Healthwatch in Greater Manchester has written to the Chair of NHS Greater Manchester Integrated Care Board (ICB) to raise serious concerns about the decision to standardise NHS-funded IVF provision to one cycle across Greater Manchester.
This follows the recent NHS GM IVF consultation, which received feedback from more than 2,200 people across the city region. The consultation responses included strong and consistent testimony about the emotional, physical, and financial impact of infertility, and the importance of fair and equitable access to fertility treatment.
Healthwatch in Greater Manchester was included as part of the consultation process. While we welcome being engaged, the final outcome raises concerns about whether public involvement is having meaningful influence on system decision-making.
What Healthwatch in Greater Manchester raised
In our letter , we highlighted that although the ICB Board paper acknowledged that public feedback did not support the preferred option, the final decision does not appear to reflect the strength or direction of that feedback.
We raised particular concerns about:
Public voice and consultation impact
The consultation feedback was clear, yet the decision appears to have moved forward with an option that was not supported by the majority of respondents.
Equity and disproportionate impact
The Board paper recognises concerns about equity, mental health impact, and disproportionate effects on people already experiencing disadvantage. However, the decision does not appear to address these risks in a meaningful way.
Departure from NICE guidance
We raised concern that standardisation should not be used as justification for reducing provision, particularly where alternative options were more closely aligned with NICE clinical guidance and public feedback.
Trust and transparency in decision making
We also raised wider concerns about how patient experience and public voice are positioned within system decision making. When engagement leads to outcomes that appear to run counter to feedback and national guidance, it risks damaging public trust and confidence in the NHS.
What Healthwatch in Greater Manchester has asked NHS GM ICB to do
In our letter, we requested that NHS GM ICB:
- Provides a clear and transparent account of how consultation feedback and public input were weighed in reaching the final decision
- Reconsiders the decision to standardise NHS-funded IVF provision to one cycle, given the strength and consistency of feedback, equity concerns, mental health impacts, and the departure from NICE guidance
Update: Response from NHS Greater Manchester ICB
Following our letter, we have now received a formal response from the Chair of NHS Greater Manchester ICB, Sir Richard Leese.
The response confirms that, having considered public feedback, NICE guidance, financial pressures and the position of other ICBs nationally, the Board has decided there is no intention to reconsider the decision to standardise NHS funded IVF provision to one cycle from 1 April 2026.
NHS GM has committed to addressing several issues raised during the engagement process that sit outside the number of IVF cycles, including:
- Addressing inequalities across the wider fertility pathway
- Working with providers to optimise outcomes from funded cycles
- Developing a sustainable approach to fertility preservation
- Reflecting on feedback from same-sex couples and single women
Next steps
Healthwatch in Greater Manchester will:
- Continue to monitor implementation of the revised Assisted Conception Policy
- Seek clarity on how the ICB will address the wider risks and inequalities it has acknowledged
- Keep the public informed about developments relating to IVF access across Greater Manchester
We remain committed to ensuring that lived experience and public voice are not only heard, but demonstrably shape decision-making across the system.