Contraceptive services cuts lead to call for wider choice

Wider choices of contraception needed to reduce clinic overload and costs.
Wider choices of contraception needed to reduce clinic overload and costs.

Nurses are “ideally placed” to advise on wider choices of contraception to reduce clinic overload and costs, according to a senior contraception and sexual health nurse.

Sexual health services are stretched to breaking point, juggling the pressure of longer clinic waiting times with ever tighter financial constraints. Half of local authorities have had to reduce their spending on contraceptive services over the last year following the £200m reduction to the public health budget, the Advisory Group on Contraception (AGC) recently found.

As a result, over eight million women of reproductive age are living in an area where there has been significant cuts to contraceptive services. However, 80% of women in the UK use regular contraception, and according to the Primary Care Women’s Health Forum (PCWHF), there is more demand than ever for contraceptive appointments. 37% of members experienced an increase in women seeking appointments for contraception, as a result of specialist services appointments becoming harder to obtain.

To exacerbate the issue, around half of all UK pregnancies are still unplanned, not only negatively impacting the health and social outcomes of women and their babies, but also carrying further significant economic burden.

It has been estimated that between £3.7bn-£5.1bn could be saved by improving access to contraceptive and sexual health services.

Although the contraceptive pill is the most common choice of contraception, studies suggest that as many as 47% of women do not take the pill properly. Yet, according to the RCGP there is reduced access for women in general practice to the most effective methods of contraception, including long-acting reversible contraceptive methods, such as subdermal implants, intrauterine devices and intrauterine systems. This is largely due to lack of funding for the additional training needed for doctors and nurses.

Self-fitting longer-acting reversible methods of contraception which require less training and fewer clinic appointments, could both reduce the number of unplanned pregnancies as well as ease the workload of overburdened sexual health services.

Helen Knox, Clinical Nurse Specialist in Contraception and Sexual Health and director of Midnight Learning Ltd, a nurse led education company, said: “With over 80% of contraception provision provided by general practice, nurses are ideally placed to take a prominent role, empowering women about a wider choice of contraceptive methods which will help to reduce the large numbers of unintended pregnancies as well as save the considerable related costs.

“Ease of use is key to contraceptive compliance and patients trust nurses to offer advice on the best choices for them depending on their lifestyle and priority of use, as well as helping them to understand how to use their chosen method effectively.”

Choices such as the contraceptive vaginal rings offer women choice and control over their contraception, and potentially free up clinic appointments. These include SyreniRing, which works like a combined contraceptive pill but instead of taking a pill every day, the ring is used for three weeks in a row and releases a small amount of two female sex hormones, etonogestrel and ethinylestradiol, which prevent the release of an egg cell from the ovaries and there is no need for it to be refrigerated.