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This is a confused report. It fails to distinguish between the different types of NICE Guidance which have different implications for NHS commissioners and providers.

The ONLY NICE Guidance where there is no discretion is NICE Technology Appraisals covered by a 2001 NHS Secretary of State Direction, but hedged by the actual NICE Guidance where treatment is an 'option' and often has associated clinical criteria.

NICE Infertility Guidance is a Clinical GUideline which is advisory to Commissioners and implementation is aspirational and discretionary, and needs to be considered against other competing priorites. Therefore the 'new rules' refered to cannot apply to IVF.