# League table of fertility clinics



## Charlies-Mum

http://www.infertileworld.co.uk/index.php?option=com_content&task=view&id=448

A league table showing the performance of fertility clinics in the UK has been published by the regulator. 
The Human Fertilisation and Embryology Authority (HFEA) published the list following a request under the Freedom of Information (FOI) Act.

The clinics are rated on several criteria, including risk management, safety and staff competence.


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## Anthony Reid

To add to this .... Newspapers today are reporting that the worst blunders include staff dropping embryos, egg and sperm on the floor, samples being mistakenly thrown into the rubbish. Failed storage equipment accidentally thawing embryos.


    * The Assisted Reproduction and Gynaecology Centre, London: -29
    * The London Women's Clinic: -22
    * The Winterbourne Hospital, Dorset: -19
    * Brentwood Fertility: -17
    * The Reproductive Medicine Unit at University College Hospital London: -16


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## Anthony Reid

Not that I know of - I'll speak with them tomorrow and see if I need to get it released under the freedom of information act.

Although I might be restricted from publishing it.

Tony
x


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## Cuthbert

Is this what you're looking for?

http://news.bbc.co.uk/1/hi/health/6247567.stm

Jules

/links


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## Anthony Reid

Perfect - thanks 

Tony
x


I think thats a good thing Elaine


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## aweeze

Mine's not on it either ...... hmmmmmmmm  

There isn't anything to say that it was optional and the five that got 0 (good) are listed so I'm not sure whether it's a good or a bad thing either!


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## Wraakgodin

Here is a snippit from the online Mail newspaper this morning:-

Poorly performing fertility clinics could be putting patients at risk, according to a new league table showing the UK's best and worst. 

One in five clinics fail to meet the basic standards expected, and just five of the 78 listed scored top marks. 

Among the six rated as worst perfomers is the Assisted Reproduction and Gynaecology Centre, London, run by director Mohamed Taranissi. 

The clinic has take-home-baby success rates which are two-fold higher than average, but the latest league table measures a wider range of categories. 

These include risk management, the safety of equipment and procedures, staff competence, the quality of patient information and arrangements for donor selection. 

The Human Fertilisation and Embryology Authority (HFEA) published the list following a request under the Freedom of Information (FOI) Act. 

An HFEA report published last month showed 140 safety lapses and incidents between April 2005 and March 2006. 

Of these, 91 were deemed to have serious consequences for the patient, embryo or safety of staff, while 38 were regarded as less serious incidents. 

Typically these involve the loss of embryos, eggs and sperm through dropping dishes or tripping when holding them. 

In some cases, the viability of embryos was damaged by equipment failure. This may ruin a couple's chance of having children. 

Overall, one in five clinics in the league table is failing to meet the HFEA's expectations for technical, clinical and patient care, while some were not providing good enough information or counselling for couples. 

There were six clinics that were responsible for almost a quarter of the overall problems reported. 

These were the Assisted Reproduction and Gynaecology Centre in London, the Reproductive Genetics Institute in London, which no longer has an HFEA licence, Brentwood Fertility, the London Women's Clinic, the Winterbourne Hospital in Dorset and the Reproductive Medicine Unit at University College Hospital London. 

According to an HFEA report, the six clinics demonstrated "the systemic problems caused by poor leadership and control". 

Other issues surrounded protocols, procedures in the laboratory, and staff competence, qualifications and training. 

Just five of the 78 clinics listed scored the top mark, including the Care Fertility Centre in Nottingham, the ISIS Fertility Centre in Colchester, St Mary's Hospital in Manchester, the Christie Hospital NHS Trust in Manchester and the Willow Suite at the Thames Valley Nuffield Hospital. 

Simon Fishel, managing director of the Care Fertility Group, said: "We do the very best by our patients, especially as we are an organisation using cutting edge techniques. 

"Although the regulation can be crippling, our staff are aware that compliance is vital and we believe in absolute transparency with patients. 

"If we make a mistake we tell patients and work to put it right." 

The HFEA said in December it did not want to "name and shame" the clinics. John Paul Maytum, a spokesman for the HFEA, said that had not been the intention of the report. 

He said: "When you are looking at the performance of a clinic, it's not so much the problems you find that matter, it's how quickly the clinic addresses the problems and improves their performance and practice. 

"A lot of these clinics had already addressed the problems by the time the inspection report was looked at by the licence committee." 

Mohamed Taranissi said he had not been officially notified of the clinic's score by the HFEA despite repeated requests over the last six weeks. 

He said: "We have not received the score or breakdown of the inspectors' report, but I will be challenging their findings and expect them to be revised."


