Whitepaper: HFEA Patient Experience Insights: What UK Fertility Clinics Must Do Next

Executive Summary

The HFEA 2024 National Patient Survey offers an up-to-date, comprehensive look at how fertility patients in the UK feel about their care. Overall, patient satisfaction with fertility treatment remains high (around 73%), consistent with previous surveys. However, beneath this encouraging average lie critical gaps and disparities that clinics must urgently address. Patients highlighted issues ranging from administrative slip-ups and poor communication, to insufficient transparency about costs and treatment add-ons. Notably, satisfaction was significantly lower for certain groups (for example, among Asian and Black patients), indicating that not all patients are receiving the same quality of experience.

This whitepaper distills the survey’s key findings and translates them into strategic actions for UK fertility clinics. It explores what these insights mean for clinic operations and patient care, and what clinics should do next to improve outcomes. In particular, we discuss how to:

• Streamline administrative coordination to reduce errors and waiting times.
• Improve transparency around costs, success rates, and treatment options.
• Strengthen communication and support to patients, with empathy and timeliness.
• Foster an inclusive, patient-centered culture that addresses the needs of diverse patients.
• Embrace digital tools and data to drive efficiency and meet modern patient expectations.

By the end of this paper, operational and clinical leaders will have a clear understanding of the 2025 patient experience landscape and a roadmap of practical steps to enhance patient satisfaction and trust. The goal is to position clinics as trusted, transparent, and digitally-ready partners in each patient’s fertility journey.

Key Findings from HFEA’s 2024 Patient Survey

The HFEA’s national survey, conducted in late 2024 with 1,500 fertility patients across the UK) revealed several important insights into patient experiences. Below are the key findings that inform our strategic recommendations:

