A long-awaited government women’s health strategy is failing fertility patients, a leading fertility charity has revealed in an analysis it has conducted
According to the Progress Educational Trust, the majority of England’s 42 Integrated Care Boards (ICBs) are failing fertility patients in general and women in particular.
When the UK government published its long-awaited Women’s Health Strategy for England in July 2022, it included a commitment to remove ‘the current geographical variation in access to NHS-funded fertility services’, known as the fertility postcode lottery.
But this week, a detailed analysis of fertility treatment commissioning policies – undertaken by fertility charity PET – found that only four out of 42 ICBs offer the recommended three NHS-funded IVF cycles across their entire area.
Of these four ICBs, three ICBs are offering full IVF cycles, as defined and recommended by the National Institute for Health and Care Excellence (NICE).
Furthermore, the recent move from Clinical Commissioning Groups (CCGs) to ICBs – combined with the fact that policies have not been fully harmonised – means that there is now a postcode lottery for treatment within a single ICB in some places.
The charity said that as an example of this, if you are a fertility patient and your ICB is Greater Manchester or Humber and North Yorkshire, then whether you are able to access three funded IVF cycles, two funded IVF cycles, or only one funded IVF cycle will depend on your postcode.
PET data also shows that ICBs are failing to improve on the legacy policies of CCGs more generally.
For example, only 15 out of 42 ICBs have policies that comply with the NICE definition of a full cycle of IVF. PET data shows that instead of complying with this definition, the majority of ICBs have instead chosen to redefine what constitutes a cycle of IVF.
The NICE Guideline recommends that women under the age of 40 should be offered NHS-funded IVF treatment. PET data shows that three ICBs have introduced a substantially lower maximum age limit of 35 years instead of complying with this recommendation.In addition to these three ICBs with a lower maximum age limit of 35 years, there is at least one ICB within which there is a postcode lottery for age limits. If you are a fertility patient and your ICB is Frimley, the age limit for eligibility for NHS-funded IVF can be 34, 35 or 39, depending on your postcode.
The Women’s Health Strategy includes a government commitment to ‘ensure all NHS fertility services are commissioned in a clinically justifiable way’. But PET data shows that non-clinical criteria are still being widely used, with 32 out of 42 ICBs refusing to offer NHS-funded IVF to a patient whose partner has a child from a previous relationship.
The Women’s Health Strategy includes a government commitment to ensure that when it comes to same-sex couples, ‘there is no requirement for self-funding and the NHS treatment pathway for female same-sex couples will start with six cycles of artificial insemination, prior to accessing IVF services if necessary’. But PET has found that 22 out of 42 ICBs clearly state that same-sex couples must self-fund at least six – and sometimes up to 12 – cycles of artificial insemination.
Sarah Norcross, Director of PET, said: “The Women’s Health Strategy promised to shine a light on the inadequacies in NHS funding for IVF treatment. Our data shows that this is not happening.
“If the Government is having difficulty honouring its commitments in the Women’s Health Strategy, then people need to know so that solutions can be found.
“Every delay diminishes women’s chances of having much-wanted babies.”
