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NHS commissioners told to end IVF postcode lottery

19 May 2014
Appeared in BioNews 754

The National Institute for Health and Care Excellence (NICE) has published a set of draft statements that aim to 'eliminate' current geographical disparities in access to treatment and support services for people affected by fertility problems in the UK.

Despite NICE issuing fertility guidance back in 2004, which was updated last year, almost three-quarters of GP-led Clinical Commissioning Groups (CCGs) are reported to not offer the recommended three cycles of IVF treatment to patients, with some CCGs offering no IVF treatments on the NHS at all (reported in BioNews 739).

The new statements provide a quality standard to be applied across all CCGs that highlights areas of care where improvements are needed most. Among other 'prioritised statements', the draft quality standard, currently under consultation, states that women aged under 40 are offered three full cycles of IVF in certain circumstances.

Sarah Norcross, co-chair of the National Infertility Awareness Campaign and director of the Progress Educational Trust, which publishes BioNews, said: 'This is an excellent move. We are delighted that NICE has accepted our recommendations and that the number of cycles has been included in the quality standard. We are also pleased that an explicit statement has been included regarding living children as this is too often used as a reason to refuse treatment'.

'This should send a strong and clear message to all commissioners and could not be a better - or clearer - indication of exactly what is needed to bring the unfair and unequitable postcode lottery approach to an end'.

The publication of the draft quality standard comes after last month's High Court ruling concerning a CCG's decision to not follow NICE guidance on the cryopreservation of eggs before chemotherapy treatment.

Despite the CCG having no legal duty to comply with NICE guidelines, the court ruled that the CCG held obligations in public law to have regard to the NICE guidance and was required to provide clear reasons for any policy choosing not to follow its recommendations. 

The draft quality standard states that people of reproductive age preparing to have treatment for cancer are offered cryopreservation.

Professor Gillian Leng, Director of Health and Social Care at NICE said: 'The quality standard that we are currently developing should help healthcare services to focus on the key areas of care that need to be addressed most urgently and ensure that the right support and treatment is available to those who need it'.

'When published, this standard will complement our guidance on the treatment and support of people with fertility problems, creating a comprehensive guide to help the NHS provide and maintain consistent and high-quality care for all'.

It is expected that the final standard will be published in October 2014.

Court warns CCG over disagreeing with NICE guidance
NICE (press release) |  6 May 2014
NHS organisations ordered to stop denying couples infertility treatment
The Guardian |  15 May 2014
NHS trusts told 'give IVF to more women': Watchdog acts as three-quarters let patients down
Daily Mail |  15 May 2014
NHS trusts told to end postcode lottery of IVF treatment
Telegraph |  15 May 2014
NICE consults on new draft standard to end 'postcode lottery' of fertility treatment
NICE (press release) |  14 May 2012
12 December 2016 - by Dr Rachel Montgomery 
Only 16 percent of Clinical Commissioning Groups in England follow the national guidance on access to NHS fertility treatment, according to an audit by campaign group Fertility Fairness...
27 October 2014 - by Sean Byrne 
The National Institute for Health and Care Excellence (NICE) has published a quality standard that aims to bring an end to a 'postcode lottery' in the provision of fertility services on the NHS, which it says is restricting access to treatment....
22 September 2014 - by Vicky Whitehead 
In the UK, clinical commissioners seem to view the national recommendations on fertility treatment as a sort of à-la-carte menu from which they can pick and choose; altering the definition of a cycle, the age requirements, the number of cycles available, and the access criteria at will...
22 September 2014 - by Rebecca Carr 
Research conducted by the campaign group Fertility Fairness has uncovered significant variations in the amount that NHS Clinical Commissioning Groups are paying for one cycle of IVF treatment....
28 July 2014 - by Ruth Retassie 
Mid Essex Clinical Commissioning Group has proposed to limit access to IVF to cancer patients and HIV-positive men under its options for reform to the funding of its fertility services....
14 April 2014 - by Cait McDonagh 
A Crohn's disease patient is challenging a decision to refuse her funding for her eggs to be cryopreserved before she undergoes a bone marrow transplant and chemotherapy...
27 January 2014 - by Julianna Photopoulos 
A recent survey carried out by the National Infertility Awareness Campaign (NIAC) found that 73 percent of clinical commissioning groups (CCGs) are not funding the recommended cycles of IVF treatment....
25 February 2013 - by Michelle Downes 
Women over the age of 40, same-sex couples, and people with disabilities have been addressed for the first time in the updated NICE guideline on fertility treatment...
3 September 2012 - by Cathy Holding 
Around one in three women who are entitled to receive IVF are being denied this right, according to a survey carried out by the National Infertility Awareness Campaign (NIAC)...
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