• Stable overall satisfaction, but disparities exist: About 73% of patients were satisfied with their most recent fertility treatment, a rate unchanged from previous years. However, satisfaction was markedly lower for Asian patients (50%) and Black patients (59%), and also lower for patients over age 40 (67%). This signals that certain patient communities are not having their needs fully met.
• Dissatisfaction with clinic administration: When looking at specific aspects of care, the coordination/administration of treatment emerged as a top pain point. Nearly one in five patients (18%) reported dissatisfaction with how their treatment was coordinated (e.g. scheduling, paperwork, errors), making it the highest area of concern. This dissatisfaction was even higher (24%) among female same-sex and gender-diverse couples, indicating that administrative processes are falling short, especially for some groups.
• Information on treatment vs. costs: Most patients felt well-informed about clinical aspects like what they were consenting to during treatment. Consent information was generally clear. However, many patients said they received insufficient information about treatment costs, especially when it came to understanding itemised bills. In other words, the medical steps were explained, but the financial implications often were not.
• Unexpected or unclear costs in private care: Related to transparency, only 62% of private patients received a personalised cost breakdown for their treatment, and of those who did receive a quote, 40% ended up paying more than initially presented. This indicates significant cost uncertainty. Surprise fees or add-ons can severely erode trust if patients feel costs are “drifting” beyond expectations.
• Clinic choice driven by location and success rates: When deciding where to have treatment, patients most often ranked location as the number one factor (62%), followed by a clinic’s success rates (51%). While convenience and outcome statistics are key across the board, it’s notable that cost was a higher priority for some groups (e.g. Black patients and single patients), likely because these groups often have less access to NHS-funded cycles. Meanwhile, patients in female same-sex or gender-diverse relationships put strong emphasis on choosing clinics known to support LGBTQ+ needs (their second-most important factor). These nuances suggest that clinics must be mindful of differing priorities and communicate accordingly (e.g. highlighting inclusive practices or financial options).
• ‍Long pathways and GP involvement issues: Accessing fertility treatment often isn’t quick or straightforward. Almost 80% of patients consulted a GP before starting fertility treatment, yet only 43% were satisfied with that GP experience. After seeing a GP, the most common wait to actually begin treatment was 7–12 months (30% of patients), but a significant 16% of patients waited over two years to start treatment. The primary reasons for delay were waiting for referrals, appointments, tests, or needing additional medical procedures. These findings show that many patients endure long, stressful waits before they even set foot in a fertility clinic, due to systemic bottlenecks. By the time they arrive at a clinic, they may already feel frustrated or anxious from the process so far.
• Widespread use of add-ons and emerging treatments: Nearly three-quarters of patients (75%) used at least one additional test, treatment, or emerging technology during their fertility treatment. The most common were relatively simple interventions like medications or nutritional supplements (reported by 39% of patients), but many patients also opted for so-called “add-on” procedures. Trends in add-on usage are shifting: for example, use of the controversial add-on “endometrial scratching” has dropped from 24% of patients in 2018 to only 10% in 2024, while use of pre-implantation genetic testing for aneuploidy (PGT-A) rose from 7% in 2021 to 13% in 2024 (particularly among patients over 38). This reflects how the field is evolving and how patients increasingly consider new technologies.
• Gaps in explaining add-ons’ value and risks: It became clear that while add-ons are common, patient understanding varies. Half of patients said their clinic explained how effective an add-on or extra treatment would be in improving their chance of having a baby, but only 37% said the clinic explained the risks involved. Moreover, only 27% of patients recalled their clinic referencing official HFEA information when discussing treatment add-ons. This suggests that many patients are making decisions about optional treatments without full information, or with information that feels too “sales-like” rather than evidence-based – a situation that can lead to confusion or regret.
• Donor conception is increasingly common, with some transparency issues: About 1 in 4 patients had used donor eggs, sperm, or embryos as part of their treatment. Among these, sperm donation was most common, and 70% of patients who used donor sperm said it was easy to access – compared to only 59% who found donor eggs easy to access. Interestingly, around half of patients using donor sperm obtained it from overseas (often citing greater choice or more information available abroad). However, this route introduced new uncertainties: 34% of those who went overseas for donor sperm reported a lack of clarity on family limit rules for those donors. In short, while donor options are expanding, clinics need to guide patients through the complexities (especially regarding information and legal limits) to prevent confusion.
• High awareness of HFEA and reliance on external information: Nearly 70% of respondents were familiar with the HFEA (the UK fertility regulator), and 58% said they used the HFEA website for information or support during their treatment. This underlines that today’s patients are proactive in researching and double-checking information about treatments, add-ons, and clinics. When clinic communication falls short, patients will seek out third-party resources. The onus is on clinics to ensure the information they provide is accurate, comprehensive, and consistent with trusted sources (like HFEA) – otherwise patients may receive mixed messages.

These findings paint a nuanced picture. On one hand, most patients leave clinics feeling satisfied with their care. On the other hand, there are clear areas where UK fertility clinics can do better: namely, administrative efficiency, transparency (financial and informational), communication (accessibility and empathy), and inclusivity/support.

Strategic Implications and What Clinics Must Do Next

The 2024 survey results are a call to action for fertility clinics. Meeting regulatory requirements and achieving good success rates are no longer enough; clinics must also excel in patient experience. Below, we break down key strategic areas that clinics in the UK should focus on, based on the survey’s evidence. Each area corresponds to a set of patient needs and pain points highlighted in the findings. By addressing these, clinics can significantly improve patient satisfaction, build trust, and differentiate themselves as patient-centered, modern care providers.

Streamline Administrative Coordination and Patient Pathways

Administrative missteps – lost or mixed-up communications, scheduling errors, slow follow-ups – may seem minor, but they deeply affect patients at a vulnerable time. The survey showed 18% of patients were unhappy with treatment coordination and administrative handling, with reports of incorrect appointments, confusing information, and even mistakes causing cancelled cycles. Such errors not only delay care but also undermine patients’ confidence in their clinic.

Clinics should treat administrative efficiency as a patient care issue. First, invest in training and protocols to minimize errors: for example, double-checking appointment bookings and billing details. Many patients in the survey said they valued having a single point of contact or a “named nurse” who knew their case. Providing each patient with a dedicated coordinator or consistent staff contact can prevent the feeling of being passed around and having to repeat information. It also helps catch mistakes – the dedicated staff member can oversee the patient’s journey end-to-end.

