News
Women refused sterilisation because they ‘might regret it’
NHS commissioned services should operate fairly, transparently and with clear clinical rationale, the Parliamentary and Health Service Ombudsman (PHSO) has said, following an investigation which found that an NHS body denied women, but not men, NHS funding for sterilisation. This aspect of commissioned services was
brought to light when Leah Spasova complained to the Ombudsman after her request for sterilisation was rejected by Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (ICB). 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. Its policy for male sterilisation routinely funded vasectomy for eligible men and did not use regret as a reason for rejection. The Ombudsman concluded that the ICB’s
approach was unfair, inconsistent, and based on subjective reasoning. It found that women were not given the same opportunity as men to make an informed decision about sterilisation. The ICB failed to explain why it chose not to follow clinical guidance. The guidance is not mandatory but says sterilisation should be available for women and that counselling – not blanket exclusion – should address the risk of regret. The investigation also identified inconsistent use
of cost-effectiveness arguments. Male sterilisation was recommended for funding without updated cost data, while female sterilisation was rejected due to a lack of recent evidence, despite older studies showing it can be more cost effective
over time. The Ombudsman found the ICB did not balance this evidence appropriately when devising their sterilisation policy. In 2024, an advisory committee was given
responsibility for making policy recommendations for six ICBs across the South East region, including Buckinghamshire, Oxfordshire and Berkshire West. Four of those six ICBs already funded female sterilisation. Following Leah’s complaint, the advisory
committee reviewed the female sterilisation policy recommendation and recognised the equality issues created by funding male but not female sterilisation. It recommended that female sterilisation should be funded. Regret or the availability of more cost-effective alternative contraception is no longer used as grounds for refusal.
Leah, a psychologist, from Oxfordshire said,
“I have been enquiring about sterilisation for 10 years and was just passed back and forth between services. Then the ICB turned down my request for funding. One of the most important lessons from my case is the systemic problems and the lengthy process that patients must go through to challenge NHS decisions. “Before approaching the Ombudsman, I
conducted my own research and found that the policy in place at the time appeared inconsistent with key principles of NHS care, did not respect the NHS Constitution, and did not align with NICE guidance around contraceptive choice. It did not follow the widely recognised principle that
clinicians provide advice, but patients ultimately make decisions about their own bodies. “These concerns about autonomy and fairness
prompted me to seek further accountability. Rejecting my application for sterilisation on the basis of regret means they were taking on liability for my feelings. The ICB says sterilisation is funded under exceptional circumstances, but nowhere do they list what those criteria are so it is impossible to know if you will be accepted or not. Someone else is making decisions about your body based on criteria you can’t even see. “Policies like this are damaging for women’s healthcare and women’s access to health services - it’s absolutely discriminatory. There is continuing widespread inequality in how permanent contraception is accessed; concerns about fairness and respect for women’s bodily autonomy remain unresolved. The key lesson from my case is how commissioning policies can create unequal barriers and why people should fight for their rights through transparency and accountability.”
At-home finger prick and cognitive test may predict Alzheimer’s
The NIHR has funded a new study that suggests a simple finger prick blood test combined with online brain testing, all done at home, could help identify people at risk of developing dementia. The study, which has been published in Nature Communications, was funded by the NIHR Exeter Biomedical Research Centre (BRC) and supported by the NIHR HealthTech Research Centre in Brain Health and NIHR Applied Research Collaboration South West. Led by the University of Exeter, the researchers found that proteins linked to dementia in blood samples were associated with performance on cognitive tests. This approach could help identify people at risk sooner, ensuring they get the right care quickly, while also reassuring those at lower risk. The research draws on the PROTECT study, in which more than 30,000 UK participants aged over
linked to broader brain decline. They found that performance on the brain tests correlated with the presence of the proteins. This enabled the team to categorise people at low, medium and high risk. Professor Anne Corbett of the University of
40 take regular cognitive tests online to measure memory, attention and executive function, or decision-making skills. A total of 174 PROTECT participants were sent at-home blood tests, which they administered themselves before posting back to the team. The researchers used these blood tests to measure two proteins: p-tau217, which is linked to Alzheimer’s disease, and Gfap, which is
Exeter Medical School, who led the research, said: “This work raises the potential for screening people for their risk without the need for clinic visits or complex clinical assessments. It would ensure the people at highest risk could be prioritised for monitoring and diagnosis, unlocking the best support and treatment for those that need it most.” This study recruited participants through Join Dementia Research, a service that enables people to register their interest in national dementia research. Join Dementia Research is run by the NIHR in partnership with Alzheimer Scotland, Alzheimer’s Research UK and Alzheimer’s Society.
June 2026 I
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