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Patients denied IVF treatment by cash-strapped PCTs



By Lilian Anekwe

Exclusive: GPs are being refused the ability to refer infertile couples for IVF treatment, with a number of PCTs now imposing a blanket ban on all applications, a Pulse investigation shows.

Data obtained under the Freedom of Information Act from 124 primary care organisations show that in some areas patients are being completely denied access to IVF, leaving GPs hamstrung when dealing with pleas from desperate infertile couples.

Current NICE guidance, published in February 2004, states that all eligible patients should be provided with access to three rounds of fertility treatment.

But our investigation shows some PCTs are flouting the guidance by either refusing to fund requests or ramping up the criteria for eligible patients, effectively making it more difficult for GPs to refer patients for treatment.

Nine trusts said they had not funded any requests for IVF treatment in the last two years, with many more reporting they were now funding fewer requests. But 19% – nearly one in five – have cut the number of procedures funded over the past three years.

NHS Brighton and Hove City restricted the number of cycles GPs can refer patients for to two from 2009/10.

NHS Cornwall told Pulse the economic downturn had forced it to revise its IVF referral policy in December 2009.

‘In the context of limited resources, treatment should be targeted at those with the most need and the greatest chance of success,’ it said in its response. ‘Up to four cycles of IUI (intra-uterine insemination) and one cycle of IVF may be funded per couple.’

Our investigation comes as some trusts imposed a blanket policy on funding applications, which has drawn a furious reaction from fertility experts.

NHS Warrington has reviewed several services that ‘are expensive but which involve a low number of people, and did not match closely the PCT’s goals’, but IVF is the first to be suspended in order to manage costs.

NHS Warrington’s response to our FOI request shows they funded 88 IVF procedures in 2009/10 at a cost of £381,000, down from 96 the year before when it had spent £408,000.

A spokesperson for the trust said: ‘Following recommendations from the review of IVF, the NHS Warrington Board has decided to stop funding IVF treatment.’

‘That decision will be reviewed in July 2011. The PCT will consider applications from GPs for “exceptional treatment” approval where they consider there is an exceptional clinical need.’

Dr Andrew Davies, chair of the NHS Warrington clinical leadership team who chaired the review, said: ‘The PCT must focus rigorously on the need to maintain financial stability while providing high quality local healthcare… unfortunately IVF does not meet these criteria.’

Mr Tony Rutherford, chair of the British Fertility Society and consultant gynaecologist at the Leeds General Infirmary, said GPs’ inability to refer infertile patients for IVF meant patients were being denied a ‘fundamental right’.

He added: ‘This is a retrograde step, out of keeping with all messages coming from central Government, and shows scant regard for the needs of the one in six couples who suffer from infertility.’

A spokesperson for NICE said they had already begun to review its guidance on fertility, ‘to ensure all of its recommendations reflect current evidence.’

Nine trusts said they had not funded any requests for IVF treatment in the last three years Nine trusts said they had not funded any requests for IVF treatment in the last three years