Greater Manchester Sexual Health Network
Briefing No. 3 - Long Acting Reversible Contraception (LARC)
July 2013
Introduction
Greater Manchester Sexual Health Network continues to prioritise the reducing under-18 teenage
conception and this remains one of the indicators listed in the Public Health Outcomes Framework.
The reduction in the teenage conception rates in Greater Manchester (see brief no.1 June 2013)
demonstrates the success of a wide ranging number of initiatives that have been introduced that
includes the Greater Manchester (GM) Long Acting reversible Contraception (LARC) Training
Programme. This has resulted in an increase in qualified professionals who can fit LARC. The
Network continues to support professionals to work collaboratively through the NW Teenage
Pregnancy Leads Group and the Priority Action Groups for Young People and for Contraception.
It is widely recognised that by investing in sexual health services to improve the provision and access
to contraception services both improves an individual’s sexual health and is cost saving for the NHS
by preventing unintended conceptions and thereby subsequent maternity and abortion costs. Further
cost saving can be achieved through increasing women’s uptake of LARC which includes implants,
intrauterine devices and injectable contraceptives.
Headlines for Greater Manchester
The monitoring of contraception data in 2010 revealed that the uptake of LARC methods across
Greater Manchester was low and in some services was not offered at all. To increase LARC uptake in
GM an audit of LARC provision was carried out to identify health professionals’ training needs
following which GM Sexual Health Commissioners, the Greater Manchester Sexual Health Network
together with the Palatine Contraception and Sexual Health Centre agreed to support and deliver a
training package (theoretical module and practical sessions) for fitting and removing sub-dermal
implants (SDI) to nominated and appropriately qualified health professionals working in the GM area.
The Palatine Centre produced a detailed SDI Training Programme Prospectus, managed the
administration of the training, regularly updated commissioners via the Network on trainees’ progress
and issued a certificate of competence qualification on completion.
Two cohorts of LARC trainees have produced almost 100 qualified LARC fitters for Greater
Manchester. Following the success of previous LARC training programmes the Greater Manchester
Sexual Health Network is funding a further cohort of trainee SDI fitters for 2013-14.
It is estimated that for every £1 invested in contraception services results in a saving of £12.50*. In
Greater Manchester it is calculated that the financial cost to the economy of unintended pregnancies is
£17m.
The Greater Manchester Sexual Health Network therefore recognised that it was a priority to
increase LARC provision by both promoting its use and by enabling more clinicians to become
qualified fitters.
2011-12
Area
Ashton, Leigh & Wigan
Bolton
Bolton FT
Bury
Heywood, Middleton &
Rochdale
Manchester
Oldham
Pennine FT
Salford
Stockport
Tameside & Glossop
Trafford Healthcare Trust
Trafford PCT
Brook – Manchester
Brook – Pennine
Brook – Wigan & Leigh
Greater Manchester
England
LARC
(%)
LARC
(number)
[as a percentage of total first
contacts with women contraception
reasons only]
39
35
Service provided by Bolton
1,326
2,345
Under Pennine FT
26
4,576
Under Pennine FT
28
36
23
14
38
33
19
17
15
27%
28%
2,912
1,260
920
700
874
495
646
748
345
17,147
256,480
[Source: http://www.hscic.gov.uk/catalogue/PUB08153/nhs-cont-serv-comm-cont-clin-eng-11-12-tab1.xls - table 15]
GM has seen a 27% increase in the number of LARCs fitted from 2010/11 (12,556) to 2011/12
(17,147). The GM uptake rate was 27% compared with the national rate of 28%; ranging from 14% to
39%. We hope to see a significant increase in numbers and uptake rate in 2012/13 data as the latest
two cohorts trained provide additional implant clinics.
Wendy Alam
Network Coordinator
*Payne, N and O’Brien, R (2005) Health Economics of Sexual Health: A Guide for Commissioning and Planning. London, DoH