Fertility funding

The news of cuts to funding for fertility services has made depressing reading over recent days, with more and more areas cutting IVF in order to save money. As many people realise, cutting funds for IVF is a questionable way to save money in the longer term – you end up with dejected, unhappy people who are far more likely to need medical help for depression and related illnesses (we know from a Fertility Network UK survey that the majority of people with fertility problems have experienced depression and that more than 40% have had suicidal feelings as a result of their fertility problems).

People struggling to fund their own treatment often end up going overseas where IVF can appear cheaper, but where there are not always the same measures in place to reduce the numbers of multiple pregnancies, which is the biggest health risk from IVF.  It doesn’t need many sets of prematurely-born triplets conceived after multiple embryo transfers overseas to wipe out any savings from cutting IVF funding here in the UK.

What was more depressing was the reaction to the news about the cuts from some quarters – people with absolutely no understanding or knowledge about infertility who felt the need to try to grab centre stage by offering ill-informed opinions. We all know that not everyone agrees with the NHS funding IVF treatment, but most of those who think this way have the good grace to recognise that infertility is tough and that anyone experiencing it deserves some empathy. Not so one person writing in the Independent who suggested that fertility treatment “only serves to fulfil people’s whimsical obsession with baby-making”, that the NHS should not pay for people to become parents “if they fancy it” and that there is no justification for treatment “just because it will make some people feel more fulfilled in their life”. It was quite breath-taking to read such a glib and insensitive dismissal of a medical problem. Right back to biblical times, the huge impact of infertility has been understood with Rachel, who was unable to get pregnant, crying “Give me children, or else I die”. Infertility is recognised by the World Health Organisation as an illness, and NICE says that IVF is a clinically and cost-effective treatment.

I’m not adding a link to the article in the Independent, or addressing the poorly researched claims as to why we shouldn’t fund IVF one by one. Suffice to say that a few hours after the piece appeared, the person who wrote it tweeted “So I’m about to go on Newsnight. No big deal, right? RIGHT?!?!”… The tweet explained everything about the lack of empathy, understanding or any shred of human kindness in the piece. This article was never meant to be a thoughtful response to a social problem, but was all about trying to create the sort of stir that gets you noticed and on television. It’s just a shame that the media desire for controversy and debate means that ignorance often gets to masquerade as valid opinion.

Possible IVF cuts in Wiltshire?

ivf_science-300x168Wiltshire is the latest Clinical Commissioning Group to be considering cutting their provision of fertility services – and sadly one of their reasons for doing so appears to be because other Clinical Commissioning Groups have taken the decision to do so. A spokesperson for Wiltshire told the BBC that they needed to reduce treatments to match what was happening in neighbouring areas where commissioners were offering fewer cycles.

Wiltshire is facing financial problems with a predicted overspend of more than two million pounds – but cutting IVF will make a minuscule reduction in this overspend and may actually end up costing more money in the future if the potential cost of multiple pregnancies from couples who end up going overseas for treatment are taken into consideration.

The latest from Bedfordshire

4cell_embryo.tifWhat a sorry state of affairs in Bedfordshire where the CCG was recommended to continue funding one cycle of IVF treatment, but instead delayed making a decision until November. Anyone needing IVF in the region was only ever getting one of the three full cycles recommended as being clinically effective and cost effective by NICE, and their consultation on cutting all IVF had led to the recommendation to continue instead.

A spokeswoman for the Bedfordshire Clinical Commissioning Group told Bedfordshire on Sunday that the evidence base and associated research was “complex”.  It is really not cost effective for the Clinical Commissioning Group to spend time trying to make sense of this when NICE has already looked into this in very great depth making use of the knowledge of some of the country’s leading experts in the field and also using skilled health economists to work out what would be most cost effective. Let’s hope that Bedfordshire CCG use this evidence when they make their decision in November, and rather than considering cutting the one cycle they currently offer, instead start funding what NICE recommends.

