NHS commissioners told to end IVF postcode lottery

The National Institute for Health and Care Excellence (NICE) has published a set of draft statements that aim to 'eliminate' current geographical disparities in access to treatment and support services for people affected by fertility problems in the UK.

Despite NICE issuing fertility guidance back in 2004, which was updated last year, almost three-quarters of GP-led Clinical Commissioning Groups (CCGs) are reported to not offer the recommended three cycles of IVF treatment to patients, with some CCGs offering no IVF treatments on the NHS at all (reported in BioNews 739).

The new statements provide a quality standard to be applied across all CCGs that highlights areas of care where improvements are needed most. Among other 'prioritised statements', the draft quality standard, currently under consultation, states that women aged under 40 are offered three full cycles of IVF in certain circumstances.

Sarah Norcross, co-chair of the National Infertility Awareness Campaign and director of the Progress Educational Trust, which publishes BioNews, said: 'This is an excellent move. We are delighted that NICE has accepted our recommendations and that the number of cycles has been included in the quality standard. We are also pleased that an explicit statement has been included regarding living children as this is too often used as a reason to refuse treatment'.

'This should send a strong and clear message to all commissioners and could not be a better - or clearer - indication of exactly what is needed to bring the unfair and unequitable postcode lottery approach to an end'.

The publication of the draft quality standard comes after last month's High Court ruling concerning a CCG's decision to not follow NICE guidance on the cryopreservation of eggs before chemotherapy treatment.

Despite the CCG having no legal duty to comply with NICE guidelines, the court ruled that the CCG held obligations in public law to have regard to the NICE guidance and was required to provide clear reasons for any policy choosing not to follow its recommendations. 

The draft quality standard states that people of reproductive age preparing to have treatment for cancer are offered cryopreservation.

Professor Gillian Leng, Director of Health and Social Care at NICE said: 'The quality standard that we are currently developing should help healthcare services to focus on the key areas of care that need to be addressed most urgently and ensure that the right support and treatment is available to those who need it'.

'When published, this standard will complement our guidance on the treatment and support of people with fertility problems, creating a comprehensive guide to help the NHS provide and maintain consistent and high-quality care for all'.

It is expected that the final standard will be published in October 2014.