The NHS Newark and Sherwood, and Mansfield and Ashfield Clinical Commissioning Groups (CCGs), made the decision to restrict access to funded IVF treatment in a bid to address their financial deficit.
Following public consultations regarding the proposed changes to eligibility for IVF, the two governing bodies decided to continue NHS-funded IVF but narrowed the eligibility to women aged 25–34 and also introduced an age limit of 40 for men. Prior to these changes, the lower female age limit was 18, the upper female age limit was 42 and there were no male age restrictions in place.
A joint CCG statement said that this particular age range was chosen to reflect the best possible chance of obtaining a successful pregnancy through IVF. However, NICE – which makes evidence-based recommendations to the NHS – states that CCGs should provide women under 40 years old with three cycles of IVF and that women between 40 and 42 should receive one cycle. The NICE fertility guideline is not mandatory, however, and CCGs can choose to adopt their own policies.
The two Nottinghamshire CCGs currently offer one cycle of IVF per couple, which costs around £300,000 per year. By limiting the number of funded IVF cycles, the CCGs say that they can reduce their annual expenditure on fertility treatments to help address their £20m funding shortfall.
Dr Amanda Sullivan, chief officer for NHS Newark and Sherwood and Mansfield and Ashfield CCGs, said: 'We have listened to the public and have analysed the results of the IVF consultation, which showed some strong support to continue to provide IVF services. In taking this decision we believe we have reached a conclusion that allows us to continue to provide the service yet still maintain our responsibilities to commission safe and effective care in Mansfield, and Ashfield, and Newark and Sherwood – still under very challenging financial circumstances.
'We do recognise the impact that our decision will have on local people but we have to balance the needs of our whole population and ensure that there is enough money to maintain high quality and safe services,' Dr Sullivan added.
Avril Mackie, clinic director of CARE Fertility in Nottingham, said: 'We are quite pleased that [Mansfield and Ashfield/Newark and Sherwood CCG] agreed to continue funding – the worry was always that they were going to cut funding completely.
'But the new criteria will deny access to many women over the age of 34 who need help to have a family, especially when the average age at which they have treatment is 36. Whilst we understand the budgetary pressures faced by the NHS, this announcement will inevitably cause distress to patients. '
Of the 424 responses to the CCGs' consultation, 74 percent disagreed with stopping IVF treatment entirely and 43 percent said it should only be provided in exceptional circumstances. Almost half agreed with reducing the female upper age from 42 to 40 years old.
The changes are set to be reviewed in 2018.