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NICE releases fertility quality standard, says postcode lottery is 'completely unacceptable'

27 October 2014
Appeared in BioNews 777

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. 

The 2013 NICE fertility guideline recommends that eligible women under 40 should be offered three full cycles of IVF on the NHS. However, fewer than one in five Clinical Commissioning Groups (CCGs) meet NICE's recommendation in full.

The recently published fertility quality standard, defined as 'a concise set of prioritised statements designed to drive measurable quality improvements within a particular area of health or care', applies across all CCGs and emphasises the importance of treating infertility.

Among its statements, it says eligible women under 40 should receive three full cycles, and women aged 40–42 one full-cycle, reflecting the 2013 fertility guidance. As the quality standard explains: 'Access to the appropriate number of full cycles of IVF for women who meet the criteria for IVF will increase the likelihood of those women becoming pregnant.'

The statements also highlight areas of care where improvements are needed most, including referring couples for specialist services earlier and that people having cancer treatment that could affect their fertility are offered cryopreservation.

Professor Gillian Leng, deputy chief executive of NICE, said that '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,' she said. There is no obligation on CCGs to implement NICE's recommendations, although they must give clear reasons for not choosing to follow its guidance (see BioNews 751).

While the Vale of York is the only CCG to not provide any IVF treatment at all, 110 CCGs fund only one cycle of treatment. Mid Essex CCG will only fund specialist fertility services in exceptional clinical cases, but has stated it will review its policy again in September 2015.

Susan Seenan, chief executive of Infertility Network UK and co-chair of Fertility Fairness, said that 'there are clear guidelines, based on cost and clinical effectiveness, and it is simply not acceptable for the CCGs to refuse to follow them'.

One cycle of IVF can cost around £3,000, although Fertility Fairness has found significant variations in the amount that CCGs are paying for a cycle of treatment (see BioNews 772).

Dr Allan Pacey, the chair of the British Fertility Society, said that '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,' he added.

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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...
20 June 2016 - by Stephen Harbottle 
Since its launch in 1948, the NHS has become the world's largest publicly funded health service and a beacon of what is possible to the rest of the world. Unless, it seems, you are finding it hard to conceive...
2 November 2015 - by Rebecca Carr 
The number of CCGs in England offering the recommended number of IVF cycles to its patients is falling, with two CCGs in Essex decommissioning their assisted conception services altogether...
30 March 2015 - by Antony Starza-Allen 
A charity has called for all NHS Boards in Scotland to move towards offering eligible patients three full cycles of IVF...
30 March 2015 - by Vicky Whitehead 
In England, the IVF postcode lottery impacts on every different level of a patient's NHS treatment in a myriad of ways. Not only is there widespread variation in who can access treatment and the number of IVF cycles available, but even in how a cycle is defined...
29 September 2014 - by Siobhan Chan 
Mid Essex Clinical Commissioning Group has announced it will no longer be funding IVF except under 'clinically exceptional circumstances'...
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....
11 August 2014 - by Ayesha Ahmad 
NHS bosses in York have been accused of backtracking on a promise to restart funding for IVF treatment, disappointing an estimated 110 couples requiring treatment in the area...
19 May 2014 - by Rebecca Carr 
The National Institute for Health and Care Excellence has published a set of draft statements that aim to 'eliminate' current geographical disparities in access to fertility treatment...
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....
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