15 May 2014

IVF postcode lottery: no more Mr NICE guy please

Wrists have been slapped today by the National Institute for Health and Care Excellence – otherwise known as NICE.

There is, they say, an unacceptable postcode lottery on IVF and they have now told the organisations within the NHS who are meant to purchase this treatment that they have to abide by the guidelines.

Those guidelines, just to remind you, are that three cycles of IVF should be offered to women aged under 40 who have failed to get pregnant after two years of trying.  If certain criteria are met, women aged 40-42 should receive one full cycle.

But NICE says that the clinical commissioning groups (CCGs) are betraying the NHS’s guiding principle of access to treatment.  The figures show that 73 per cent of CCGs do not offer the full three cycles, 49 per cent only offer one cycle and 24 per cent only offer two.

In fact, only 24 per cent offered the recommended three cycles.

So now NICE has drawn up draft quality standards to remind the CCGs of the duties of care.

This is, of course, admirable.

I know first-hand the pain of not being able to conceive.  I went through four rounds of IVF and two of egg donation before I was able to have a baby.  None of this was provided by the NHS because at the time I was doing it, the general cut off age was between 35 and 37.  Nor did I expect the NHS to fund it.

But there are women (couples) who do expect it because they have been told by the likes of NICE that they should be given the treatment.

So, it must add considerably to their anguish to be fighting a largely faceless CCG who are completely ignoring the guidelines.  What is more, they will be sitting in their GP’s office saying please help me have a baby, and that same GP may be sitting on the CCG which is saying we are not paying for that.


There is an added problem.  NICE says women should be given these treatments and they say it is shocking that CCGs are ignoring their guidelines.

But then what?  Because every time I have asked NICE (and it has been several times on this specific subject) what they are going to do about this recalcitrant funding bodies, they say they go and talk to them and ask if they need any help in working their way around the funding issue.

Now I realise I started this piece by saying they were slapping CCGs on the wrist.  But it is a slap so mild it would barely tickle.  CCGs and before them primary care trusts have ignored NICE and have not funded IVF.

So unless NICE can think of a way of being a damn sight more stern, then I fear the situation will never change.

Just as a footnote, though:  IVF clinics and drug companies could perhaps think about dropping their absolutely astronomical prices.

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