removed NHS IVF has almost doubled in the last year, Professor Regan said “These figures are shocking and it’s very disappointing to see even fewer CCGs following NICE guidance and providing full access to NHS fertility treatment. Current access to treatment is a postcode lottery and these health inequalities people face are unacceptable. Infertility can have a devastating effect on people’s lives, causing distress, depression, and the breakdown of relationships. IVF treatment is cost-effective and should be available on the NHS. The RCOG is committed to working with UK commissioners and healthcare providers to support them in following NICE Fertility Guidelines.”
Fertility Network UK is inviting anyone facing fertility issues to an event at Westminster on 1 Nov from 4 – 6 pm to discuss fair funding for IVF.
Speakers include Peter Thompson from the HFEA, Paula Sherriff MP, Rebecca Manson Jones (Candidate for Women’s Equality Party), Geeta Nargund (Director of Create Fertility clinics) and patient campaigner Richard Clothier.
There are limited spaces for the event, and if you would like to attend you can find further details here
There’s an interesting development in Australia where the arrival of a low-cost IVF provider has been reducing the price of IVF treatment – you can read more about this from the Sydney Morning Herald here. Some are predicting that costs could still fall further.
In Australia, IVF funding works differently as there is a financial rebate from Medicare, the publicly funded healthcare system, but the fact that one IVF provider undercutting the others could have an influence on the market is a development which could potentially have an impact elsewhere…
Fertility Network UK have a number of media requests for people to talk about how the cuts to NHS fertility services that are happening across England are affecting them. They really need people who are willing to talk about it as the situation is only reported on when the media can give an insight into how this affects those who need treatment.
In particular, they are looking for people who are unable to access any NHS IVF services because they live in South Norfolk, mid-Essex or north-east Essex where funding has been cut completely. They also need people who live in areas where NHS IVF could be cut completely in the near future: Basildon & Brentwood, Bedfordshire, Ipswich and East Suffolk, and West Suffolk. Other areas where cuts have occurred include Cambridgeshire and Peterborough, North East Lincolnshire and Somerset.
ITV news have been looking for people affected by the postcode lottery anywhere in the UK. They are keen to speak to people who have moved house to try to access NHS treatment, who are going overseas because they can’t access NHS treatment or are embarking on treatment in the private sector because they can’t get NHS treatment.
This is your chance to have your voice heard. Email firstname.lastname@example.org or phone 07469-660845.
I’m off to the South West for the day today – and am sad to note that it is one of the worst areas in the country when it comes to the provision of NHS-funded fertility treatment. Earlier this week, Somerset became the most recent area to cut IVF fertility treatment and offer just one single cycle of funded IVF.
When funding for fertility treatment is cut, the excuse is often that commissioners are only following what the public wants. However, Somerset Clinical Commissioning Group (CCG) have decided to cut fertility funding despite the fact when they carried out a public consultation, most people wanted them to offer three full cycles rather than cutting down to one. Sarah Norcross, Co-Chair of Fertility Fairness explains: ‘The CCG’s own consultation shows that the majority of people consulted (57 per cent) want three cycles of IVF to be funded and that the majority of those consulted (74 per cent) also said that the number of NHS-funded IVF cycles should not be reduced in order to balance the costs of reducing fertility treatment waiting times from three years to two. We are appalled to see patients and the public ignored and let down by Somerset CCG.
Susan Seenan, co-chair of Fertility Fairness and chief executive of leading fertility charity Infertility Network UK said: ‘Somerset CCG is also ignoring national public health guidance on treating the disease of infertility. The National Institute for Health and Clinical Excellence recommends that it is both clinically and cost effective that all eligible couples should receive up to three full NHS-funded cycles of IVF or ICSI where women are aged under 40. Reducing IVF provision will have a drastic impact on patients and the health economy. The pain and grief of fertility problems has severe social and economic consequences – leading to depression, social isolation and the breakdown of relationships.’
So why do Clinical Commissioning Groups so often decide that fertility patients don’t deserve the treatment NICE recommends? Why are so many cutting back? And what can we do to stop it? If your local provision is not good, writing to your MP or local Healthwatch will certainly help – look at the Infertility Network UK website for some template letters to assist with this, and do visit the Fertility Fairness website too for more information about provision across the UK and the campaign to improve it.