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## sue93

hi all,

does anyone know if we can get the actual details behind these scores (ie the actual incidents that led to the score)? It would make an enormous difference to me if points were about, say, confidentiality, rather than dropped/mistakenly thawed embryos.

Is that info in the public domain does anyone know?

sorry if i'm being dense and it's somewhere really obvious!

many thanks

Sue x


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## Betty M

If you are concerned about a particular clinic then you can get copies of all the clinic inspection reports from the HFEA website. This wont give you the scores referred to in the league table but will give you the incidents which the HFEA felt were contrary to the regulations/bad practice etc and you can try and work it out from there. Putting my day job hat on, as the league table was apparently the result of a FOI request the info which made it up will be available somewhere in the HFEA but you may need to make a new specific FOI request for a breakdown of the scores for any particular clinic as the background data may not be in an form which would otherwise be publically available. 

Betty


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## sue93

hi Betty, thank for that. I wasn't sure whether this scoring was related to those reports. That's good news for me it if is, as I've looked at the reports you mention and altho there WERE lots of areas of concern, they weren't in the particular areas that would make me want to change clinic.

Not sure that sentence made sense, but you know what i mean!

thanks again

Sue


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## lissyg

On a general note - and as someone who has had a successful outcome from ARGC (so far, fingers crossed, etc.) , the clinic named worst according to these scores -  

I think that until there is more information about what these really mean the newspaper stories are potentially quite scaremongering and misleading. I'd hate for people's choices to be determined by these scores when, as Sue points out, we don't know what kinds of mistakes make up the scores. Also, presumably the mistakes we should really care about are the ones that reduce the chance of a live birth, and those ones feed through to the standard success rate statistics.

My own experience at ARGC mirrors that expressed by many, many people who have written on these message boards, that behind the chaotic surface they are extremely meticulous and careful in determining each woman's individual treatment, in monitoring for possible adverse side effects, and moreover that behind the mayhem there is an ethos of kindness that I did not feel with other doctors I consulted about our infertility. Obviously I am biased because my IVF/ICSI seems to have worked first time round.

But I just wanted to advise people who are choosing their clinics for the first time not to look at these particular tables in isolation - presumably want you most want is a healthy baby, and the other types of league tables that are already publicly reported by HfEA probably tell you more about that. (Though none are perfect of course...)

Would be interested to know what other people think about this! 

Also, I've heard several trailers for a Panorama programme to be shown on Monday night exposing ARGC (and perhaps other clinics?) because it is so expensive. Of course I'm sympathetic to the idea that the "infertility industry" is a huge money spinner, and that there are probably a lot of very unprincipled people getting very rich out of our pain. On the other hand my instinct on this one is again that it is wide of the mark. The top clinics that get the best results are bound to charge more, however unfair that might seem. But if you need fewer rounds of IVF before you get  a positive result, in the end you probably won't spend that much more. (My sympathies of course are with those who spend all they've got without success). But maybe I'll wait and watch the programme before rushing to judgement any further.

Wishing all the best to everyone.
Alissa


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## Mish3434

Just been on the HFEA website and cannot find Barts on the clinic list, but on the earlier link they scored -6 anyone any ideas why I can't find them on HFEA??  I even typed in their own post code and nearest it came up with was Guys 0.3 miles away?

Shelley x


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## aweeze

Shelley - try this - http://guide.hfea.gov.uk/guide/Clinic.aspx?cliniccode=0094

/links


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## Mish3434

Cheers Aweeze

didn't realise they where called that    

Shelley x


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## Caz

Yesterday I read with some interest the clinic inspection reports for both the ARGC and my own clinic (The Lister). I read the ARGC's simply because they came out the worst in the league tables and I wanted to get some idea of what sort of problems were being identified. I know the inspection reports are not directly related to the league table scores but it is the best information we, as patients, have to assess the sorts of problems that the clinic has.

To be honest it seemed to me that the ARGC's main problems from the report were of a clerical nature. To give an example: it was noted that the ARGC do not notify the HFEA of the outcome of treatment cycles within the specified period of time. While on the surface that seems fairly trivial, the point the inspection made was that the HFEA is then reporting incorrect figures for the clinic because the information may not be included within the correct period. For example the ARGC had records of 640 cycles while the HFEA had been notified of only 314. The inspection indicated that 82% of their cycles are not reported within the appropriate timescales. If, as a potential new patient, you are going to the HFEA website to find a clinic, you look at their stats and see they only treated 314 people that year you would think they were a fairly quiet clinic when, the truth is, they actually treat more than double that. This is going to affect your perception of the clinic and might even affect their final success rates. The HFEA (in a subsequent comittee meeting also reported on their website) felt this was a breach that might be serious enough to affect their licence.

