Quality statement 3: Counselling
Quality statement
People who are having problems conceiving are offered counselling before, during and after investigation and treatment for their fertility problems. [2014]
Rationale
People experiencing fertility problems should be offered counselling because fertility problems themselves, and the investigation and treatment for fertility problems, can cause emotional stress.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
Proportion of people who have problems conceiving and who have investigations or treatment for fertility problems in secondary or tertiary care who receive counselling.
Numerator – the number in the denominator who receive counselling.
Denominator – the number of people who have problems conceiving and who have investigations or treatment for fertility problems in secondary or tertiary care.
Data source: The Human Fertilisation and Embryology Authority (HFEA) national patient survey collects data on satisfaction with various aspects of support given, including whether people were able to access counselling. Data can also be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.
Outcome
People who are having problems conceiving feel supported throughout and after investigation and treatment for their fertility problems.
Data source: The HFEA national patient survey collects data on whether people felt supported during fertility treatment. Data can also be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient satisfaction surveys.
What the quality statement means for different audiences
Service providers (secondary and tertiary care services) ensure that counselling services are available for people who are having problems conceiving before, during and after investigation and treatment for their fertility problems.
Healthcare professionals refer people who are having problems conceiving for counselling before, during and after investigations and treatment for their fertility problems.
Commissioners ensure that counselling services are available before, during and after investigation and treatment for people with fertility problems, and that pathways and referral criteria are in place.
People finding it difficult to get pregnant have the opportunity to see a counsellor before, during and after any tests or treatment for fertility problems.
Source guidance
Fertility problems: assessment and treatment. NICE guideline NG257 (2026), recommendation 1.2.4