On 20th July 2022, the UK government published the first Women’s Health Strategy. A long-overdue proposal with one goal in mind: to eradicate gender discrimination in the NHS. For decades, women have experiences instances in which their gynaecological issues have been swept under the carpet and belittled by medical professionals.
What is the Women’s Health Strategy?
This strategy shines a light on several instances in which women are not afforded adequate care under the current regime, and highlights proposals to be put into practice over the next 10 years so that care can be improved.
Whilst the Women’s Health Strategy covers a range of issues pertaining to women, this post will explore the impacts we can expect to see in fertility treatments.
Access to Fertility Treatments
It’s long been publicised that access to NHS funded fertility treatment is disparate. Up to now, both clinical and non-clinical factors are considered to determine eligibility to access funded treatment.
Thanks to the new Women’s Health Strategy, we will move to a system in which access to NHS funding is based purely on clinical factors. As such, all current non-clinical eligibility criteria will be removed.
This is a giant step forward in making access to NHS treatment more equitable. There are three main ways that this will help.
1. Female same-sex couples
Current criteria expects women in same-sex relationships to self-fund six rounds of IUI (intrauterine insemination) to prove their fertility issues before they become eligible for NHS funded IVF treatments. This increases the financial burden faced by these couples that is not experienced by heterosexual couples wanting to conceive. Because of this, there will no longer be a requirement to self fund IUI treatments in these circumstances. Up to 6 rounds of IUI will be available on the NHS to female same-sex couples before progressing to NHS funded IVF if necessary.
2. Those with a child from a previous relationship
Many couples currently find themselves ineligible for NHS IVF funding when one partner has a living child from a previous relationship. This is set to be reversed as part of the new Women’s Health Strategy 2022. It will be a welcome step in the right direction for many couples who will now become eligible for NHS funding.
3. Postcode Lottery
Sadly, this section of the report was quite vague. However, alongside the intention to remove non-clinical barriers to accessing NHS funded IVF is a pledge to address the current postcode lottery and geographical variation in access.
What is as yet unclear, is whether this will translate to more NHS funded IVF cycles across the board, or fewer. The current NICE guidelines are that 3 funded IVF cycles should be offered. But the report suggests that the NICE guidelines are currently being updated and that a revised version is not due to be released until 2024.
Education Around Fertility Treatments
Just as the news concerning improved access to NHS funded fertility treatments is welcome, so is the news that education surrounding fertility and fertility treatments will be improved. As part of this 10 year Women’s Health Strategy, fertility along with contraception, family planning, maternity care and pregnancy loss will be taught explicitly from a young age. It is hoped that this will break down the pre-existing taboos concerning these issues in wider society.
Similarly, more education will be provided to those seeking fertility treatments so that they are able to make more informed choices. This includes information regarding treatment success rates as well as the efficacy of treatment ‘add-ons’.
Updates to Maternity Services
Of course, the aim of fertility treatment is to become pregnant and eventually give birth, so it is fair to say that any updates to maternity services are also of interest to those seeking fertility treatments.
The Maternity Transformation Programme will continue to improve services across the country, particularly in the wake of the Ockenden Review, which highlighted severe failings in maternity care. Enhanced ante-, peri- and postnatal care is on the agenda, too.
Miscarriage and Pregnancy Loss
All too often, those going through fertility treatment, as well as those who experience spontaneous pregnancies, suffer through miscarriage and pregnancy loss. This is highlighted in the strategy, where interim findings of the Pregnancy Loss Review have lead to the inclusion of a new provision of recording pregnancy loss prior to 24 weeks’ gestation.
For those who unfortunately experience recurrent miscarriages, new guidelines are expected later in the year, with the Women’s Health Strategy supporting the implementation of the updated guidelines.
There are many welcome outcomes of the Women’s Health Strategy that will impact fertility treatments and associated maternity services. The strategy outlines a number of measures to be brought in over the course of the next ten years to improve women’s experiences. Of course, it’s right to make fertility services more accessible and equitable, though the lack of clarity – and definitive time scales – around how these changes will be brought about is less than ideal.
Nevertheless, this is a step in the right direction. For all women.