IVF consultation

Closed 21 Apr 2013

Opened 9 Mar 2013

Feedback updated 29 May 2013

We asked

In light of new NICE guidance, how should NHS Stockport fund IVF?

You said

Should extend criteria to include: • women up to 42 • same sex partners • former private patients and offer 3 cycles.

We did

We have extended the criteria to include: • women up to 42 • same sex partners • former private patients and will offer 2 cycles this year. Next year we will see if we can fund 3 cycles.

Results updated 29 May 2013

From 9 March – 21 April the CCG ran an online survey asking for views on the key areas of change suggested in the NICE guidance. The CCG circulated the survey to a wide range of stakeholders, including potential service users, residents who had previously contacted the local NHS about IVF services, the Infertility Network, the CCG’s Patient Panel, local GPs and staff who are likely to refer into the service, local Patient Reference Groups, young mum’s groups and communities most affected by the potential changes, such as the lesbian, gay and bisexual community.

The survey was also circulated around the CCG’s database of around 300 community groups and the Healthwatch Stockport’s mailing list, which represents local groups with a collective membership of over 3,000 Stockport residents.

The survey was promoted on the CCG’s website, in the Healthwatch newsletter, the Lesbian and Gay Foundation’s newsletter and on Pure Radio’s local station.

Results

82 people filled in our survey and gave us their views, of whom:

  • 35% of respondents currently work for the NHS, a small number were former NHS employees or private healthcare staff, but the majority (60%) were members of the public
  • the majority of respondents came from the Heatons & Tame Valley area of Stockport, with a small number of respondents from outside Stockport
  • The vast majority were female (79.27%)
  • Only a small minority reported being transgender (2.439%)
  • 21.95% reported a disability or long-term illness, 78.05% had no disability
  • 91.46% were White British – similar to local demographics
  • 62% were married with another 17% co-habiting and 3.7% in a civil partnership
  • just under half (42.68%) of the respondents are Christian with 45.12% having no religious beliefs
  • 81.71% of respondents were heterosexual, and 12.19% were lesbian, gay or bisexual
  • The age of survey respondents ranged from 18 to 91 years, with most respondents being under-40. 

Number of NHS-funded cycles

The vast majority thought we should be offering 3 cycles – in line with NICE guidance

 

No. of cycles

Number of responses

Percentage

Zero

5

6.76%

One

4

5.41%

Two

15

20.27%

Three

47

63.51%

Other

3

4.05%

Views on the number of cycles that should be offered ranged from a strong backing of the NICE guidelines to the view that IVF should not be funded while there are still children waiting to be adopted:

Q2 We asked people how we should define childlessness in our policy on IVF and who should receive NHS-funded cycles.

The vast majority (85.14%) thought we should define ‘childless’ as a couple, neither of whom has a child. However, 50% of respondents felt we should also fund IVF treatment for couples where one partner has children from a previous relationship. Less than 30% of respondents felt that the NHS should fund IVF treatment for couples who both already have children from previous relationships.

 

Possible definitions of ‘childless’

No. of

responses

Percentage

A couple, neither of whom has a child

63

85.14%

A couple who do not have children together, but one partner has a child/ children from a previous relationship

37

50.0%

A couple who do not have children together, but both partners have a child/ children from previous relationships

22

29.73%

Not answered

6

8.108%

Again, comments were varied, from those who felt that all those unable to conceive should be eligible for NHS-funded IVF, to those who believe that the NHS should not fund IVF for anyone.

Q3. Should NHS Stockport fund IVF treatment for women aged 40-42?

67.57% of respondents thought funding be should extended to those aged between 40 – 42 in line with new NICE guidance. 

 

Fund age 40 - 42

No. of responses

Percentage

Yes

50

67.57%

No

24

32.43%

Not Answered

0

0%

Comments given ranged from those who felt that 40 - 42 is still very young to those who believed that 40 years should be the absolute maximum.

Question 4: Do you agree that NHS Stockport should fund IVF for same-sex couples?

The majority of respondents felt that it was right for the NHS to fund IVF for same-sex couples.  

 

Fund same sex couple

No. of responses

Percentage

Yes

50

67.57%

No

24

32.43%

Not Answered

0

0%

Question 5: Do you agree that NHS Stockport should fund IVF treatment for single women?

The majority of respondents (62.16%) felt that the NHS should not offer IVF treatment to single women.

 

IVF offered to single women

No. of responses

Percentage

Yes

28

37.84%

No

46

62.16%

Not Answered

0

0%

Views ranged from those who felt thatHalf of the country is made up of single-parent families - there is no reason to treat single women any differently” to those who felt that it would be unfair to the unborn child.

Question 6: Should NHS Stockport fund IVF treatment for smokers?

