We have now drafted a single fertility policy for North Central London. A critical part of this stage is seeking views on the draft policy from residents, fertility service users, clinicians and others. The feedback we receive will be used to shape the final policy.
The draft policy represents a significant improvement for most of our population as it expands the provision of NHS-funded fertility treatment in a number of boroughs. If implemented, the policy would offer equitable provision of NHS-funded treatment across the five boroughs in North Central London. Having a single policy in place would offer residents and clinicians greater clarity and consistency on the eligibility, provision and funding of specialist fertility treatments. By offering equitable and consistent access to specialist fertility treatments, we envisage this would also improve patients’ experience.
We have carefully considered the equality impact of the draft policy – on age, race, religion, sexual orientation, disability and other protected characteristics. Overall, the draft policy has a positive impact for most protected characteristic groups.
The draft policy is more closely aligned to NICE guidance than our current five policies. NICE guidance is the main national clinical guidance used by CCGs to inform local fertility policies. In a limited number of areas, the draft policy varies from the full recommendations made by NICE. A range of factors, including affordability, were taken into consideration.
A Steering Group is leading the development of the new single policy. The Group has a clinical Chair, and its membership includes other clinicians, commissioners and two Community Members (a resident and a representative from the Fertility Network UK). We will also engage with local Health Overview and Scrutiny Committees for feedback.
Key elements of the draft policy are:
- IVF cycles – the draft policy proposes up to 6 embryo transfers, from a maximum of 3 fresh IVF cycles, are funded in eligible women under 40. This is broadly consistent with NICE guidelines, and is an increase compared to four current policies and equal to current provision in Camden
- For eligible women aged 40-42 the draft policy proposes up to 2 embryo transfers from 1 fresh cycle; this is no change from the baseline position
- Funding up to 6 cycles of intrauterine insemination (IUI) for eligible female same sex couples and single women who have not managed to conceive after 6 cycles of self-funded IUI – this was previously only funded in 2 boroughs
- Female same sex couples (and others not trying to conceive though sexual intercourse) who do not have a known cause of infertility required to undergo 6 unsuccessful artificial insemination before they are eligible for NHS funded IUI (aligned with NICE guidance). The draft policy specifies this is to be undertaken in a fertility clinic, to ensure it is effective, safe and reduces legal risks for patients (this is not specified in NICE guidance).
- Ovarian reserve eligibility criteria included for women of all ages (varies from NICE guidance; which only recommends this for women aged 40-42). Low ovarian reserve is linked to a decreased chance of a live birth
- Funding donor eggs and sperm for use in NHS fertility treatment – previously not funded in any boroughs
- Women of all ages who do not have a diagnosis which indicates they will not conceive naturally, will need to try to conceive for 2 years before being eligible for IVF (aligned to NICE guidance) – current policies allow heterosexual women aged >36 to be referred for IVF after 1 year of trying to conceive