Risk of regret used to deny women NHS sterilisation

A woman who was refused a form of permanent birth control by an NHS body over fears she may regret the procedure has won her case with the health ombudsman.

Leah Spasova complained after her request for sterilisation was rejected by the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB).

Her request had been refused over concerns regarding potential regret and cost-effectiveness, despite the ICB regularly funding vasectomies for men without applying the same criteria.

In a statement, the recently formed Thames Valley ICB - which replaced BOB ICB earlier this year - said it accepted the ombudsman's findings against it.

Spasova said she had been enquiring about sterilisation for 10 years and was "just passed back and forth between services", before the ICB turned down her request for funding for the procedure.

The decision "did not follow the widely recognised principle that clinicians provide advice, but patients ultimately make decisions about their own bodies"," she said.

"Rejecting my application for sterilisation on the basis of regret means they were taking on liability for my feelings."

She added: "Policies like this are damaging for women's healthcare and women's access to health services - it's absolutely discriminatory."

The psychologist, from Oxfordshire, decided to take her complaint to the Parliamentary and Health Service Ombudsman.

In issuing its judgement on the case, the ombudsman said: "At the time, the ICB did not routinely fund female sterilisation and cited the risk of regret as a reason for refusing women the procedure."

In contrast, it found that the ICB "routinely funded" vasectomies for eligible men and "did not use regret as a reason for rejection".

It also found "inconsistent use of cost-effectiveness" as reasonings for or against male or female procedures.

The ombudsman concluded that the ICB's approach to sterilisation had been "unfair, inconsistent, and based on subjective reasoning".

"This case shows the power of the patient voice," Paula Sussex, from the ombudsman, said.

"Leah complained about her experience and the ICB is now reviewing its sterilisation policy."

"This could benefit and empower many more women to make informed decisions about their health."

A committee that took responsibility for making policy recommendations for six ICBs across the South East in 2024, including Buckinghamshire, Oxfordshire and Berkshire West, reviewed the female sterilisation policy following Spasova's complaint.

It has recommended that the procedure should be funded, and that regret or the availability of other contraception is no longer used as grounds for refusal.

The ombudsman recommended that the ICB write to Spasova to acknowledge its failings, and also said there "may be similar wider problems" in multiple areas of the NHS.

In a statement, Thames Valley ICB said it had since "introduced a new policy to ensure that patients who meet the criteria are able to access female sterilisation".

"As a new ICB, we are also redesigning our complaints function to ensure concerns about local services are responded to more effectively and in a timely way," it added.