(updated from original posted March 2019)
The emotional impact of NHS IVF funding cuts is always a topic of discussion at our fertility awareness events and on our Facebook page. Funding throughout the East of England varies depending on where you live – with Cambridge and Peterborough CCG not funding any treatment at all – which has caused a ‘postcode lottery’ in the region.
Krishani and Prasad received NHS funded IVF treatment in Cambridge before it was removed, and now have their son Thimath: “Our son is a miracle to us,” says Krishani. “He is our little prince.”
However, there has been some good news recently. South Norfolk has recently reversed its decision not to fund IVF and from 1st April 2019 will offer two cycles of IVF treatment to people that meet its criteria – removing the postcode lottery in Norfolk.
On 2nd July 2019 the Cambridge & Peterborough Clinical Commissioning Group (CCG) will also reconsider its decision and consider whether to reinstate NHS funding for IVF.
This is an opportunity not just to influence the decision of the commissioners, but also to propose new ways to improve the fertility service so we hosted a survey to gain feedback on the impact of the cuts to funding. Over 300 people participated in this survey and the findings have been given to the CCG.
From its work with the NHS in Norfolk, Bourn Hall believes it is possible to create efficiencies in the service and allow more people in Cambridgeshire to benefit from the significant expertise that is available.
Cambridge – home of IVF
Cambridge is the home of IVF. It is here that the pioneers Steptoe, Edwards and Purdy established Bourn Hall as the world’s first IVF clinic in 1980. It was always their intention that the treatment should be freely available to whoever required it. Unfortunately in those early days the NHS was unwilling to support IVF treatment so they had to set up their own clinic and gained funding from supporters.
However, very soon Bourn Hall proved that IVF was repeatable and successful and the NHS agreed to fund patients to have treatment here.
Bourn Hall has developed the techniques that are now used by IVF clinics around the world and has also gained a reputation as a centre of excellence specialising only in fertility treatment and research. This makes the team one of the most experienced in the UK and beyond. Over 20,000 babies have been born as a result of treatment here.
Bourn Hall proven success rates
Embryologists are highly specialised and only provide support for IVF. To maintain their skills it is important that they support a wide variety of patients and sufficient numbers of cases. This centre of excellence, proven track record, high success rates and the number of cycles performed has made Bourn Hall the only clinic based in the East of England that has an NHS contract for the region.
In 2016, East and North Herts CCG negotiated a competitive deal with its five IVF suppliers on behalf of the twelve CCGs that serve Herts, Cambs, Beds, Norfolk and Suffolk. Of these CCGs only Cambs and Herts Valley provide no funding for IVF treatment following their decision in 2017.
It is estimated that only about 100 couples a year in Cambridgeshire meet the NHS criteria for IVF, so removing funding will have had a negligible impact on the CCG finances, which has a £1.15bn budget – one of the largest in the country. The financial data presented to the commissioners during the public consultation in 2017 about the amount of saving possible was challenged by a number of parties and subsequently the CCG agreed it was flawed.
IVF treatment is now only available to those who can afford it
Bourn Hall has always treated NHS patients and for many years was a partner to Addenbrooke’s, providing the hospital’s specialist fertility treatment. Bourn Hall has won the NHS tender processes since 2009 to be the only NHS approved IVF provider for patients in the East of England for the last ten years.
In 2011 Addenbrooke’s Hospital opened its own IVF clinic, Cambridge IVF, which offers a service to private patients that meet its criteria and can pay its fees. It is often not understood that, although the Cambridge IVF facility is NHS funded and staffed by NHS employees, it has never performed a sufficient number of cycles or achieved the success rates required to meet the commissioning criteria to provide NHS funded IVF for the people of Cambridgeshire.
Three months’ wait for NHS fertility testing
Cambridge University Hospitals NHS Foundation Trust says that over 50 per cent of those on its waiting list for NHS fertility testing have been waiting more than three months for their first appointment.
40 years of treating patients and investment in research into the causes of infertility has shown that there are many underlying reasons and that both physical and emotional factors are important.
Time is also important, as fertility for all women declines after the age of 35 so getting the best advice quickly is really important, especially as for some people natural fertility can be restored with minimal treatment and lifestyle advice.
Dr Thanos Papathanasiou, Regional Lead Consultant at Bourn Hall, is concerned that Cambridgeshire residents are not getting the advice they need.
He says: “We are concerned that by removing IVF as an NHS treatment option, patients in Cambridgeshire may now be less likely to have their infertility fully investigated. This means that people who could benefit from other types of treatment such as medication or specialist fertility advice may not be receiving that support through the NHS. For example, we have been told that fifty per cent of the people referred for fertility testing on the NHS have been waiting more than three months for their first appointment. Fertility declines with age so every month is precious.
“There is now an opportunity to review the way that the fertility service is delivered and to suggest improvements that would offer better outcomes to all patients by creating efficiencies rather than cutting funding.”