New Measures By Dept Of Health To Reduce Inequalities In NHS Treatment, UK

Main Category: Fertility
Article Date: 26 Jul 2007 - 1:00 PDT

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Infertility Network UK (I N UK) welcomed new measures announced by the Department of Health aimed at helping to reduce the continuing inequalities in NHSfunded infertility treatment.

Primary Care Trusts (PCTs) in England are failing to adopt a consistent definition of a full cycle of IVF treatment, despite clear guidance published by NICE in 2004. PCTs' interpretation of full implementation of the NICE guidance also varies and I N UK hopes that these measures will help to address these issues.

I N UK is also aware of the considerable variation in social eligibility criteria for access to infertility treatment and is pleased to be able to work with the NHS to develop a standardised approach across England.

In response to these findings, the Minister of State for Public Health, Rt. Hon Dawn Primarolo MP, said: "When the NICE guideline was published in February 2004, the then Secretary of State said that the Department of Health would be looking for PCTs to offer all women aged 23-39 who meet the NICE clinical criteria a minimum of one full cycle of IVF from April 2005. He added that he would expect the NHS to make progress to full implementation of three full cycles of IVF in the longer term.

"We have initiated a project with Infertility Network UK to help the NHS in the development of good practice in the provision of fertility services, including involving patients in decision making. We want to help the NHS to provide an effective service, which meets patients' needs. I will be writing to the NHS to give them feedback on the survey, which I N UK has carried out as a starting point for the project. I will also make clear that the Department is looking to PCTs to move towards the provision of three full cycles of IVF for patients who need this treatment, as recommended in the NICE guideline."

Clare Brown, Chief Executive of I N UK and Chair of the National Infertility Awareness Campaign (NIAC), said that: "In defining a full cycle, the NICE guideline includes both the replacement of fresh embryos and the replacement of any good quality embryos not replaced during the initial transfer and subsequently frozen and stored for future use. It is therefore unacceptable that many PCTs are failing to include frozen embryo transfers as part of their IVF cycles.

"This is vitally important given the likely move towards single embryo transfer (SET) for appropriate patients. We also believe it is unacceptable to create something as special as an embryo on the NHS but only to allow it to be transferred if you have the ability to pay. We believe SET is an important step towards reducing the health risks associated with multiple births but it is absolutely vital that in moving to this, patients have access to up to three full cycles of treatment including frozen embryo transfers."

1. In February 2004, the National Institute for Health and Clinical Excellence (NICE) published a clinical guideline on assessment and treatment for people with fertility problems. Amongst other recommendations covering a full range of fertility investigations and treatment, the guideline recommended that couples in which the woman is aged 23-39 years at the time of treatment and who have an identified cause of their fertility problems or who have infertility of at least 3 years' duration should be offered up to three stimulated cycles of in vitro fertilisation treatment.

2. Around one in six couples in the UK seek specialist treatment for fertility problems and the impact of infertility can be devastating. However, excellent results can be achieved in treating infertility if patients are rapidly investigated and referred for appropriate treatment.

3. I N UK has been asked by the Department of Health to undertake a project to liaise with Primary Care Trusts (PCTs) in England to encourage, through the sharing of good practice, implementation of the National Institute for Health and Clinical Excellence's (NICE) fertility guideline and screening for chlamydia. This includes helping ensure that the voices of fertility patients are heard when decisions about the provision of services are made at a local level. The project is funded by a Section 64 grant, made available over 3 years.

4. As a starting point, the project aimed to assess the picture across England with regard to implementation of the NICE guideline and screening for chlamydia. This involved gathering data from across England to identify a number of key issues that I N UK would look to take forward with the Department of Health and through liaison with PCTs.

5. I N UK is a member of the National Infertility Awareness Campaign (NIAC), an umbrella body formed in 1993 as a development of National Fertility Week. It was established with support, which it continues to enjoy, from a wide range of organisations involved in the field of infertility, including infertility charities, patient support groups, healthcare professionals and the pharmaceutical industry. NIAC campaigns for equal access for those with an established clinical need to a full range of services for the investigation and treatment of infertility on the NHS.

6. In April 2007, the Human Fertilisation and Embryology Authority launched a consultation to find the best way of reducing the number of multiple births after IVF. The consultation followed a report by an independent group of experts, which recommended that the only safe way to reduce the risk for IVF babies was to move towards transferring one embryo in those women with the best chance of IVF success. However, it also concluded that the greatest obstacle to single embryo transfer was the lack of NHS funding for fertility treatment and the lack of progress in implementing the NICE fertility guideline (One child at a time; Independent Expert Group on Multiple Births after IVF; October 2006).

http://www.infertilitynetworkuk.com