PET report shows GPs confused over NICE Fertility Guideline

Many NHS GPs in England do not have an accurate understanding of the NICE Fertility Guideline, local funding or eligibility for referral for specialist consultation, research commissioned by the Progress Educational Trust (PET) has shown.

This research published by PET in its Power of Three IVF Cycles report, found that just 50 percent of 194 GPs in England surveyed knew that the NICE Guideline states NHS funding should be made available for up to three full cycles of IVF treatment, for eligible patients. Nearly half of GPs, 48 percent, thought that local commissioners in their area made funding available to meet or exceed this guideline, despite just 10-12 percent of commissioning areas doing so.

Sarah Norcross, director of PET, said: 'These survey results show that there is utter confusion over the current NICE Fertility Guideline. Our results should send a strong message to the Government, NHS England, the Women's Health Ambassador and commissioning bodies. The lack of understanding of the Guideline by GPs is making the postcode lottery worse.'

GPs were also unclear on NICE criteria for referral for specialist consultation. While 62 percent said they would refer patients who had been trying to get pregnant through unprotected sex for one year, just 34 percent said they would refer after three miscarriages in two years.

While 73 percent of female GPs stated that they would refer if there was a known cause of infertility or reduced fertility, only 52 percent of male colleagues said the same. Younger and less experienced GPs were more likely to refer than older ones.

The survey also highlighted the factors used to determine IVF policies for treating NHS patients. More than half (57 percent) said treatment was determined by the NICE Guidelines, and almost a third (32 percent) said budget was a factor.

54 percent of GPs indicated that there had been changes to NHS provision of IVF in their area within the last year, and around three-quarters of GPs reported that these changes restricted availability. A recent example involving Staffordshire and Stoke-on-Trent Integrated Care Board saw a region-wide decrease in the number of IVF cycles offered to all residents, from three to one (see BioNews 1181).

'PET research in 2022 showed that 67 percent of the UK public supported NHS funding of fertility treatment. The public wants this, patients need this, and doctors should offer this.' Norcross said (see BioNews 1148).

The NICE Guideline was introduced in 2004, received its last major update in 2013, and is currently undergoing another update which is due to be completed in 2024. 'As NICE updates its Fertility Guideline, we urge it to make its new recommendations crystal clear, so that there is less room to misunderstand or cynically misinterpret the Guideline.' Norcross continued.