GP-led CCGs have been responsible for commissioning fertility services since April 2013. Although many CCGs are currently reviewing their infertility policies, some are choosing to continue with the policies of their predecessor organisations.
Clare Lewis-Jones, chair of NIAC, said: 'I acknowledge the fact that CCGs are still finding their feet but this should not prevent commissioners from acting on NICE's latest guideline, which should serve as the basis for all future funding discussions at a local level. I hope they will use the information contained within this report to inform their thinking'.
The NICE guideline on fertility, which was updated last year, states that women aged 39 and under who have not conceived after two years of trying should be offered three full cycles of IVF. However, the report found that of the 198 CCGs that funded IVF, 24 percent offered two cycles of IVF and 49 percent offered only one. Others, such as Sutton and Merton in South London and four in North Yorkshire and York, do not offer any funding for IVF.
'It is now nearly ten years since the original NICE guideline was published and yet here we are... still facing a situation whereby the level of service is determined by postcode', said Ms Lewis-Jones.
Commenting on the report, Susan Seenan from Infertility Network UK said: 'It's not fair... Where you live shouldn't determine how much treatment you are allowed'.
Additionally, the report highlighted that many CCGs will not offer IVF to couples where one of them has had children from a previous relationship - something that is not stipulated in the NICE guideline - as well as if one smokes, is obese, or drinks even a moderate amount. The NICE guideline is not mandatory and CCGs are able to apply additional criteria for access to NHS-funded treatment.
A report by the All Party Parliamentary Group on infertility in 2011 found that many primary care trusts did not offer the number of cycles recommended by NICE (see BioNews 611). In comparison to this report, NIAC says it is 'disappointing to see a distinct lack of progress'.
'This is despite the shift in focus towards clinician led, outcomes based commissioning which is enshrined in the NHS Outcomes Framework', the NIAC report states.
NIAC says it recommends that the Department of Health works with NHS England and NICE to produce a mandatory list of access criteria for IVF/ICSI treatment. 'This would finally end unfair and differing lists of criteria produced at a local level', it said.