The rationing of services to which GPs can refer patients is continuing, as five CCGs have stopped funding for IVF completely amid mounting NHS pressures.
The data has been supplied to Pulse by the charity Fertility Network UK, which monitors the availability of fertility treatment to patients finding themselves unable to conceive.
The updated 2016 audit of England’s 209 CCGs has revealed that NHS Croydon CCG, NHS Mid-Essex CCG, NHS North East Essex CCG, NHS South Norfolk CCG and NHS Basildon and Brentwood CCG are all no longer offering NHS-funded IVF treatment.
The figures also show that 60% of CCGs now offer just one NHS IVF cycle – despite guidance from NICE recommending three cycles of IVF for women under 40 years.
At the same time, 23.4% of CCGs provide just two NHS IVF cycles and only 14.8% offer three NHS-funded IVF cycles.
Further cuts look set to be on the horizon as nearly one in ten CCGs (9%) are known to be currently consulting on cutting or decommissioning NHS fertility treatment.
A spokesperson for Fertility Network UK said: ‘The overwhelming majority of CCGs (98%) ration NHS fertility services unfairly – either by cutting the number of cycles they offer, or denying access if one of the couple has a child from a previous relationship.
’Just four CCGs out of 209 provide the ‘gold standard’ that Scotland does: three full IVF cycles and enable access if there is a child from a previous relationship.’
Cash-strapped NHS Richmond CCG is one of the latest groups consulting on proposals to restrict IVF treatment.
The CCG wants to limit IVF access to patients with ‘exceptional clinical circumstances’ – these might include infertility following cancer treatment, or prevention of the transmission of chronic viral infections, such as HIV.
NHS Richmond CCG currently offers one fresh and one frozen cycle of IVF to women aged 39 years or younger.
The CCG blamds financial pressures for the proposal to cut back IVF treatment, which is out for consultation, arguing that it needs to make savings of at least £13m in the next financial year.
GPC deputy chair Dr Richard Vautrey told Pulse that the move was another sign that many areas of the NHS were under intense pressure.
He said: ‘This is leaving patients in an unacceptable postcode lottery situation where if you live in one CCG you will be restricted in IVF funding while you will receive funding if you live in a neighbouring CCG.’
Dr Vautrey said that he could see how some patients would be ‘angered’ by the situation and advised affected patients to raise the issue as part of the general election campaign.
In January this year the board of NHS Ipswich and East Suffolk CCG was forced to drop plans to cut IVF treatment after receiving strong public opposition. The commissioners said they would continue to offer couples up to two IVF cycles, after the public rejected proposals on reducing the number of cycles.
Restricting fertility treatment has been taking place for years. In 2014 NICE urged CCGs commissioners to stop restricting IVF funding in a bid to put an end to the ‘postcode lottery’ of care for infertile couples.
However, one third of GPs think NHS should stop funding IVF treatment for patients with fertility issues, according to a survey of 521 GPs, conducted by the research division of Pulse’s publishers, Cogora, in 2016.
The news comes as regions seeking to ration access to elective care services by introducing new thresholds or ‘lifestyle’ criteria, like stopping smoking, must now seek pre-approval from NHS England ‘at least four weeks’ in advance following media scrutiny.
CCGs rationing fertility treatment
CCGs which have completely stopped funding IVF:
- NHS Croydon CCG, NHS Mid-Essex CCG, NHS North East Essex CCG, NHS South Norfolk CCG and NHS Basildon and Brentwood CCG.
CCGs considering cutting the number of NHS-funded IVF cycles they offer or removing NHS IVF altogether:
- NHS Kingston CCG, NHS Richmond CCG, NHS St Helens CCG, NHS Cambridge and Peterborough CCG, all of Lancashire’s eight CCGs (Blackpool, Fylde &Wyre, Lancashire North, Chorley and South Ribble, Greater Preston, Blackburn with Darwen; East Lancashire, West Lancashire), four of Cheshire’s CCGs (Eastern Cheshire CCG, South Cheshire, Vale Royal, and West Cheshire), and all three Worcestershire CCG (South Worcestershire, Redditch and Bromsgrove, and Wyre Forest).
Source: Fertility Network UK