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

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.

Would you ask strangers for money to pay for IVF?

It may sound incredible, but apparently people are having to come up with ever more inventive ways to fund their fertility treatment in the current economic situation.  With many couples already living on overdrafts, cutting back on holidays or other luxuries will not free up the ready cash needed, and getting loans or using already overloaded credit cards is becoming increasingly difficult. So, in the States at least, some couples have apparently turned to the internet using websites or Facebook to ask strangers for money to fund their treatment – see this article.  Could you consider this? Should you have to?

Here in the UK, the postcode lottery for treatment continues to cause distress to many couples who find they can’t access IVF despite being eligible according to the national guidelines because in their local area the primary care trust has decided not to fund treatment – or to ration it.  It can be very difficult to find the money for private treatment which will cost more than the NHS would pay.  Lord Winston campaigned on this some time ago – saying that many clinics were hugely overcharging for fertility treatment and that it could be far cheaper.

Asking strangers for money may seem extreme, but does perhaps illustrate how difficult it can be to live with involuntary childlessness…