Frequently asked questions
Why is NHS Cheshire and Merseyside proposing changes to local fertility policy?
Currently, there are ten NHS subfertility policies being used across Cheshire and Merseyside, which means that people have varying access to NHS funded fertility treatment, depending on where they live.
NHS Cheshire and Merseyside is proposing a new, single policy, which would mean that in the future everyone would get consistent access to fertility treatment in our area.
The new policy would include a number of changes that would remove variation, and ensure local practice is in line with national guidance, but we are also proposing to make some changes for financial reasons.
To learn more about this, go to: Share your views on proposed changes to fertility treatment policies in Cheshire and Merseyside - NHS Cheshire and Merseyside
What is being proposed?
One of the key changes being proposed in the new policy is to reduce the number of in vitro fertilisation (IVF) cycles that the NHS pays for to one cycle per eligible individual or couple. Currently, between one and three cycles are funded by the NHS, depending on where people live.
Other changes are being proposed to help standardise some of the eligibility criteria for accessing fertility treatment, and bring the local policy in line with the latest clinical guidance. This includes proposed changes to eligibility based on BMI (body mass index), smoking status, the lower and upper age limit, and the definition of childlessness.
Why can’t we leave things as they are now?
This would mean continuing with a situation where the number of NHS funded IVF cycles offered, and who has access to those cycles, varies depending on where people live.
Also, if we keep things as they are now, we would not be able to reduce the cost to the NHS, which is something we need to do.
Is it just about saving the NHS money?
Some of the proposed changes are about saving money, because the NHS is currently facing serious financial challenges, and this means we’re having to make some difficult decisions about how we spend our local health budget.
Some of the proposed changes are also about ensuring that local practice is in line with the latest national guidance, and removing variation so that people across Cheshire and Merseyside have the same access to fertility treatments in the future.
How can you justify reducing the number of IVF cycles being funded?
We know that access to fertility treatment is a sensitive issue, but we believe that moving to a single IVF cycle is the best way to ensure that we can continue to provide this treatment for our local population, while making sure that it remains affordable for the NHS.
However, before we make a final decision, we need to hear what people think about the proposal, which is why we’re holding a public consultation.
How much will the NHS save if these changes go ahead?
The NHS in Cheshire and Merseyside currently spends over £5 million on IVF treatments every year, and it’s estimated that the proposed change would save the local NHS around £1.3 million per year.
What does the proposed IUI change mean for same sex couples and single women?
The proposed change is to make IUI available for people in Wirral, in the same way it currently is for those in other areas. However, this change would not impact on the current requirement for self-funded IUI for same sex couples and single women before becoming eligible for NHS care.
It’s important to stress that a key aim of this piece of work is to create consistency across Cheshire and Merseyside. We are expecting new national guidance on fertility treatments to come out from the National Institute for Health and Care Excellence (NICE) later this year, so our new policy would be an interim one. When this new guidance comes out, we will review it again to make sure our policy is up-to-date with the latest medical evidence.
Why aren’t you also looking at two cycles?
We did consider whether we could provide two cycles of IVF to everyone who is eligible, and this was also the option that local NHS fertility specialists supported. However, it is estimated that to do this would cost around £40,000 extra each year, compared to what is currently spent on IVF.
Because the NHS is facing such a serious financial situation, we do not believe this would be the best way to spend our limited resources. We need to look at options which would reduce the amount we spend on IVF cycles, not increase it.
If you’re only consulting on one option, haven’t you already made a decision?
We have drafted the new policy based on what we feel balances local need and affordability - but we haven’t finalised it yet.
Before we do that, we are committed to listening to feedback from our communities.
We are encouraging people to share their views and tell us how these changes might affect them, and what they think might help to minimise any negative impact.
People can do this by completing a questionnaire at: Share your views on proposed changes to fertility treatment policies in Cheshire and Merseyside - NHS Cheshire and Merseyside
When will a final decision be made?
Once the consultation closes on 15 July, the findings will be analysed and compiled into a report. This report will be presented to the Board of NHS Cheshire and Merseyside for a final decision, likely in late summer or early autumn 2025.
What happens if most people are against this change?
The purpose of public consultation is to gather people’s experiences and views in order to help inform decision-making, highlight any unintended consequences, and identify ways to minimise any potential negative impacts for specific people or groups.
The final decision about this consultation will be made by the Board of NHS Cheshire and Merseyside, who will carefully consider the consultation findings.
If these changes went ahead, when would it happen?
Further information will be shared about the outcome, and what this means for people who use fertility services, when a final decision is made. This is likely to be by autumn 2025. Until then, the existing policies will still apply and people can continue to access fertility treatment just as they do now.
Where can I see and compare the current policies with the new draft policy?
To read the new draft fertility policy in full, you can go to: draft-proposed-policy-nhs-funded-treatment-for-subfertility.docx
To view the ten existing local subfertility policies, go to the following link, scroll to the map at the end of the page and then click on the area you want to see the policy for: https://www.cheshireandmerseyside.nhs.uk/your-health/clinical-policies/
Questions about specific patient’s fertility treatment and care plans
For the time being, all existing fertility policies will still be applied and people can continue to access fertility treatment as normal. If you have any questions which are specifically about your current fertility treatment, please speak to your care provider for advice.
If proposed policy changes go ahead, could people be impacted mid-treatment?
At this stage, no final decision has been made, and current policies still apply.
Ahead of treatment starting, the Hewitt Fertility Centre confirms to people how many IVF cycles the NHS will fund for them, in line with the policy for the area they live in.
If the proposed change to the number of NHS-funded IVF cycles goes ahead, there would be no change for people who had already been told by the Hewitt Fertility Centre how many cycles they would be entitled to during their care. Therefore, there would be no impact mid-treatment.
However, any future change would apply to people who had not yet started their care with the Hewitt Fertility Centre at the point a decision to change the policy was made.
As soon as there is a decision about what happens next, which we expect to happen in late summer/early autumn 2025, the NHS will share further information.