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Let teenagers stockpile emergency contraceptives

NICE plans to cut teen pregnancies and STIs among socially disadvantaged

Onmedica staff

Tuesday, 25 May 2010

Doctors and nurses working in contraceptive services must improve their communication skills and provide wider, faster access to help cut levels of STIs and unwanted pregnancies among socially disadvantaged young people.

Draft guidance from the National Institute for Health and Clinical Excellence (NICE) recommends that young women should be able to obtain free emergency hormonal contraceptives (EHC). It says there is "strong evidence", from four randomised clinical trials, to support advanced provision of EHC to socially disadvantaged young women.

"In most cases increased use was not at the expense of other contraceptive use, and did not promote risky sexual behaviour; the exception was one study with adolescent mothers," the draft guidance states.

NICE makes 13 recommendations, including making free condoms more available in schools and youth clubs and ensuring speedy access and referral to specialists.

It also calls for better collaborative evidence-based commissioning between PCTs to provide contraception and sexual health services for young people at convenient, accessible locations such as city centres, colleges and schools, so that no young person is denied services because of where they live.

NICE says all staff who work in contraception, sexual and reproductive health services with young people should receive both formal training and workplace training, in offering basic information and advice about contraception.

"They should understand the range of methods, the advantages and disadvantages of each method, the measures that can be taken to ameliorate any side effects and an understanding of pregnancy and abortion. Training should be regularly updated and tailored to individual needs to ensure staff have the necessary skills and knowledge relevant to their role."

All contraception and sexual health services, including those provided in general practice, must meet the "You’re welcome" quality criteria (DH 2007) as a minimum requirement. The draft also revised standards for sexual and reproductive health services, as specified by the Faculty of Sexual and Reproductive Healthcare (2010a) and the Department of Health/Medical Foundation for AIDS and Sexual Health (Medical Foundation for AIDS and Sexual Health/DH 2005).

NHS managers must ensure that there are integrated and managed service networks and comprehensive referral pathways for all young women and men, both into and out of contraceptive services. "Ensure these referral pathways cover abortion services, maternity services and all other relevant health, social care and children’s services, youth and community services, education, and the voluntary and private sectors."

And when commissioning provision of contraceptive services, including emergency contraception, ensure that pharmacies, walk-in centres and all services that are commissioned to provide contraceptive services (including emergency hormonal contraception) do so consistently, rather than variably, depending who is on duty.

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