Additionally, clinics must address delays proactively. While some delays stem from the NHS referral process beyond a clinic’s direct control, clinics can still help patients navigate these waits. This might include giving patients clear guidance on what to expect after a GP referral (since many felt “unprepared for the waits”) or offering interim resources (for example, suggestions for counseling or lifestyle adjustments while waiting). Once treatment begins, ensure that internal waiting times for appointments, tests, or results are minimized. Audit your clinic’s cycle timelines to identify bottlenecks where patients are kept waiting (e.g. is there a backlog for HSG tests or counseling sessions?) and find solutions – perhaps by adjusting staff allocation or using digital tools to speed up processes like results delivery.

The bottom line: smooth, well-coordinated treatment processes reduce patient stress. They also free up clinic staff from fire-fighting mistakes, allowing more time to focus on patient care. By prioritizing coordination – treating administrative touchpoints with the same importance as clinical touchpoints – clinics can prevent small issues from snowballing into big dissatisfaction.

Improve Transparency Around Costs and Information

Lack of transparency came through in the survey as a major source of frustration for patients. Financial transparency is a chief concern: patients reported unclear cost estimates and surprise add-on fees, which is especially problematic for those paying privately. Given that only 62% of private patients received an upfront cost breakdown and 40% of those still paid more than expected, clinics must tighten their financial communication.

Action 1: Provide clear, personalised cost estimates.

Every patient – whether NHS-funded or private – should receive a written, itemised quote before treatment begins, with an explanation of each line item. If something could change (for example, “If we need to freeze embryos, there will be an additional storage fee of £X”), that should be explicitly noted. Transparency early on builds trust, and it prepares patients for potential costs. Also, avoid jargon on bills; ensure invoices and quotes are easy to understand. If the treatment plan evolves mid-cycle, update the patient proactively about any cost implications rather than waiting for the bill to surprise them.

Action 2: Be open about success rates and treatment options

Patients are choosing clinics based on success rates, yet a common complaint was receiving “generic” information or not enough detail about their personal chances. Clinics should share their success statistics in a digestible way (e.g. live birth rates per age group for IVF) and, importantly, put those stats in context for the individual patient’s situation. Similarly, when offering optional add-on treatments, staff should discuss evidence of effectiveness and any risks. It’s concerning that only 37% of patients said risks were explained for add-ons. Patients deserve an honest conversation about, for example, whether an immune therapy or embryo glue truly improves success odds or if it’s unproven. Leveraging third-party information can help: the HFEA publishes patient-friendly guidance and “traffic light” ratings for treatment add-ons, and yet only 27% of patients heard HFEA information from their clinic. Referring to these impartial resources during consultations can increase transparency and credibility.

Action 3: Ensure transparency in donor conception processes.

With a quarter of patients using donors, clinics should double-down on clear information in this area. Patients need to understand things like donor availability, wait times, legal family limits, and costs (especially if considering overseas donors). The survey showed confusion here – e.g. a third of those using overseas donor sperm didn’t understand family limit rules. Clinics should provide written FAQs or one-on-one counseling about using donor gametes, covering how UK law and HFEA rules apply, and what to expect if sourcing donors abroad. Transparency here safeguards against future issues (like patients later discovering their donor had more offspring than they realized).

In summary, transparency is about no surprises – financially or information-wise. When patients feel information is withheld or sugar-coated, trust breaks down. By contrast, being forthright with both good and bad news (e.g. “our pregnancy rates for your age group are X%” or “this treatment will cost £Y more if you need an extra cycle”) demonstrates respect for the patient’s right to know. In an age where information is readily available online, being transparent also means your patients are less likely to find contradicting or alarming info elsewhere without your guidance. Clinics that champion openness will be seen as partners in the journey rather than service providers acting behind a curtain.

Enhance Communication and Provide Proactive Support

Effective communication is the cornerstone of a positive patient experience, especially in fertility care where emotions run high. The HFEA survey highlighted that many patients struggled with basic communication issues: difficulty reaching clinic staff when needed, impersonal interactions, and feeling left alone during critical moments. On the flip side, clinics that were responsive and compassionate earned high praise.

