Postcode lottery of fertility treatment in our region is laid bare as free IVF scrapped in county where it all began
PUBLISHED: 15:38 07 September 2017 | UPDATED: 08:18 08 September 2017
Women who are struggling to conceive face extra heartache after a decision to scrap NHS funding for IVF treatment in the county where it was pioneered.
Funding for specialist IVF services was scrapped by health bosses in the Cambridgeshire and Peterborough area on Wednesday, and provision was suspended with immediate effect.
The decision has shone the light on the “postcode lottery” services across the east of England, where no clinical commissioning group (CCGs) offers the full three cycles of IVF recommended by The National Institute for Health and Care Excellence (NICE).
Those in south Norfolk join couples trying to conceive in Cambridgeshire and Peterborough with CCGs not offering any access to NHS-funded treatment, except in very specialist circumstances.
In all other areas of Norfolk, two cycles are offered, with Great Yarmouth and Waveney CCG being the most recent to cut out one cycle last year.
Dr Mike Macnamee, chief executive of Bourn Hall Clinic, said the cutting of NHS IVF services was “absolutely devastating”.
Bourn Hall, which was the world’s first IVF centre and offers private treatment, has clinics in Norwich, King’s Lynn, Cambridge and Peterborough - as well as in Essex.
Dr Macnamee said previously all CCGs in the east of England offered the same provision in line with NICE guidelines.
“But now it is a postcode lottery, with more and more CCGs withdrawing funding,” he said.
Many CCGs have pointed to squeezed budgets as a reason for cutting treatment.
And Dr Gary Howsam, chairman and chief clinical officer of Cambridgeshire and Peterborough CCG, said: “The decision to suspend routinely commissioning specialist fertility services is a financially necessary decision.”
But Dr Macnamee said: “This is worth funding. It’s stressful being infertile. Just because people are not bleeding does not mean they are not in a huge amount of pain.”
Anya Sizer, from charity Fertility Network UK, said when the full three cycles recommended by NICE were not available, the chances of conceiving dropped.
“People need to think of IVF like a course of antibiotics,” she said.
“It’s a course of treatment.”
‘More people will go abroad’
Both Dr Macnamee and Ms Sizer said if the number of cycles of IVF were cut of restricted, it could push people to go abroad for treatment.
And while much work has been done in the UK to reduce the chance of conceiving twins or triples through IVF, this has not happened elsewhere.
“People think ‘twins, that’s a bonus’,” said Dr Macnamee. “But it isn’t really, because usually twins or triplets are born early and may have other complications.”
He said the funding of looking after twins or triplets, and possibly caring for them if they were born prematurely, outweighed the money saved by cutting IVF cycles.
“So it’s shortsighted of the NHS to want to save money this way.”
Ms Sizer added: “One of the things we’ve found is people do go overseas, because that’s cheaper than private treatment here, and the regulation is very different to over here.”
Charity warns of cutting funding altogether
According to Fertility Network Uk, one in six couples will go through fertility issues.
“That’s a huge number,” Ms Sizer said.
“We’ve carried out a comprehensive survey and it told us what we already knew. But it found 90pc of those with fetility issues had experienced depression, 70pc said it had an effect on their relationship. And 42pc said they had had suicidal thoughts. So it really does create one of the biggest life crises for someone to go through.”
She said removing or restricting the number of cycles available only made those experiences worse.
The charity is calling on all CCGs across England to offer the full three cycles of IVF recommended by NICE, as is the case in Scotland.
She said: “I think we’re now as a crossroads where either IVF funding will be cut from the NHS altogether, or there will be a step change in Parliament and money will have to be ring-fenced.”
What the CCGs say
• Dr Gary Howsam, chair and chief clinical officer of Cambridgeshire and Peterborough CCG, said: “The CCG has finite resources to fund a whole range of health services and treatments. We need to save £46.5m this financial year, and so we have had to review all areas of our spending and make some difficult decisions. The decision to suspend routinely commissioning specialist fertility services is a financially necessary decision, following evaluation of the options available to us to reduce expenditure.”
• Rebecca Hulme, chief nurse at Great Yarmouth and Waveney CCG where two cycles are offered, said: “Like all other NHS organisations, we regularly assess and review the services we commission to ensure that they are evidence based and provide value to our whole population. This does mean that we have to look carefully at all services and make decisions about how we make the best use of our finite resources in a way that maintains quality and benefits the largest number of patients. The change from offering three cycles to two was made in 2016 as part of this programme of ongoing review.”
• A spokesman for CCGs in south, west and north Norfolk, and Norwich, said: “South Norfolk CCG does not routinely fund IVF procedures. This decision was taken at a meeting of the governing body in public in December 2015, following a period of public engagement. This policy is reviewed periodically. Exceptions may be considered for people undergoing treatment which would make them infertile, such as those with cancer, and for people who a have life-threatening viral infection which could be passed on such as HIV, and providing they meet other access criteria in respect of age etc.
“North Norfolk, Norwich and West Norfolk CCGs offer up to two cycles of IVF for women aged between 23 and 40, or 1 for women aged 40-42. The CCGs changed the number of cycles provided from three to two for women between the ages of 23 – 40 in 2014 for Norwich and North Norfolk and 2013 for West Norfolk CCGs. This decision allowed us to extend IVF services to women aged between 40 – 42. Eligibility criteria includes for example couples must have undergone initial fertility tests and support and are ineligible if there are any living children from any previous relationship.”