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.”

 

Update on fertility funding

A decision to cut IVF funding just a fortnight after the deputy Chief Executive of NICE made it clear that fertility guidelines were there to be followed shows just how badly the current system is failing fertility patients.  The guidelines for funding, set by NICE, are based on lengthy in-depth research and analysis of what is both clinically and cost effective for the NHS looking at all the available evidence, yet some local commissioners have decided to completely ignore this carefully researched guideline, instead coming up with their own ideas about what’s effective and what isn’t.

In East Anglia, clinical commissioning groups in West, North and South Norfolk, Norwich and Cambridgeshire and Peterborough have reduced the number of cycles of IVF they fund without any formal consultation – or any formal announcement.  Last night, I went to talk to Susie Fowler-Watt about this on BBC Look East as they wanted to understand what the decision would mean to patients – and it’s clear it will be devastating, adding pressure and anxiety to those who are already living with the impact of fertility problems.

Let’s be clear – infertility is a medical condition, and IVF is an appropriate treatment for that medical condition. Not being able to conceive affects every area of your life, and can lead to isolation and depression, damaging relationships and friendships. Fertility funding is easy to cut because fertility patients are not going to be out there with placards shouting about it – many are unable to even talk about the corrosive effect it has on their lives, they may not even tell their closest friends and family. There’s still a stigma attached to infertility, and these kind of decisions add to that stigma.

We are meant to have a NATIONAL health service, but when it comes to fertility we have a postcode lottery where your access to the treatment you need for a medical condition depends entirely on where you live.

Susan Seenan, Chief Executive of Infertility Network UK and Co-Chair of the National Infertility Awareness Campaign, said last night: “NICE originally recommended 3 full cycles back in 2004; it is clear that 3 cycles is what is expected nationally and it has been proven to be the most clinically and cost effective number for commissioners to offer on the NHS. Indeed Gilian Leng, deputy chief executive of NICE, has recently confirmed that CCGs which don’t follow the guidance are exacerbating the problem of variation in care, which contradicts the fundamental aims of the NHS. Infertility doesn’t discriminate, and neither should the CCGs. We would urge them all to take heed of the guidance issued by NICE and reverse these decisions to ensure that access to fertility treatment is fair and equitable right across the country.”

 

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.