Make it easy for patients to contact you. It’s unacceptable today for patients to feel they are shouting into the void of a generic inbox or constantly hitting a switchboard. Clinics should establish direct, responsive communication channels. For example, have a nurse or coordinator hotline, or use a secure messaging app for routine questions. Many clinics are now adopting patient-facing apps or portals (like Salve’s platform) that allow secure two-way messaging. These tools unify communications so that patients don’t feel lost between phone messages, emails, and voicemails. Accessibility is key: if a patient has an urgent concern (e.g. a medication question or signs of an adverse reaction), they should know exactly how to get a quick answer from the clinical team. Setting expectations is part of this – from the start, tell patients, “Here’s how to reach us and typical response times.”

Respond with empathy, especially in tough times. Fertility treatment has ups and downs; how a clinic communicates during the downs is especially critical. Patients in the survey noted that when something went wrong – a failed embryo transfer, a miscarriage – a timely, empathetic response from the clinic made a world of difference. A call or message offering condolences, a prompt follow-up appointment, and resources for support can help patients feel cared for rather than abandoned. Clinics should train staff in “difficult conversations” – how to convey bad news sensitively and how to listen to an upset patient. Even in routine communications, empathy matters: avoiding overly clinical, cold language and acknowledging the patient’s feelings (e.g. “I know this process can be stressful, let’s walk through your questions”) can foster trust. Remember that what is routine for staff may be anything but routine for the patient.

Close the feedback loop. Communication should not be one-way. Patients value the opportunity to **provide feedback or ask questions and have them addressed】. Clinics can implement simple ways to listen: brief post-visit surveys, a suggestion box (physical or digital), or even a patient advisory group. Importantly, act on the feedback. If multiple patients complain about difficulty getting through on the phone, that’s a sign to improve the phone system or add staff at peak call times. When patients see improvements based on their input, it reinforces that the clinic cares and is continuously improving. In the UK, where patient opinion can influence clinic reputation (through HFEA’s patient ratings or word-of-mouth in the community), showing that you listen is also strategically smart.

Finally, communication isn’t just between clinic and patient – it’s also about including partners and families (with patient consent). The survey mentioned some partners felt sidelined or not treated as equal participants. Clinics should strive to communicate with the wider unit involved in treatment. Simple gestures like addressing both partners during consultations, or cc’ing both on emails (when appropriate), make a difference. When the patient’s support network is informed and involved, the patient feels more supported too.

In summary, think of communication as part of the treatment. Just as you wouldn’t compromise on lab protocols, don’t compromise on communication protocols. A clinic that communicates promptly, clearly, and kindly will mitigate a lot of patient anxieties before they balloon. In practice, robust communication reduces phone tag, misinterpretations, and frustration – making the experience smoother for patients and more efficient for staff. As a trusted partner in fertility care, Salve advocates for unified communication platforms and compassionate training, because when patients feel heard, they also feel cared for.

Foster an Inclusive, Patient-Centered Culture

One of the striking themes in the patient feedback was that not all patients feel equally supported. Some groups – including same-sex female couples, single women, older women, and Black and Asian patients – reported feeling less empathy or that they were treated as “different” cases. No clinic intends to be less caring to any group, but these perceptions indicate subconscious biases or gaps in cultural competence that need addressing. Every patient, regardless of background or identity, deserves to feel respected, understood, and valued by their clinic.

Train and sensitize staff to diverse patient needs. Fertility patients come from all walks of life: different ethnicities, religions, sexual orientations, and family structures. Take proactive steps to educate your team on inclusive practices. This might involve training on LGBTQ+ fertility pathways, using gender-inclusive language (e.g. saying “pregnant person” where appropriate, understanding pronouns), and being aware of cultural norms or stigma around infertility. For example, a lesbian couple might be more sensitive to a clinic that explicitly acknowledges their parenthood journey as equal, or a patient from a certain cultural background might prefer a female clinician for certain discussions – these small accommodations can greatly impact comfort. The survey showed some patients felt “disregarded” due to personal circumstances like sexuality, age, or race – a clear sign that sensitivity must improve. Regular workshops or seminars on diversity in fertility care can help staff unlearn assumptions (like not assuming every patient is a married heterosexual woman) and learn positive ways to make everyone feel welcome.

