Stop the rationing of fertility services
Reproductive & Gynaecological On Saturday 25 March, a patient day of action will invite everyone affected by the unfair rationing of NHS fertility services to write to their MPs. The call is for people to share their personal journeys with infertility, and to highlight the state of local NHS fertility services.
Official NHS guidelines for fertility treatments are freely available, yet almost all - 98 per cent - of England’s 209 local NHS clinical commissioning groups (CCGs) do not comply fully – and further cuts remain on the cards. Fertility Network UK, which is holding the day of action, believes that just over one in ten of England’s CCGs are currently consulting on reducing IVF services.
Susan Seenan, who heads the Fertility Network UK charity, says this postcode lottery stands in stark contrast to Scotland, Wales and Northern Ireland, where access criteria and provision are standardised and equally accessible. Improvements expected this year in Scotland look set to widen the gap further still.
98% of England's CCGs do not comply fully with official NHS guidelines for fertility treatments
Fertility Network UK believes it is “entirely possible for England to implement NHS IVF recommendations.” Ms Seenan says: “Fertility treatment is almost always the first – even, the only - option considered for decommissioning. All CCGs experience the same financial pressures, but some have found ways to ‘work smarter’.”
The ones that do, she believes, share the realisation that to cull fertility services is a false economy; the NHS picks up the tab for any pre and postnatal complications following fertility treatment abroad, where multiple embryo implantations are more common. “One triplet pregnancy will wipe out the savings achieved by decommissioning NHS fertility treatments,” Ms Seenan points out.
The spiralling costs of psychological therapies among subfertile couples – counselling, etc – are another issue. A Fertility Network UK survey finds that 90 per cent of people with fertility problems feel depressed and 42 per cent have had suicidal feelings. Ms Seenan says: “We hear about people who go to the GP with this or that medical complaint, but the root cause of their medical issues is depression about their inability to conceive.” Unfortunately, little is known about the impact on same-sex couples who face a harder battle to prove unexplained fertility.
"It is entirely possible for England to implement NHS IVF recommendations"
- Susan Seenan
Then, there is the administration – and the cost to the NHS - of dealing with individual funding requests by patients. “If you fit the NCE criteria for treatment, then appealing to the CCG or submitting an individual funding request is one way to try to get the CCG to fund your treatment,” says Ms Seenan, adding that template resources to help individuals appeal are on the Fertility Network UK website.
But, most of all, and what “definitely works”, says Ms Seenan, is to ensure that the voice of real people with fertility problems is heard. “CCGs which have retained fertility services tell us that they have listened to what people said. So, write to your MP, to the public health minister and to your local CCG to get it on the radar that blanket restrictions are unacceptable. People can make a difference to the politics.”