All too often, IVF is criticised as being “unsuccessful” when people look at the chances of getting pregnant from an individual cycle of treatment – but now a new study shows that the majority of couples are successful if they are able to have more than one cycle. The research, published in the Journal of The American Medical Association, has found that 65% of patients will have a baby if they have six or more cycles.
The recommendation here in the UK is for three funded cycles, and in many parts of the country fertility patients can’t even access that, but this research suggests that more people could be successful with more treatment. The researchers found that in all women, the cumulative percentage of live births across all cycles continued to increase up to the ninth cycle.
You can read more about the study, whose main authors were Professor Debbie Lawlor of the University of Bristol and Professor Scott Nelson from the University of Glasgow’s School of Medicine, on the Bristol University website here
This is really welcome research as all too often when NHS funding is cut, local commissioners claim that IVF has very little chance of success after one or two cycles, but this research suggests there could be benefits to extending the number of IVF cycles beyond three or four.
The study included 156,947 U.K. women who received 257,398 IVF cycles between 2003 and 2010 and were followed up until June 2012. It was funded by the Wellcome Trust and the Medical Research Council.
We’ve all heard the arguments about the cash-strapped NHS and IVF is a treatment that commissioners in North East Essex have recently decided they can’t afford. But is this really a sensible financial decision? Whatever you think about the rights and wrongs of cutting funding to one group of patients based on the fact that you’ve decided they aren’t as deserving of treatment as some others, there’s also a question of economics.
In Canada, the funding decisions seem to be going in the opposite direction with more states looking into offering treatment after a very detailed report showed that funding and regulating IVF treatment would actually SAVE money rather than costing money when multiple births were taken into consideration.
This is an issue that was raised with Mid-Essex CCG when they were cutting treatment,a s they were warned that some people would go overseas for cheaper, unregulated treatment. In Mid-Essex, they said this was a risk they were prepared to take, despite the fact that we know that it is the biggest risk to health from fertility treatment – and that one very premature triplet pregnancy could cost more than offering IVF to everyone who needed it in the area. Last year’s Canadian study would back this up as it showed millions of pounds in savings in health care and societal costs over 18 years by offering regulated IVF treatment.
You can read more about what’s happening in Canada here, but it does show that CCG decisions about cutting treatment in this way are unlikely to save any money in the long run and may end up being an expensive mistake.
York has not been the place to have a fertility problem for many years, having funded no IVF treatment at all. Then, earlier this year, hopes were raised when Vale of York CCG announced that it would offer funding for one cycle of IVF. Sadly, just a month later and before anyone had managed to benefit, the CCG said it had decided it couldn’t afford to do this after all, estimating the cost at £2 million to offer one cycle to an estimated 110 people (and explaining what other essential services they could provide with this much money). This rather baffling figure was more than four times the cost of IVF at most fertility clinics.
Now, Vale of York CCG is due to look at IVF funding again on Thursday and may change their minds once more on this policy having looked again at the cost.
Of course, anyone in York waiting for treatment will be delighted if they are finally able to access one cycle of treatment, but we shouldn’t forget that this is still not what NICE recommends that the CCG should be funding – three full cycles to those under 39 who are eligible. And we should perhaps take a moment to think about how this must feel for those people who have spent the last few months having their hopes raised and dashed because the CCG has not been able to come to a clear conclusion.
Just a quick reminder that there’s still time to have your say on fertility funding in mid-Essex where the CCG are proposing to cut fertility treatment to all fertility patients – and only offer it to people who are having cancer treatment and HIV positive men. Why those two groups? You may well ask… It seems that both were mentioned in last year’s update of the NICE fertility guidelines – but that was only because the way these groups should be offered treatment needed updating, not because they were being singled out in any other way.
One of the fertility clinics in the area, Simply Fertility, have come out and expressed their concern about this – and you can do that too. Have a look at the Simply Fertility blog for more details, or go straight to the consultation here and fill in the survey by following the link. It doesn’t take long, and your views will be appreciated.
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.”