Personalize the patient experience. An inclusive culture is also a personalized one. Patients who have gone through multiple cycles mentioned they learned to self-advocate and felt better when they could influence decisions. Clinics should encourage patients to share their values and preferences – and then honor them. This might mean involving patients more in decision-making (like discussing pros/cons together rather than dictating a plan), or accommodating requests when possible (such as allowing a patient to have a friend or doula present for emotional support during certain procedures). Additionally, consider the role of partners: ensure that male partners, female partners, or intended co-parents are all kept in the loop and offered support (e.g. mental health resources for the partner, not just the patient). Inclusivity extends to how you consider all individuals impacted by the treatment.

Bridge the “empathy gap”: A comment from the survey noted that for clinic staff infertility can become “routine,” but for patients it is laden with “shame” and “anxiety”. Combatting the routinization of empathy is important. Some clinics instill this by sharing patient stories (with permission) in team meetings to remind everyone of the human side, or by having staff shadow the patient process from start to finish to identify pain points. The goal is to cultivate a culture where staff don’t become numb to the emotional aspects. Celebrate the diversity of your patient success stories internally – whether it’s a single woman freezing embryos or a same-sex couple having a baby via IVF – so that supporting each unique journey becomes a point of pride for the clinic.

Ultimately, inclusivity and patient-centric care aren’t just moral obligations; they have business and clinical benefits too. Patients who feel understood are more likely to trust their doctors, comply with treatments, and recommend the clinic to others. In a UK context, treating NHS-funded patients with the same attentiveness as private patients is part of this ethos – no one should feel like a “second-class” patient due to funding, a concern some raised about being NHS-funded. By doubling down on equitable, compassionate care, clinics strengthen their reputation as trusted partners in the community. Being patient-centered in culture translates to better reviews, better word-of-mouth, and likely better outcomes as patients engage more openly. It’s a virtuous circle: inclusivity drives satisfaction, which drives success.

Embrace Digital Solutions and Data-Driven Practice

In 2024 and beyond, digital readiness is no longer optional for fertility clinics – it’s a necessity. Patients are tech-savvy and often prefer clinics that offer the convenience and connectivity that modern technology provides. Meanwhile, many of the challenges discussed (from communication lapses to administrative errors) can be mitigated with the right digital tools. Adopting technology thoughtfully can streamline operations, improve consistency, and give patients greater control and insight into their journey.

Unify and automate communication and records. A recurring issue in the survey was fragmented communication – patients dealing with multiple contact points and sometimes getting mixed messages. Clinics should consider integrating their systems so that appointments, treatment calendars, test results, and messages are all in one platform accessible to both staff and patients. For example, Salve’s fertility platform allows clinics to centralize patient communications, forms, and treatment plans in a secure app. When everything is in one place, there’s less risk of something being overlooked (say, a patient emailing one nurse and phoning another – and the messages not converging). Automation can help too: use automated appointment reminders, medication alerts, and even digital consent forms to reduce the load on staff and ensure patients don’t miss critical steps. Importantly, any platform should be encrypted and GDPR-compliant, as patients must feel confident their data is safe.

Leverage data to personalize care. Digital tools aren’t just about efficiency; they also generate data that clinics can use to improve care. For instance, track the questions patients commonly ask via the patient portal – this might reveal topics where your standard counseling is lacking, prompting you to improve your patient education materials. Use patient satisfaction surveys (delivered digitally for ease) to identify trends – perhaps patients in a certain age group are consistently rating their experience lower, indicating you need a targeted initiative for that demographic. By analyzing such data, clinics can make evidence-based tweaks to protocols much like they use clinical data to tweak treatment approaches. Additionally, with integrated systems, clinicians can see at a glance a patient’s entire journey (e.g. how many failed cycles, what add-ons tried, what concerns they’ve messaged about) and tailor consultations accordingly, rather than treating each appointment in isolation.

