Decision made on proposed changes to fertility treatment policies in Cheshire and Merseyside

NHS Cheshire and Merseyside held a public consultation between 3 June – 15 July to provide further details and invite comments, with more than 2,100 people sharing their views.

Feedback received from the consultation was analysed and set out in a report. This document was presented to the Integrated Care Board, alongside an equalities impact assessment (EIA) detailing the impact of the change for different groups, including women, people with disabilities, and people from Black and ethnic minority backgrounds. 

The decision was taken at the ICB’s Board meeting, which took place in public on Thursday 27 November. You can find further details of the meeting here.

What is changing?

The number of IVF cycles being funded:

• Under the new policy, eligible people aged under 40 years will be offered one in vitro fertilisation (IVF) cycle funded by the NHS. Those aged 40 to 42 are already only offered one cycle.  

Currently, people can access between one and three cycles funded by the NHS, depending on where in Cheshire and Merseyside they live.

• The NHS in Cheshire and Merseyside currently spends over £5 million on IVF treatments every year, and it ’is estimated that moving to a single cycle will save around £1.3 million per year.
• It brings Cheshire and Merseyside in line with the majority of other areas in England – 66% of ICBs only fund one IVF cycle currently.

NICE recommends that women aged under 40 years should be offered three full cycles of NHS-funded IVF. However, because of the highly challenging financial position the local NHS is facing, the move to a single IVF cycle offers the best opportunity for the ICB to continue providing this service, while ensuring that it is affordable.

Other eligibility changes
 

Other changes as a result of the introduction of the single policy are:

• Aligning body mass index (BMI) eligibility criteria in Wirral with the rest of the region by removing the requirement for non-carrying partners to also meet the BMI criteria.
   
• Standardising eligibility criteria on smoking to specify that both partners must be non-smokers – this is a new requirement in Halton, Knowsley, Liverpool, Sefton, St. Helens.
   
• Revising the definition of 'childlessness' in Cheshire East and West to exclude those who have previously had a live birth (or adopted a child) from any further embryo transfers – all other areas of the region already apply this rule.
   
• Changing the wording around the lower and upper age limit in the new policy to make it clearer that there is no lower age limit for treatment, and that people are eligible until their 43rd birthday.
   
• Introducing the use of intra uterine insemination (IUI) for specified patient groups in Wirral (where it is not routinely commission it currently) - to bring it in line with NICE guidance and the offer in all other areas.

Where someone does not meet the eligibility criteria based on their smoking status or BMI, they can be signposted to additional NHS support to help them meet the requirements for treatment, such as free stop smoking services and weight management support.

What are the next steps?

• The date from which the new policy would be introduced has not yet been confirmed. For the time being, existing subfertility policies for each area will continue to apply.
• Further communications will be issued in the coming weeks.
• When the new policy is introduced, it will only apply to new patients accessing NHS funded fertility care from this date onwards.
• The decision will not affect the provision of care for anyone who has already been referred to fertility services or is already accessing treatment prior to the new policy being introduced.