SPH was commissioned to review existing fertility policies across a group of Integrated Care Boards (ICBs) in order to support a collaborative approach to ICB policy making.
The work included:
- a comparison of assisted conception policies
- identification and analysis of up to date evidence regarding the effectiveness of a variety of treatment / policy options
- a discussion of the ethical considerations; collation and analysis of data on activity, outcomes, costs and inequalities
- and modelling of a range of policy scenarios
The work was completed over six months. After an initial review of policies and a workshop with stakeholders from each ICB to confirm the project scope and key areas for consideration, we carried out the evidence enquiries and analysis of ethical considerations. Alongside this, data sharing agreements were put in place with ICBs, NHS providers and private providers and data were obtained, collated and analysed. Discussions with the Human Fertility and Embryology Authority allowed us to also receive up to date local data on activity and outcomes for NHS and private patients. Based on this, a workshop was held to agree a wide range of policy scenarios for modelling.
A high level model was developed to illustrate the impact of different policy scenarios on numbers treated, outcomes, costs and cost effectiveness (for each ICB). The assumptions used were clearly stated and the model allows changes to be made to these assumptions in future if, for example, the evidence base in relation to effectiveness, cost, uptake or drop-out rates changes.
The final reports included a short summary comparing policy scenarios and highlighting key ethical considerations and next steps, and a full report with appendices.