Don't get me wrong, I am not picking on the ARGC. I am sure that if I read a random sample of reports half a dozen clinics I might find similar issues, but I do think that there is this temptation for most of us to blindly stand up for their own clinic and see their own consultant as some kind of deity without really questioning what goes on behind the scenes. I know I am just as guilty of that as anyone else. 
As I say, I read the HFEA inspection report on my own clinic and I was quite alarmed by one or two of the things it picked up on there - breaches in code of practice standards that may potentially lead to sample mix ups or serious implications on the health of the child concieved via treatment - in fact, some of these issues I would personally consider far more serious and offputting from a patient perspective than a little incorrect paperwork.  What I found encouraging though, was my clinic's willingness to accept and adapt to meet the HFEA's standards. This, I think is something that you can only read between the lines and something that ought to be taken into account when deciding where to go far more than what actually is found to be wrong.

I suspect the reason that places like the CARE and NHS clinics have fared so well in the league tables is because they are larger organisations with set processes and procedures that are managed by people not necessarily directly involved in the clinical care of patients. 

In either respect I would highly recomend to anyone starting out of the IVF journey, that they read both the clinic statistics, any personal literature from the clinic and the inspection reports before making a decision on where to have treatment.

C~x


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## fiwi

HI all,
I am very interested in all this because I have just decided to go for IVF and I picked the Argc as my 1st choice (although I haven't started anything yet) because of good reports I read on this site but mostly because of their above average success for my age group and it sounds like these reasults might not be all they appear to be. 
The lister would be my second choice for practical reason (I am in Brighton and the lister has an 'annexe' there) but I didn't read such good feedback on this site and the results were not as high as the Argc.
On Monday 15/01 there is a Dispaches programme on BBC1 about IVF and I think it is about the Argc (and the richest doctor in the UK), it is not a good sign for a hospital if reporters go there undercover!
Fiwi


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## fiwi

I meant Panorama on BBC on Monday


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## Caz

fiwi, I would  advise you not to let all the negative press put you off the ARGC entirely. There is no doubt in my mind that they are a very dedicated clinic with caring professionals that do their upmost to get everyone they treat pregnant. 
The HFEA reports, and the supposed "expose" we are due to see on TV do not paint nearly the whole picture. 

I think if you ask anyone on here being treated by any clinic to be honest about its pros and cons you will find there is something to recomend everyone and something to make you think twice about them. 
I would recomend that you check out the clinic review folder and read as many reviews about each clinic as you possibly can. It is a natural inclination for us all to sing the praises of our own clinic/consultant so you will have to remember there is a degree of bias with every person on here.

I don't want to clog this thread up with an abbreviated clinic review so I have sent you a PM with some of my thoughts on the clinics you have mentioned.

C~x


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## Anthony Reid

I asked the HFEA why some clinics were not on the report.

I thought you would like to see the response..........

Yes, in terms of the last week's story, we'd strongly encourage anyone to read the HFEA's report, as the media accounts are understandably simplifying a fairly long report. It can be found at http://www.hfea.gov.uk/cps/rde/xchg/hfea/hs.xsl/1468.html).

The report, "Driving Improvement", was published in December last year and was not intended as way of comparing individual clinics. The best way to compare clinics on the non-success rate elements of the clinic's performance is by looking at the inspection reports we publish on our website.

The "Driving Improvement" report was to provide a snapshot of the performance of the IVF sector as a whole at a particular point in time - the year March 2005- March 2006. The report looked at compliance with the fertility legislation, the HFEA code of practice and recomendations made in HFEA inspections. This is only one aspect of clinic performance, but an important one. The 'scoring' was based on inspection reports reported to an HFEA licence committee between 1 April 2005 and 31 March 2006.

Not all clinics had an inspection report presented to an HFEA licence committee during this period, so not all clinics are included in the information released under the Freedom of Information Act request that came in after the report was first published (and which is what sparked the coverage last week), so no significance should be attached to whether a clinic is included in the report or not.

If we find problems in a clinic we take appropriate action to deal with these problems and encourage the clinic to improve . We have been working with this centre for a long time now to encourage the clinic to improve some areas of its performance.


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## ChrisA

Anyone treated at the ARGC will not be too surprised that there are clerical issues, on a busy day you have to have a sense of humor 

Anyway what I wanted to ask is, is it no longer possible to get a proper performance table, I mean old style based on real results?

Chris


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