IVF postcode lottery 'blights patients' lives and damages the NHS' reputation', says minister

Health minister Jackie Doyle-Price has urged England's 195 Clinical Commissioning Groups (CCGs) to end the IVF postcode lottery.

The inequality of IVF provision on the NHS throughout England 'has, for too long, been allowed to grow – to blight the lives of patients and to damage the reputation of the NHS', wrote Doyle-Price in a letter to CCG chief executives.

'For far too long, fertility services have become known for the "postcode" variation in their availability to NHS patients,' she wrote. 'It is unfair to patients with infertility, who have every right to expect NHS services based on clinical need… All CCGs should move towards full implementation of the NICE fertility guidelines recommendations.'

The publication of the HFEA's recent report 'Commissioning guidance for fertility services' (see BioNews 1000), provides CCGs with the necessary tools to improve provision of IVF, she wrote. The National Institute for Health and Care Excellence (NICE) recommends that women under 40 be offered three NHS-funded IVF cycles. The majority of CCGs – 88 percent, according to data from Fertility Fairness – do not offer this. 

Speaking exclusively to BioNews, Doyle-Price said: 'CCGs have a statutory responsibility to commission healthcare services that meet the needs of their whole population, including fertility services.

'The HFEA guidance for commissioners is a new tool to help them implement NICE fertility guidelines and utilise the benchmark price for IVF.'

Research by the fertility campaign group Fertility Fairness has found that:

• Since 2017, one in five CCGs have reduced IVF services by cutting the number of IVF cycles they offer, decommissioning services or introducing access criteria without a basis in evidence
• One in ten CCGs are currently consulting on cutting or removing IVF provision
• Five CCGs do not offer any fertility treatment at all
• Seven in ten CCGs offer just one cycle of IVF
• One in eight provide the recommended three IVF cycles

'This is a national disgrace for the country that pioneered IVF,' said Sarah Norcross, chair of Fertility Fairness and director of Progress Educational Trust (which publishes BioNews). 'The result is already distressed patients struggling with infertility face the devastating consequences of an IVF postcode lottery where their medical treatment is based on where they live and not their clinical need.

'Fertility Fairness urges CCGs to listen to the government and ensure their "access to NHS IVF" policies are in line with national recommendations. It is time to end the IVF postcode lottery.'

Commenting on the data, health minister Doyle-Price added: 'The data collected by Fertility Fairness suggests a worrying trend and a growing inconsistency with the NICE guidelines.' 

Steve McCabe MP, who put forward a private member's bill in 2018 to end the IVF postcode lottery (see BioNews 946) told BioNews: 'I am very pleased that the minister has listened and wants to make a difference. However, this guidance really needs to be instructive and not advisory if we are going to make a breakthrough on behalf of the three and a half million people who need help with fertility issues… It's a scandal that a medical condition, recognised by the World Health Organization, is routinely ignored by accountants seeking to trim CCG budgets.'

McCabe said that he was writing to CCGs to ask how they would be updating their fertility treatment commissioning in response to the recent guidance. 'I will keep pushing until we end the postcode lottery and the moralistic judgements of commissioners about who is entitled to IVF,' he said.