The shocking truth about the cost of IVF to the NHS

You’d assume that the amount the NHS pays for each IVF cycle is pretty much the same wherever you live – and that commissioners negotiate a good deal given that they are purchasing IVF treatments in bulk…

In fact, the campaign group Fertility Fairness has discovered that the amount paid by the NHS for a cycle of IVF treatment varies hugely across the UK, costing at least twice as much in some areas as in others. Fertility Fairness has gathered information from all but one of the Clinical Commissioning Groups (CCGs) across England which shows that average prices paid for IVF range from £2,900 to £6,000, with some claiming even higher and lower costs.

Their audit also shows a clear reduction in the number of CCGs offering the three full cycles of IVF treatment recommended, with just 18% currently offering what NICE recommends.  Two CCGs offer no IVF funding at all, and seven others were claiming to offer three cycles of IVF when in fact they only offered one.

Y3qgabAY_400x400Sarah Norcross, Co-Chair of Fertility Fairness, said: “Our audit has revealed a picture of widespread confusion about the real cost of IVF, and illustrates the need for a national tariff to inject some parity and value into the commissioning process. Cost is cited by NHS commissioners as a major barrier to complying with NICE guidance, and yet we now know that it is not even clear how much an individual cycle of IVF should cost. The discrepancies are huge, and this needs to be addressed as a matter of urgency.”

Susan Seenan, Chief Executive of patient charity Infertility Network UK said: “Access to fertility treatment in the UK still depends entirely on where you live, and patients are at the mercy of the postcode lottery. Now it appears that some CCGs are apparently paying more for a cycle of NHS-funded IVF than an individual patient might expect to be charged at a private clinic. It is patients who suffer the effects of this mismanaged system. Clear guidance on costing would help CCGs to implement the NICE guideline fully and allow patients to access the treatment they need.”

For more information about Fertility Fairness, visit www.fertilityfairness.co.uk

Lord Winston calls for better provision of NHS fertility treatment

Thanks to Lord Winston, for using the occasion of receiving an honorary degree from Birmingham City University to call for better provision of IVF from the NHS. This comes at a time when we’ve seen a number of high-profile cases where commissioners are clearly showing how little commitment they have to helping fertility patients – from Vale of York where the CCG did a bizarre U-turn having promised to start funding IVF and then changing their minds just a few weeks later to Mid-Essex where they have come up with the extraordinary idea of only offering fertility treatment to people who don’t actually have fertility problems…

Lord Winston also talked about alternatives to IVF – as he feels it is often offered as the only treatment where others may be just as good if not better. You can read more about what he said here 

Behind the scenes in York

Many couples living in the area covered by the Vale of York CCG were left devastated by the decision to make a U-turn on the promise to start funding some fertility treatment. Having been singled out as the worst provider in the country, it had seemed that the local CCG was about to improve matters for fertility patients – and so the change of heart just a month after the original promise seemed particularly cruel.

It has now emerged that one of the panel of voters – who had been in favour of offering IVF to local patients – abstained from the vote because he will be standing as an election candidate.  You can read the full story in the Yorkshire Post, but it has emerged that the vote was lost five to four – which would not have been the case had Dr Mark Hayes used his vote.  This was also covered by ITV News.

A petition has been launched by the fantastic fertility support group in York, and you can sign it here – please do!

Refused NHS funding in NW London?

Do you live in North-West London? Have you been refused NHS-funded fertility treatment? The NICE guidelines say that if you’re 39 or under and need IVF, you should be entitled to three full cycles, but at present that’s not happening in many areas of the country, including the London boroughs of Brent, Ealing, Hammersmith & Fulham, Harrow, Hillingdon, Hounslow, Kensington & Chelsea, and Westminster.

If you’re fed up about what you’re being offered and live in one of these areas, could you contact katebrian@infertilitynetworkuk.com – this isn’t for media purposes, so you can remain anonymous.  Many thanks in advance!

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