Titled ‘Harnessing the potential of long-acting reversible contraception (LARC) to improve public health, generate savings, and cut waiting lists: a consensus statement’, it has been endorsed by 14 organisations and individual experts in Women’s Health and reproductive healthcare, including the Faculty of Sexual and Reproductive Healthcare (FSRH), Royal College of Obstetricians and Gynaecologist (RCOG) and the All Party Parliamentary Group on Sexual and Reproductive Health (APPG on SRH).
The community-backed consensus statement identifies the current issues in primary care LARC access. LARC methods, including contraceptive implant, intrauterine device (IUD), intrauterine system (IUS), and contraceptive injection1, are highly clinically and cost-effective forms of contraception2 and have a key role in supporting women’s reproductive health. However, many women in the UK currently face a stark postcode lottery in access to different types of LARC methods – consequently, women in the most deprived areas of England are more than twice as likely to have an abortion as those in the least3, generating health inequalities with far-reaching impacts across women, their families, and the NHS.
While Government analysis has illustrated significant savings to the NHS through improved provision: every £1 invested in the provision of LARC in primary care saves £48 in healthcare and non-healthcare costs over 10 years,2 this return on investment is currently underpowered. Fragmented commissioning arrangements and variation in fitting fees are the two main reasons for disabling many general practices or community services to provide LARCs for contraception and gynaecological purposes.4
Issued on the heels of the Government’s new priorities in Women’s Health for 2024, of which a key area is the rollout of Women’s Health Hubs in every Integrated Care System (ICS), the consensus statement sets out a suggested policy framework. It calls on the Government to ask all ICSs to jointly commission integrated LARC pathways – underpinned by a nationally-set, minimum fee for LARC in primary care via Women’s Health Hubs. The framework has been developed in consultation with expert stakeholders and specifies the principles to support sustainable LARC services in a cost-effective way, to help systems benefit on return-on-investment in LARC.
Ursula Montgomery, Head of Healthcare Policy and Partnerships, Bayer UK, comments:
“With a key role in supporting women’s reproductive health, access to LARC is an important public health issue. We are very pleased that so many women’s health leaders have endorsed the statement. Together, we wish to work in partnership with Government to deliver this recommendation for fair and sustainable LARC provision as it develops further guidance for local areas on Women’s Health Hubs and look forward to continuing to play a role in this important discussion.”