Cuts ‘hitting fertility treatment’

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Published: Thursday 23rd October 2014 by The News Editor

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Women across Britain are being denied fertility treatment because NHS trusts are trying to cut costs, a health watchdog has warned.

Thousands of couples struggling to conceive are being subjected to unfair “postcode lotteries”, causing “widespread inequality”, experts have said.

And many are having to resort to costly private care because NHS provision is so patchy and hard to access, fertility groups have warned.

The National Institute for Health and Care Excellence (Nice) has warned that fewer than one in five commissioning groups are paying for the full number of IVF cycles recommended.

And the commissioning group covering mid Essex will not fund IVF treatment unless there are “clinically exceptional circumstances”.

Professor Gillian Leng, deputy chief executive and director of health and social care at Nice, said: “Infertility can have a potentially devastating effect on people’s lives – it can cause significant distress, depression and possibly lead to the breakdown of relationships.

“It is unacceptable that parts of England are choosing to ignore Nice recommendations for treating infertility. This perpetuates a postcode lottery and creates inequalities in healthcare across the country.

“We understand that the NHS is under financial constraints, but fertility is a core NHS service.”

Current Nice guidelines say the NHS should provide three full cycles of IVF treatment for women aged under 40 who have failed to get pregnant after two years of trying, or 12 cycles of artificial insemination.

Women aged 40 to 42 should receive one full cycle if certain criteria are met.

The warning comes as Nice issues a quality standard on fertility reminding the NHS that IVF treatment is a core part of NHS services and should not depend on where you live.

Susan Seenan, chief executive of Infertility Network UK and co-chair of Fertility Fairness, said: “It is totally unacceptable that ten years on from the initial Nice recommendations, access to fertility treatment still depends entirely on where you live. Patients are still suffering as a result of clinical commissioning groups ignoring national guidance and cutting services.”

Anna Bradley, chairwoman of Healthwatch England, said: “Fertility issues are a particularly emotive subject and it should be a basic right of couples from Bradford to Bedfordshire, or wherever they live, to be able to access the same level of care and support on the NHS.

“Sadly, the so called ‘postcode lotteries’ created by the inconsistent decisions at local level is causing widespread inequality, resulting in unnecessary confusion and frustration for patients and their loved ones. Ultimately, this raises some very serious questions about whether Nice treatments should indeed be made mandatory.

British Fertility Society Chairman Allan Pacey said: “By cherry-picking aspects of guidelines to fund services of their choice, local commissioners fly in the face of what Nice is all about. Their guidelines must be taken as a whole if we are to deliver the best and most cost-effective use of NHS resources.”

Currently Nice recommendations remain guidelines and it is up to the individual commissioning group what services they pay for in their area.

More than half (52%) clinical commissioning groups only offer one IVF cycle to eligible couples, while people with fertility problems in the Vale of York are refused the treatment altogether.

A spokeswoman for the Vale of York clinical commissioning group said IVF services “carries a great element of financial risk” and cost up to £2 million.

She said: “The decision about IVF is one of many tough choices that the governing body will be making through an open and transparent decision process.

“It is hoped that the current non-commissioning of IVF will be a temporary position. The aspiration to meet National Institute for Clinical Excellence (Nice) criteria and to commission IVF services for couples in the Vale of York still remains.”

Published: Thursday 23rd October 2014 by The News Editor

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