Fifty out of 74 respondents felt that only non-smokers should be considered for IVF funding with comments such asAs there is clearly rationing, you should put the funding to where the evidence suggests results are most likely to be favourable.”

 

IVF for smokers

No. of responses

Percentage

Only non-smokers should be considered for NHS funding

50

67.57%

Smokers should be advised of the adverse effects of smoking on chances of conception and encouraged to participate in a smoking-cessation programme

20

27.03%

The NHS should fund all patients, regardless of whether or not they smoke

4

5.405%

Not Answered

0

0%

Question 7: Should NHS Stockport fund IVF treatment for people who drink excessively?

84% of those taking part in the online survey felt that the NHS should not fund IVF for those patients who drink excessively.

 

Fund those who drink excessively

Total

Percentage

The NHS should not fund IVF for patients who drink excessively

62

83.78%

The NHS should advise patients about alcohol consumption, but it should not affect IVF funding

10

13.51%

The NHS should fund all patients, regardless of their alcohol intake

2

2.703%

Not Answered

0

0%

The question on this criteria evoked a large number of comments, which mainly centred around the importance of protecting the unborn child. It was strongly felt that in commissioning IVF the NHS has a duty to protect the unborn child and that people wanting to become parents should take responsibility for their health by reducing alcohol intake.

Question 8: Should NHS Stockport fund IVF treatment for patients who use recreational drugs?

A huge 90% of those taking part in the survey felt that those who use recreational drugs should not receive NHS funding for IVF with one person answering “Oh my God! Hell no!”

 

Fund those who use recreational drugs

No. of responses

Percentage

The NHS should not fund IVF for patients who use recreational drugs.

67

90.54%

The NHS should advise patients of the potential impact of recreational drugs on chances of conceiving and on the health of the unborn baby, but it should not affect IVF funding

6

8.108%

The NHS should fund all patients, regardless of their use of recreational drugs

1

1.351%

Not Answered

0

0%

Again, the comments received were very emotive and centred around the importance of protecting the health of the unborn child.

Question 9: Should NHS Stockport fund IVF treatment for patients who have already paid for IVF privately?

The majority of respondents (66.22%) felt that all patients should be offered the same number of NHS funded IVF regardless of previous cycles undertaken privately.

 

Fund after private treatment

No. of responses

Percentage

All patients should be offered the same number of NHS-funded IVF cycles, regardless of previous cycles undertaken privately

49

66.22%

The number of IVF cycles undertaken privately should be considered by the NHS (if patients have funded 2 or more cycles privately they should not be entitled to any NHS cycles, but if they have only funded 1 cycle privately, they should be entitled to 1 NHS cycle)

20

27.03%

Patients who have gone privately should be excluded from any NHS funding

3

4.054%

Not Answered

0

0%

Comments highlighted the major financial burden of undertaking IVF privately. Many felt that going private indicated the commitment of patients to have a child and should not be used against them when they run out of money to go private.

Overview

The National Institute for health and Clinical Excellence (NICE) recently updated its guidance on infertility and who should be eligible to receive IVF treatment under the NHS.

NHS Stockport is now updating its eligibility criteria based on this guidance and other feedback we have received on our current criteria.

We want to ask local people for their views on how IVF should be commissioned for Stockport patients.

 

Why your views matter

In vitro fertilisation (IVF) is one of several techniques available to help couples with fertility problems to have a baby. 

In 2013, the National Institute for health and Clinical Excellence (NICE) published new guidelines on fertility and who should have access to IVF treatment on the NHS in England and Wales.

 

Proposed changes to Eligibility Criteria

  • the new NICE guidelines suggest that women aged between 40 and 42 should now be offered one cycle of IVF on the NHS 
  • IVF should also be extended to same-sex couples and single women

 

Local Decisions

NICE guidance is not mandatory, so we want your views on how we should proceed in Stockport.

Focus Groups

The CCG plans to run 3 focus groups on the IVF criteria:

  • 11-13.00 11th April
  • 14-16.00 15th April
  • 11-13.00 18th April

If you would like to attend a focus group to give us your views in person, contact:

Shirley Hamlett on 0161 426 5895

shirley.hamlett@nhs.net

What happens next

Local views will be written up and presented to the Clinical Policy Committee for consideration, alongside the NICE guidance on Wednesday 24 April 2013.

Their recommendations will then be discussed at the Governing Body of the CCG on Wednesday 8 May 2013 and new criteria would be implemented from the date of the meeting.

All CCG Governing Body meetings are held in public. Please call 0161 426 5617 or email paul.pallister@nhs.net if you would like to attend one of our Governing Body meetings.

Areas

  • All Areas

Audiences

  • Men
  • Women

Interests

  • Sexual Health
  • Access