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12.12.16

STPs urged to protect contraception as report reveals extent of cuts

Health providers have been urged to use their sustainability and transformation plans (STPs) to protect women’s access to contraception as it emerged that services are increasingly at risk due to budget cuts.

New research from the Advisory Group on Contraception (AGC) shows that 14% of councils, which have had responsibility for public health since 2013, have shut down community contraceptive services or are planning to do so, with a further 13% considering it.

Around 7.5% also revealed they would cut their contracts with local GP surgeries to fit and remove IUD and IUS devices in 2016-17, and 24% said the contracts were under review.

Over one-quarter of respondents also had policies limiting free access to contraception by place of residence or age, with women over 25 likely to be denied free contraception despite figures showing an upturn in older women seeking abortions.

Natika Halil, chief executive of the Family Planning Association and a member of the AGC, said: “Councils are between a rock and a hard place when faced with cuts to public health budgets, but it’s a false economy to restrict women’s access to contraception. Every £1 spent on contraception saves £11 in averted health costs.

“Making it harder for women to choose the right contraception for them will mean more unplanned pregnancies and more abortions. Councils need adequate funding to deliver the comprehensive contraceptive services women need and deserve.”

To address the problem, the APG said that all STP footprints, as they develop, should have regard for the importance of contraception and ensure women have access to the full range of contraceptive services.

It also called on the Department of Health (DH) to commit to providing sufficient funding to Public Health England and NHS England for primary care, particularly general practice, in order to enable the full range of contraceptive services.

Other recommendations included a DH review of commissioning arrangements to identify where women are being denied contraceptive services because of age or location, and supporting commissioners to resolve any restrictions on provision.

The APG also argued that contraceptive services should not be decommissioned before an assessment of the impact of the decision on local health outcomes had been carried out, and that the DH and Health Education England should publish guidelines to clarify where responsibility for funding the training of health professionals to provide contraception lies.

Dr Anne Connolly, an AGC member and GP in Bradford, added: “It’s hugely concerning to see that in many parts of the country contraceptive services are being cut, meaning that women can’t access the most reliable types of contraception.

“Without close scrutiny, I’m worried this trend will only continue – and women will bear the consequences.”

Last week, Public Health England also recommended that all STPs should include measures to help local residents stop smoking, despite existing concerns about the STP process as a whole. For example, Jim Mackey, chief executive of NHS Improvement, warned last week that plans have so far failed to produce convincing business cases for increased investment.

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