New data reveals the UK fertility sector is performing well, and most patients are satisfied

The report shows that the UK fertility sector performed well in 2017-18 with HFEA licensed clinics meeting the standards required. Very few incidents took place compared to the number of treatment cycles, which continue to rise year on year.

Inspections of 101 licensed clinics took place in 2017-18 with most awarded a four-year licence, the maximum length possible. This shows that the vast majority of clinics are meeting all the required standards. At inspections at the time of licence renewal, two thirds of clinics also met more standards than the last time they were inspected.

The independent national survey of patients who recently had fertility treatment reveals that 75% of patients are satisfied with their treatment experience at clinics, with no significant differences in satisfaction levels among patients whether they paid privately or were treated by the NHS. Patients were more likely than partners to say that they felt involved and treated with respect and dignity in certain aspects of their treatment and those receiving treatment more recently reported higher levels of the use of treatment add ons than those who were treated two to five years ago. However, more worryingly, 62% of patients whose most recent treatment was at a private clinic said they paid more than they expected.

Sally Cheshire CBE, HFEA chair said: “I am pleased that this report indicates there is continued good performance across the UK fertility sector, but we know there is more work to be done to make sure that all patients receive the best quality of care.

“This year we have gone further to gather patient feedback by carrying out the first national patient survey. The results provide us with rich data to better understand the experiences of patients and their partners in fertility clinics. Whilst it is good news that the majority of patients are satisfied with their treatment we are concerned that a quarter are not, and we will be working closely with clinic leaders to address this.

“We have renewed our focus on clinic leadership to ensure they not only meet the legal and clinical responsibilities under the HFE Act, but those of ethical and responsible treatment and care. We also want clinics to provide patients with better emotional support throughout their treatment and we have updated the requirements in our Code of Practice to reflect this. We will continue to monitor progress in all areas through our inspections and patient feedback mechanisms.”

Our state of the sector report indicates the fertility sector is generally performing well and it includes details of non-compliances, incidents and complaints handling in clinics. In 2017-18 there were 380 non-compliances in clinics across the 37 themes we look at in inspection, with the main reason for non-compliance being the clinics’ quality management system. There have been improvements in witnessing and a further reduction in multiple births, a key risk for mothers and babies.

The number of incidents reported in 2017 remains low at 570 (0.7% of all treatment cycles) although this increased by 4.6% from last year, in line with the number of cycles carried out. There were no grade A incidents – the most severe, but the proportion of grade B incidents increased to 41% in 2017-18, compared with 32% in 2016-17. The number of grade C incidents decreased from 328 to 302 in 2017-18. The increase in grade B incidents resulted largely from a greater awareness of the need for clinics to report these and issues associated with third parties who provide services to clinics. Clinical incidents include laboratory incidents, equipment failure and cases of severe or critical ovarian hyperstimulation syndrome (OHSS) which clinics must report to us immediately. The risk of OHSS from fertility treatment remains low but there were 52 patients reported as having severe or critical OHSS in 2017-18.

Sally Cheshire reiterated the need for clinics to be open about incidents so that they and the wider sector can learn from them.

“The UK’s fertility sector shows a high level of professionalism, reflected by fewer than 600 incidents occurring out of more than 80,000 treatments, with no grade A incidents reported in the last year.

“But any incident is one too many and it’s not only the grade A incidents that can have an adverse effect on patients. Clinical and administrative errors can cause patients distress and more work must be done in clinics to prevent incidents occurring, including cases of OHSS. We are working closely with partners, the professional bodies and clinics to ensure the systems for the prevention and reporting of incidents, including OHSS are as rigorous as possible.”

In 2017-18 more patients came to the HFEA with complaints about their clinic. There were 86 complaints from patients who had been unable to resolve their complaint with their clinic, a 21% increase on number received in 2016-17. There has been a decrease in the number of clinical complaints and an increase in communication and general complaints during the year.

Sally adds: “Given the number of treatment cycles taking place in the UK every year, I am pleased that we receive only a small number of complaints. However, I want clinics to work hard over the next year to respond and resolve complaints first time.”

ENDS

Notes to editors

A copy of the full state of the sector report.

A copy of the national patient survey.

All figures, unless otherwise stated in the patient survey, are from YouGov Plc. Total sample size was 1017 adults. Fieldwork was undertaken between 3rd September - 2nd October 2018. The survey was carried out online. The figures have been weighted and are representative of fertility patients in the UK.

Categories of incidents:

Grade A: the most serious type of incident which happen infrequently. These involve severe harm to one person, such as a death or being implanted with the wrong embryo, or major harm to many, such as a frozen storage unit containing embryos of many patients failing.

Grade B: involves serious harm to one person, such as the loss or damage of embryos for one patient, or moderate harm to many, such as sensitive personal data about more than one patient being sent to the wrong recipient.

Grade C: involves minor harm, such as one of many eggs being rendered unusable in the laboratory.