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Funding cuts leave contraceptive services in jeopardy

Over eight million women of reproductive age live in an area suffering cuts to contraception budgets

Louise Prime

Thursday, 13 September 2018

More than eight million women of reproductive age are now living in an area where cuts to contraception budgets have taken place, limiting access to the full range of contraceptive methods, new data published by the Advisory Group on Contraception (AGC)* have revealed. The Faculty of Sexual and Reproductive Healthcare (FSRH) said the figures are deeply concerning, and the Royal College of GPs (RCGP) warned that it is vital to stop “this decimation of services”.

The AGC issued freedom of information (FOI) requests to all 152 upper-tier local authorities in England, and its audit of the resulting data showed that 74 councils (49%) have reduced or plan to reduce the number of sites commissioned to deliver contraceptive services in at least one year between 2015-16 and 2018-19. The number of councils closing services each year has accelerated from 12 out of 138 councils (9%) in 2015-16 to 33 out of 140 councils (24%) in 2017-18.

The FSRH pointed out that councils have been under severe financial pressure, including cuts to the public health grant, and two-thirds of local councils have cut their sexual and reproductive health (SRH) budget since 2016/17. As a result, it said, more than eight million women of reproductive age are now living in an area where the council has reduced funding for SRH services.

The Faculty is concerned that these cuts are putting at-risk women’s access to the full range of contraceptive methods. Over the past three years there has been a 6% drop in prescriptions for long-acting reversible contraception (LARC), the most effective contraceptive methods of contraception, according to NHS Digital data on SRH services in England; and, the FSRH added, these data show a decrease in contacts with SRH services in 2016-17.

Faculty CEO Jane Hatfield said: “Doctors and nurses working at the frontline of contraception care are desperately worried about the impact of continuous cuts on their patients. The fact that more than eight million women of reproductive age are now living in an area where their council has reduced funding for these services is deeply concerning.”

She went on: “We are already seeing a drop in cervical screening rates and a drop in prescriptions for long-acting reversible contraception – in the long run this will cost society and women far more than the meagre savings it has provided.

“Investing in free and accessible contraception is one of the most cost-effective health interventions we can invest in. If the government is, as it claims to be, looking for long-term, prevention-focused cost-effective health interventions it need look no further than sexual health screening and access to contraception.”

The RCGP said it was extremely concerned and frustrated by the potential effect on millions of women of such large-scale cuts. College chair Professor Helen Stokes-Lampard commented: “It seems bizarre when there is strong evidence that investing in good contraception services is one of the most cost-effective healthcare interventions available. … we’ve seen teenage pregnancy rates halved; we’ve seen take up of LARCs increasing. But the most recent data shows prescriptions for LARCs – reliable, cost-effective contraception – decreasing.”

She added that there has been inadequate funding for GPs running LARC-fitting clinics, and to train staff in safe fitting, which “simply isn’t sustainable”.

She warned: “We’re at a crossroads, whereby all the progress we’ve made is under serious threat, and we fear it will be some of our most vulnerable patients who are affected most.”

“So much progress had been made in this area in recent years and the service is too important to be allowed to fall into decline. It is vital that this decimation of services is stopped, and the trend immediately reversed.”


*The AGC is an expert advisory group, founded in 2010, made up of leading clinicians and advocacy groups. The group’s website says: “Support for the AGC is provided equally by Bayer plc and MSD, who fund AGC meetings, activities and the AGC secretariat, delivered by Incisive Health. Bayer plc and MSD have no influence or input in the selection or content of AGC projects or communications. Members of the AGC receive no payment from Bayer plc and MSD for their involvement in the group, except to cover appropriate travel costs for attending meetings.”

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