Improve accessibility and support through digital means. Not every form of support needs an in-person visit. Consider offering telehealth consultations for certain appointments (e.g. follow-ups, injection teaching, counseling sessions). The pandemic accelerated telemedicine, and many fertility patients appreciate the flexibility of a video call for appropriate touchpoints. Digital education resources are another boon: an online library of videos or articles (perhaps curated via your patient app) about IVF, egg freezing, or coping with treatment stress can empower patients with knowledge 24/7. The survey indicated over half of patients resorted to the HFEA website for information; clinics should aim to be just as useful a source by providing or pointing to quality content. A digitally engaged patient is likely to feel more in control and less anxious. Moreover, features like online scheduling or an AI-powered FAQ chat can further enhance the experience by catering to patients’ needs instantly without adding staff workload.

Ensure staff are on board and trained. A digital tool is only as good as its adoption by the people using it. Choose solutions that integrate with your clinic’s existing systems (for example, linking the patient app with your electronic medical record so that data flows automatically). Invest time in training your staff to use these tools confidently. When the whole team uses a unified system, it breaks down internal silos too – the nurse knows what the embryologist communicated, the finance team sees what was quoted, etc., creating a seamless internal workflow.

By embracing digital innovation, clinics can position themselves at the forefront of fertility care. It allows you to do more with the resources you have – handling growing patient volumes or complexities without sacrificing personal touch. Importantly, it resonates with patients: a well-designed app or quick digital service shows patients that their clinic is modern, responsive, and committed to convenience. As one patient put it, fertility care shouldn’t feel like “a fertility conveyor belt”; digital personalization helps avoid that, by tailoring information and interactions to each individual. In sum, digital tools, used wisely, amplify human-centered care – they do not replace the human element, but rather support it by ensuring no detail or person slips through the cracks.

How Fertility Clinics Can Move Forward

The HFEA 2024 National Patient Survey offers a clear message: while UK fertility clinics are delivering successful treatments and many patients are satisfied, there is significant room for improvement in patient experience. Issues like administrative mistakes, poor communication, lack of transparency, and uneven support can tarnish what is otherwise world-class medical care. Fertility treatment is not just a clinical journey but an emotional and logistical one – and clinics must excel at all aspects to truly serve their patients.

The good news is that the path forward is well-defined. By focusing on the strategic areas outlined in this paper – efficient coordination, full transparency, empathetic communication, inclusive care, and smart use of technology – clinics can transform patient experience for the better. These changes are not just “nice-to-haves”; they are rapidly becoming expectations among patients in 2024. Moreover, addressing these areas will help clinics operate more smoothly, relieve staff burden (through fewer complaints and fires to fight), and likely improve clinical outcomes as patients who feel supported are more likely to adhere to treatment plans and stay with the process.

For UK clinics, there is also a broader context to consider. The fertility sector is growing and evolving, with new players, consolidations, and ever-more discerning patients. A reputation for excellent patient experience can be a key differentiator in a competitive market. Furthermore, regulatory bodies and NHS commissioners are paying more attention to patient experience metrics. Proactively improving now positions clinics ahead of any future guidelines or incentives that might emerge around patient-centered care.

In closing, we urge clinic leaders to treat patient experience improvement as an ongoing, strategic initiative. Listen to your patients, learn from their feedback, and let data guide your investments in processes and tools. Small changes – like a clearer cost sheet or a quicker way to reach nurses – can have outsized effects on a patient’s peace of mind. And big changes – like adopting a unified digital platform for the entire patient journey – can redefine how your clinic delivers care, for the better.

Salve’s perspective, as a trusted digital partner to fertility clinics, is that those who marry compassionate practice with technological efficiency will lead the next era of fertility care. We have seen clinics turn patient experience into their strongest asset by implementing many of the strategies discussed. Our hope is that the insights and recommendations in this whitepaper inspire you to take the next steps at your own clinic. By doing so, you’ll not only meet the standard of “what must be done next” – you’ll exceed it, setting new benchmarks for patient-centered, empathetic, and effective fertility treatment in the UK.