Shared learning database

Type and Title of Submission


Raising the profile of LARC in North Lincolnshire




Does the submission relate to the general implementation of all NICE guidance?


Does the submission relate to the implementation of a specific piece of NICE guidance?


Full title of NICE guidance:

CG30 - Long Acting Reversible Contraception

Category(s) that most closely reflects the nature of the submission:

Implementation policy

Is the submission industry-sponsored in any way?

Grants received to support the social marketing element of the local LARC (Long Acting Reversible Contraception) implementation plan.

Description of submission


To raise the profile of LARC methods and increase contraceptive choices for women and men in North Lincolnshire.


1 To raise the profile of LARCs and create a demand through using social marketing approaches with the resident population of North Lincolnshire. 2 To raise awareness with clinical and non clinical staff of the merits of LARC methods, provide training for fitters and increase overall capacity where required. 3 To monitor uptake in use of LARC methods


After public consultation in 2002 NL PCT ceased traditional family planning services and contracted with all General Practitioners to deliver contraception as an additional service. LARC methods were commissioned separately as either a Locally enhanced service or Nationally enhanced service. A separate service was commissioned for U25's called Choices providing a holistic health service for young people, including access to contraception. NLPCT engaged with CG30 in 2005/06. A working group was established and an implementation plan was drawn up. Central to this plan was the desire to increase the public's awareness of LARC methods and increase the demand, alongside raising clinician's awareness of LARC methods to ensure that it was offered as a choice alongside the traditional front runner of oral contraception. This was achieved by: 1 Undertaking a PCT wide audit on service standards against the contracts and undertaking a survey through pharmacy targeting women aged 15-49 to ask them about their views on the services provided for contraception in NL to identify and support wider service development requirements. 2 Providing clinical and non clinical awareness sessions. 3 Providing training to clinicians wishing to fit both implants and IUD/IUS 4 Increasing the number of services available in NL 5 Developing and delivering a series of marketing campaigns using a social marketing approach. In 07/08 this has included firstly running a poster campaign on the buses and in the cinema across NL targeting the U25's, funded by the Teenage Pregnancy Partnership, and linked into wider campaigns promoting Choices; and secondly, running a public health campaign through local pharmacies where women obtaining pill prescriptions receive a credit card resource in their prescription bag prompting them to think about the potential benefit of switching to a LARC method. 6 Setting a baseline from which to monitor uptake of LARC methods on a quarterly basis.


1 The social marketing campaigns are currently being evaluated and preliminary findings show that young people have seen the adverts at the cinema and on the buses, find them eye catching and of interest and where contraception is forefront have suggested that they would consider a LARC method now. Feedback from the pharmacy campaign show that women receiving the cards have not complained about the inserts (pharmacists cite this as positive as they normally do receive complaints) and they have had women request further information about LARC methods as a direct result. 2 The audit and survey has shown that we have a well established network of services, that are performing to a high standard and that are acceptable to the population. There are 19/21 practices proving access to a fitter for both implants and IUD/IUS and in April 2007 Choices also began providing access to both the Implant and IUS/IUD. 3: NLPCT set its baseline year at 2006/07. In 2007/08 NLPCT has seen a 52% increase in the use of LARC methods overall. In terms of rates per 1000 women aged 15-49 the PCT has increased from 24.9 per 1000 in 06/07 to 37.8 per 1000 in 07/08. The PCT will be reviewing the impact of this increase on prescribing for Oral Contraceptives. In 06/07 there was no change in prescribing patterns from 05/06, we await the data being provided.

Results and evaluation

The significant growth area in 2007/08 for implants has been fittings in women aged 15-25 and for IUS/IUD has been women post 30. The PCT continues to monitor removals within 1 year of fitting. In 07/08 75/826 implants fitted were removed within 1 year. In 2006/07 5.5% of implants fitted were removed within 1 year and in 2007/08 9% were. The PCT is monitoring which services are removing significant numbers and will provide training relating to pre fitting counselling and alternatives to removal to try and reduce the numbers taken out. The PCT is unable to provide data on IUD/IUS removed within 1 year. This is currently being addressed by the PCT. With the LA the PCT will be reviewing the data on unintended Teenage Pregnancy rates and Abortion rates to identify any significant changes as a result of increased usage of LARC. The PCT intends to run the contraceptive survey again in 2008/09 to build upon data already collected and identify any significant changes in local perception and awareness of local campaigns. The audit of services will also take place as part of the annual review of those contracted to provide services. Choices have included questions on LARC methods, the campaigns and its services as part of its annual survey, the result of which are expected by August 2008. Young people receiving Sex and Relationships Education in local schools have also been asked to complete a questionnaire on the Campaigns run during 07/08. The preliminary responses to date have been incredibly positive. This evaluation is due to complete in July 08. It is anticipated that once all results are available that an annual report will be written for the PCT and possibly wider publication.

Key learning points

To be successful you need engagement from commissioners, service providers and key partnerships. Raising awareness and increasing service capacity is not enough, you need to create a demand from women and men who wish to access contraception in order to plan when they become parents in order to promote and ensure informed choice. Setting a baseline and being able to monitor uptake and show a cost or other benefit is key to continued support from commissioners, service providers and key partnerships.

This submission was shortlisted for the 2008 Shared Learning Award.

Contact Details

Name:Natasha Philips
Job Title:Sexual Health and Substance Misuse Commissioning and Service Development Manager
Organisation:North Lincolnshire PCT
Address:Health PLace
County:North Lincolnshire
Postcode:DN20 8GS
Phone:01652 251012


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This page was last updated: 20 May 2008

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.