Patients across Lancashire and South Cumbria who require help to conceive will have access to only one cycle of treatment after a new policy was approved by a powerful health committee.
The Joint Committee of Clinical Commissioning Groups (JCCCG) supported a reduction from two cycles to one for treatments like IVF (in vitro fertilisation) – as well as the standardisation of other eligibility criteria, including maximum and minimum ages.
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But a meeting of the JCCCG heard that changes to treatment definitions could result in some people being given an increased chance of conception compared to the current, apparently more generous, system.
As part of the new policy, all embryos created during an episode of “ovarian stimulation” will now be utilised. At the moment, providers in some parts of the region are transferring only two or three of the resultant embryos.
“It is possible for one treatment unit to give patients access to more embryo transfers than two previous cycles might have [done],” Elaine Johnstone, chair of the commissioning policy group, said.
“It will be dependent on how many individual embryos they are able to create and how many it takes before they achieve pregnancy,” she added.
Anybody who has already begun treatment will remain entitled to the number of cycles permitted in their area at the point at which they were referred.
Previously contrasting policies on the age at which assisted conception is provided were also harmonised across Lancashire and South Cumbria.
The maximum age of the woman will now be 42 – an increase of two years for every part of the region except the Blackpool and Morecambe Bay CCG areas, where it already applied. Meanwhile, the minimum age will stand at 18 – a reduction of five years for patients in Greater Preston, Chorley and South Ribble, Blackpool and West Lancashire.
Meanwhile, couples who have their own or adopted children from previous relationships will not be eligible for NHS help to conceive – a reduction in access to treatment for those in the Fylde and Wyre and Morecambe Bay CCG areas.
Chair of Morecambe Bay CCG, Geoff Jolliffe, wanted to know whether the change risked breaching human rights laws. “If they are turned down [because one partner already has children], most people will go and pay for the treatment – but there are some who cannot afford to do that,” he said.
The meeting heard that legal advice had confirmed that the new rules complied with legislation.
Other eligibility requirements will include both partners being non-smokers throughout the treatment process and any resulting pregnancy and also that the woman has a body mass index of between 19 and 30.
A public consultation on the assisted conception policy attracted more responses – almost 700 – than any other proposed change to the provision of services so far considered by the JCCCG.
Lancashire and South Cumbria currently spends £2.5m per year on assisted conception. But committee members were told that a lack of population data meant it had been “virtually impossible” to estimate the cost of implementing the new policy.
Elaine Johnstone said there was “an expectation” that savings from a reduction in the number of cycles would balance out the increased costs of extending treatment to a wider age range.
Penny Morris, chief clincial officer at Blackburn with Darwen CCG, said it was important that GPs provided the same information across the area to avoid the "angst" which some people were experiencing over the changes.
"The assumption is that we are restricting people's access and we're not necessarily doing that," she said.