NICE seeks to reduce unwanted pregnancies by improving contraceptive services

Young people need better access to contraception and advice about using it effectively, according to the National Institute for Health and Care Excellence (NICE). In draft guidance, issued for public consultation today (25 May), NICE aims to ensure all young people can access contraceptive services at convenient, accessible locations so no-one is denied services because of where they live. The draft guidance also includes a number of recommendations to help all young people obtain the full range of contraception methods, including long-acting reversible contraception (LARC) (also referred to as lasting and reliable contraception), condoms and emergency contraception, including advance provision.

Young people's teenage years and the period up to their mid twenties is the time when they are exploring and establishing sexual relationships. Although most young women use at least one method of contraception, national research demonstrates abortion rates have increased since 1999 (Office for National Statistics 2009) and just under half of all pregnancies among 15 - 18 year olds lead to an abortion. Improving contraceptive services will ensure young people get the right support they need and help reduce unwanted pregnancies and abortion rates.

This guidance focuses on helping those up to the age of 25 and mainly targets socially disadvantaged young people, for example, teenage parents, young people living in areas with high levels of deprivation, some minority ethnic groups, and young offenders. Current evidence indicates socially disadvantaged young people find it difficult to access contraceptive services, for a variety of reasons, including lack of knowledge about service opening times and locations, and concerns about service confidentiality. For that reason, this draft guidance focuses on socially disadvantaged young people to ensure they receive culturally sensitive, confidential, non-judgemental and empathic advice and support tailored to their individual needs.

Dr Gillian Leng, NICE Deputy Chief Executive, said: “Although this guidance focuses on socially disadvantaged young people, key recommendations are also relevant to all young people, regardless of their background.

“This draft guidance responds to a real need to improve existing contraceptive services, making it easier for young people, especially the most disadvantaged, to get the right information, advice and treatment at the right time.”

Key draft recommendations include:

  • establish collaborative evidence-based commissioning arrangements 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.
  • doctors, nurses and pharmacists should where possible, provide the full range of contraceptive methods, especially long-acting reversible contraception (LARC), condoms to prevent transmission of STIs and emergency contraception (both hormonal and timely insertion of an intrauterine device).
  • provide additional support for disadvantaged young people to enable them to gain access to contraceptive services without delay and to support them as necessary in using the service (for example, access to interpreters, one-to-one support, facilities for people with physical and sensory disabilities, and assistance for those with learning disabilities).
  • ensure all young women are able to obtain free emergency hormonal contraception, including advance provision.
  • ensure young men and young women know where to obtain free advance provision of emergency hormonal contraception.
  • in addition to providing emergency hormonal contraception, professionals should ensure that all young women who obtain emergency hormonal contraception are offered clear information about, and referral to, contraception and sexual health services.
  • encourage all young people to use condoms and lubricant in every encounter, irrespective of their other contraceptive choices, because condoms help to prevent the transmission of sexually transmitted infections.

Penny Barber, Chief Executive, Brook in Birmingham said: “As a member of the NICE programme development group, I helped develop this draft guidance. It includes a number of key recommendations including ensuring young women can access free emergency contraception, in advance if necessary.

“We know emergency contraception is more effective the sooner you use it after sex so it's crucial young women have it on hand in case they need it. Evidence demonstrates that making emergency contraception available in advance does not change the amount of sex young people have.

“These draft recommendations are set to make a real difference by helping young people to get confidential and clear information about the range of contraception methods available so young women and men can obtain the most effective contraception that best meets their needs. Our aim is to make sure all young men and women use the right contraception for them.”

Anyone wishing to submit comments on this draft guidance is invited to do so via the NICE website,, until 23 June 2010. Final guidance is expected in October 2010.

Download the press release.

This page was last updated: 24 May 2010

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