Obese People Could Have IVF Treatment Access Limited in Worcestershire

An NHS trust in Worcestershire has become one of the first to consider restricting access to IVF to overweight individuals.

Couples attempting to utilise the treatment in order to achieve pregnancy may be denied the IVF solution if deemed obese.

And financial malaise in the NHS can be blamed for this decision.

Three Clinical Commissioning Groups (CCGs) in Worcestershire claim that they face ending the financial year £25 million over budget unless savings are made.

The three CCGs have a combined budget of £717 million.

Leaders at the NHS trust suggest that major financial savings must be made in Worcestershire owing to the public demand for an increasingly diverse range of services.

It is asserted by health service bosses that the existing demand is simply unsustainable.

As the health service in Worcestershire continues to examine where savings should be made, a public questionnaire has been launched seeking the opinions of the public regarding where the axe should ultimately fall.

Suggestions include restricting access to IVF which costs £500,000 a year and restricting treatments for patients with unhealthy lifestyles such as heavy drinkers, smokers and obese people.

And Worcestershire health bosses are pains to point out that this survey included the critical text indicating that denial of IVF will occur “particularly where the need for that operation has been partially caused by their own unhealthy lifestyle”.

Other potential options include restricting access to chiropody (£2 million a year), and restricting access to cataract surgery for people with minor vision difficulties (£3 million a year).

Commenting on the issue, a spokesman for the three CCGs Indicated that the idea was still being floated at present, but that it was under serious consideration.

“No decisions or even formal proposals are being made; this is just a very broad engagement exercise to see what people think. The results of this survey will inform future plans we make as healthcare commissioners and further engagement work will follow. If any of these ideas are considered in more detail in the future then we would undertake a more formal consultation with the public, providing clear proposals, the reason for these proposals, and invite further public discussion about such plans.”

The spokesperson further indicated that the trust was confident that it was taking the right decision, and that’s public input would be particularly valued.

“We believe this is absolutely the right thing to do to make sure we are reacting to the views of our local population and having an open and honest discussion with them is the best way to achieve this.”

But Peter Pinfield, chairman of patient watchdog HealthWatch Worcestershire, Believes that savings will have a negative impact on services, and encourage the public to participate in the questionnaire in order to illustrate the major difficulties that will ultimately result.

“This is about finding out what the people of Worcestershire think. Let’s have a wide debate and encourage as many people as we can to contribute. Yes NHS funding is increasing but it’s not keeping up with demand. We’re living longer and the NHS is being squeezed.”

Worcestershire health bosses will terminate the survey on 30th May and then seek results and ultimate conclusions.

 
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Mothers of Twins and Triplets not Receiving Requisite Care According to Report

A report from the Twins and Multiple Births Association and the National Childbirth Trust suggests that women expecting twins are triplets are suffering from relatively poor care.

The organisations conducting the report surveyed 1,400 such parents from all over the UK.

They found that the South East and West Midlands are particularly poorly served in this department, while women expecting wins or triplets in the north-east received the best care in the country.

The report also found that the National Institute for Health and Care Excellence (NICE) guidelines on antenatal care had not been adequately implemented.

One of the undesirable results of this was that access to specialist care was severely limited in some regions of the country.

The latest figures indicate that stillbirth rates for multiple births rose by 13.6 per cent between 2013 and 2014.

Meanwhile, multiple pregnancies in fact account for around 3 per cent of all births in the United Kingdom.

Yes the risks associated with women giving birth to twins or triplets are significantly higher than for usual pregnancies.

Such babies have a significantly higher neonatal death rates, while the chances of poor health and disability after birth are also significantly increased.

NICE introduced guidance for multiple pregnancies in 2011 and quality standards in 2013.

Commenting on the results of the research, Keith Reed, chief executive of the Twins and Multiple Births Association, suggested that the existing situation reflects rather poorly on healthcare services.

“This report paints a bleak picture with shocking variations in the standard of multiple-pregnancy care across the country. The NHS England maternity review needs to address this issue as a matter of urgency to prevent babies’ lives being put at risk.”

In addition, Louise Silverton, director for midwifery at the Royal College of Midwives, concurred with these sentiments, stating that the findings of the report should be considered particularly worrying.

“It is crucial that we find out why this is happening and take steps to address it. The fact that so few trusts are implementing the guidelines is also a real concern. The guidelines are there for a reason and trusts should be using them.”

Responding to the report, a spokeswoman from NHS England indicated that there would be a direct reaction to the review.

NHS England indeed intends to “assess how best we can respond to England’s growing birth rate and the need for safe and flexible services which are tailored to the needs of women, babies and their families”.

About one in three of the women surveyed said they did not see a named specialist obstetrician, while only 20 per cent saw a specialist midwife and 28 per cent saw a specialist sonographer.

 
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Young Women Should be Offered ‘Fertility MOTs’ on the NHS

The British Fertility Society (BFS) has suggested that women from the age of 25 should be offered so-called ‘fertility MOTs’ on the NHS.

Central to these check-ups should be counting how ovaries these young women have left remaining.

Despite the fact that fertility actually diminishes rapidly during a woman’s thirties, this is a morsel of information that often escapes the notice of couples attempting to produce a baby.

Indeed, Prof. Adam Balen suggested that “every week in our clinics I see couples where surprise is expressed – they didn’t realise the degree to which fertility goes down in your 30s.”

In particular, the British Fertility Society noted that career women who consider themselves to be ‘in control’ on their own lives were often surprisingly ignorant of their dwindling ovarian reserve.

With this in mind, a national system of five-year checks, beginning at the age of 25, could help prevent women who wish to conceive from being unable to do so due to lack of ovarian produce, according to the BFS.

Cervical screening would be central to this process, but the British Fertility Society has also called for a wider program of education.

In particular, the aforementioned Balen has suggested that lessons for teenage girls and university students in how to protect and prolong fertility should be considered essential.

Family planning lessons should also be carried out at both schools and universities, as far too many women are currently optimistic about their biological clocks on the basis of anecdotal evidence.

“There is lack of understanding of the dramatic decline in fertility, and there are pressures to develop careers,” Balen suggested.

With regard to the new schemes, it has been pointed out that such checks are already offered regularly in other countries, with Denmark being a particular pioneer.

Regular screening could allow women to have a real insight into their current level of fertility, which could then have an impactful benefit on their decision or otherwise to attempt to conceive.

Women should also be given diet and lifestyle advice, with obesity and anorexia – which damage fertility – both on the rise according to advice from the British Fertility Society.

This latest advice comes in the context of a trend in which the age of motherhood continues to rise.

With this increasing average age of mothers, comes a parallel increase in the risk of infertility, miscarriage or babies suffering abnormalities.

Figures have also indicated that British women begin families later than equivalent females in other countries.

The average age at which women conceive in the UK is 30, which represents an increase of nearly two years in the last twenty years alone.

This figure compares to 28 in France and Scandinavian countries, and just 25 in the United States.

Balen suggested that the late 20s or early 30s should be considered the latest point for young couples to start a family.

There were 695,233 live births in England and Wales in 2014, a decrease of 0.5 per cent from 698,512 in 2013, and the total fertility rate decreased to 1.83 children per woman, from 1.85 in 2013.

 
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