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National standards needed for IVF cycles, says health minister

2 March 2020
Appeared in BioNews 1037

UK health minister Matt Hancock has said Clinical Commissioning Groups (CCGs) should not be determining the level of access to National Health Service (NHS) fertility services; instead commissioning of NHS-funded IVF should be decided at a national level with national standards.

Speaking at a Nuffield Trust event, he said: 'Why should three cycles of IVF be allowed in some parts of the country when some other parts offer none? A local part of the NHS deciding it's okay not to offer IVF… it's absurd, it's unacceptable in a national system.'

He continued: 'It is not for a CCG to decide whether you should have zero, one, two or three rounds available. The idea that a local body that does not have elected legitimacy [such as CCGs] should make what is in effect an allocative decision around different parts of the country [is wrong]. [We should] set national standards then leave local areas to do their best.'

Sarah Norcross, director of Progress Educational Trust (PET), which has been campaigning to end England's IVF postcode lottery for years, said: 'PET is delighted to hear health and social care secretary Matt Hancock's comments that local clinical commissioning groups should not be denying infertile couples access to NHS-funded IVF based on where they live or any other arbitrary access criteria. His words that commissioning of NHS fertility services should be centralised with national standards that are fair for all are a victory for common sense.'

'What we need to see now is a policy shift towards a centralised and fair IVF commissioning model; time is of the essence for the one in six couples experiencing the far-reaching devastation infertility wreaks' she said.

The National Institute for Health and Care Excellence (NICE) guidelines recommend that women under 40 receive three full IVF cycles, and women aged between 40-42 to have one full IVF cycle because this has been determined to be the most clinically effective and cost-effective treatment for infertility. However, this guidance is not mandatory and, outside of Scotland, NHS fertility services are rationed unequally.

Wales provides two full IVF cycles for clinically eligible women under the age of 40, plus one full cycle for women aged between 40-42. Northern Ireland provides one partial IVF cycle for women under 40, though it has announced plans to increase this to three cycles.

Access to NHS fertility treatment in England is decided at a local level by CCGs. According to Fertility Fairness data, the majority of CCGs (88 percent) do not provide three full IVF cycles, with five CCGs offering no treatment. 

In the last four years, there has been sustained disinvestment in NHS fertility services in England: more than one in five CCGs have either cut the number of cycles they offer or introduced stricter access criteria, and almost one in ten are currently consulting on cutting or removing NHS fertility treatment.

SOURCES & REFERENCES
Hancock: CCGs' power to determine IVF cycles should be removed
HSJ |  28 February 2020
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