Overview
The ICB is carrying out a review of its policy on specialist fertility treatment. The review is open until midnight Sunday 13 August 2023.
The current policy was agreed by the three clinical commissioning groups (CCGs) that existed before the ICB came into being in July 2022 when the government created ICBs across England.
All policies need review from time to time and this particular one was due for a review in 2022. An extension was agreed to September 2023 which is why we are now seeking some views from local people.
The proposals outlined here would not lead to significant changes to the current policy. They are mostly about making some things clearer and ironing out a few inconsistencies in terms of how the policy is put into practice. Much of the increased clarity that we are proposing for our revised policy is a direct result of what patients have told us about the uncertainties our current policy. Making changes to the policy document to make things clearer will help us ensure fair decision-making about treatments.
We know that there are strong views about the policy in Hertfordshire and west Essex and beyond, and that is why we are running this engagement programme – to be transparent about what we are proposing and the limits of these current proposals.
A national women’s health strategy was published in August 2022. The strategy sets out nation-wide plans for achievements on various aspects of women’s health in the next ten years. The strategy includes the ambition to widen access to IVF in a number of specific ways. Crucially, the strategy calls for consistency in provision of services so that people are entitled to receive the same level of service (including number of cycles of IVF), wherever in England you live. The strategy also states that all non-clinical reasons for restricting access should be removed, and that single-sex female couples should have access to NHS-funded artificial insemination.
The strategy does not yet have a plan for how this will be implemented on a national scale, and at the same time we know that new NICE guidelines for IVF treatment are being considered and these are expected to be published in 2024.
We welcome the move towards a more nation-wide approach to policies on IVF, and the ICB will follow all national policies it is required to take on. We will review our own policies again once any new national ones are confirmed, and we are committed to doing that within a year of their announcement.
We will encourage local people to take part in any public consultation about new policies that come out of the women’s health strategy implementation plan and will share information about it as widely as we can. And we will pass on any comments we receive as part of this engagement about the wider issues on access to treatment to those who are dealing with this centrally.
Proposed changes
We have a draft new policy however the key proposals for changes are as follows:
- The policy will clarify that patients looking to access fertility treatment services will need to have been a non-smoker for at least eight weeks. The current policy is not clear about this, and the practice is being applied in some, but not all, cases. There is clear evidence that smoking can reduce fertility
- The policy will be reviewed within one year of the publication of any new national guidance around access to IVF.
- We propose to make some of the definitions in the policy clearer, including the definition of what an IVF cycle consists of. This will make it easier to apply the policy fairly and consistently.
- We propose to remove some of the more technical details in the current policy, that are about contracts with providers of specialist fertility services. This will make the policy more straightforward and easier to understand.
- The policy will undergo some amendment in its language to recognise transgender and non-binary people.
- The blood test (known as AMH) that shows hormone levels and is a guide to egg count will be current for six months. This means that patients will not need to submit further samples after three months, and the test can’t be repeated within that six-month period.
- The policy will clarify that couples who have unexplained infertility will be eligible for fertility treatment if the woman has not conceived during the previous three years. This is because conception is a sign of fertility even if the couple later experience a miscarriage (loss of pregnancy at any point during the first 23 weeks).
Have your say
This survey closed at midnight on Sunday 13 August.