Cambridgeshire NHS bosses rules out funding IVF, causing heartbreak for those needing treatment
A postcode lottery for access to IVF will remain as NHS bosses ruled out offering the service in Cambridgeshire.
The county’s clinical commissioning group (CCG) has cut all routine IVF services for women under 40 due to funding pressures. Cambridgeshire and Peterborough CCG is one of just five that does not offer routine IVF. This is despite a recommendation by the Department of Health and Social Care that the service should be provided.
Sarah Norcross, co-chair of campaign group Fertility Fairness and director of the Progress Educational Trust, said: “Fertility patients in Cambridgeshire and Peterborough will be devastated to hear that the clinical commissioning group has decided to remove access to NHS IVF indefinitely – despite the government’s warning that it is unacceptable to do so and that the IVF postcode lottery blights patients’ lives and damages the NHS’ reputation.”
The decision to extend a suspension into a longer-term withdrawal of the service looked set to go ahead earlier this year, with multiple delays raising the prospect of a change.
But despite new information from the Department of Health, under-pressure county NHS bosses extended the suspension with no specified end date.
Routine treatment for women under 40 is available almost everywhere else in England. Official guidelines state it should be available, but each CCG makes the final decision in its area.
CCG medical director Dr Mark Sanderson told the meeting: “It was a difficult decision at the time [in 2017] and it is still a difficult decision. Whenever we make hard decisions about how we spend resources on healthcare, whether it be on cancer treatments, children’s services or physiotherapy, they are all very difficult. And fertility treatment is no less difficult.
“But as a CCG, we’re clearly responsible for spending the taxpayers’ money responsibly and trying to do the best for all the patients that we can and we’ve heard of the financial challenges that we are in at the moment.”
For Cambridge couple Eleanor Jordan and Richard Heeps, pictured, the decision is devastating. Eleanor, 33, lost both her fallopian tubes after two life-threatening ectopic pregnancies and would need IVF to achieve her dream of having a family.
“It feels really unfair and it really hurts that having been through two very traumatic medical emergencies I won’t now be able to have IVF treatment on the NHS,” she told the Cambridge Independent.
“The postcode lottery here means that only people with enough money will be able to have fertility treatment, so it creates an elitist society.
“It’s a devastating shame because the health minister wrote to the CCGs saying it should not be a postcode lottery. This is recognised by NICE as a disease and should be treated as one.
“We have considered moving quite seriously but that is a big thing to do.
“I first found out I would need IVF in 2015. I was led to believe because of my medical situation I would be able to have treatment when I was ready. Then I found out the funding wasn’t available. I’m 33 so it’s important that I do this soon. The best age to do it is before 36. We are really strong as a couple and we are in it together.”
Fertility Fairness’ data on access to NHS IVF in England, collected since 2013, illustrates the sustained disinvestment by CCGs in NHS fertility services.
In the last two and a half years alone, one in five CCGs (21 per cent) have slashed services by cutting the number of IVF cycles they offer, decommissioning services or introducing arbitrary access criteria.
Five CCGs do not offer any fertility treatment at all; 70 per cent of CCGs offer just one cycle (often a partial rather than a full IVF cycle); 15 per cent provide two IVF cycles and just 12 per cent provide the recommended three IVF cycles.
Gwenda Burns, acting co-chair of Fertility Fairness and head of charity operations at Fertility Network, said: “This is a cruel, unfair decision. Infertility affects 3.5 million people and has a far-reaching impact: 90 per cent of people are depressed and 42 per cent feel suicidal.
“It is appalling that Cambridgeshire and Peterborough CCG is ignoring the devastation infertility wreaks and refusing to allow access to NHS treatment.”
That suspension was due to be reviewed in April, and then June, then July – but the decisions were delayed.
The recommendation to the CCG said it should “continue not to fund the provision of specialist fertility services until such point that the CCG returns to a sustainable financial surplus or is instructed otherwise by our regulators”.
But the financial situation has been getting worse since the initial suspension in 2017. The CCG had a £21.6m deficit then, which has risen to a forecast £75m this year.
The IVF decision is one of many the CCG has made to tackle the deficit.
IVF – in vitro fertilisation – is a medical procedure where an egg removed from a woman’s ovaries is fertilised with sperm in a laboratory, and can help couples with fertility problems to conceive.
The technique is used across the world but was first successfully carried out in Cambridgeshire. IVF will still be available at private practices. The CCG says its average cost per patient is close to £5,000 per cycle of IVF.
The original suspension was expected to save £700,000 per year. The latest CCG report shows that between September 2017 and March 2019 it saved £730,000.
The CCG estimates that 159 patients have been impacted by the suspension between September 2017 and June 2019. If the suspension continues,then the CCG estimates that a total of 148 patients will be affected in 2019-20 and a further 154 patients in 2020-21.
Additional reporting by Ben Hatton, Local Democracy Reporter