Quality statement 1: Contraceptive information and methods

Quality statement

Women asking for contraception from contraceptive services are given information about, and offered a choice of, all methods including long-acting reversible contraception.

Rationale

Offering information about the full range of contraceptives available, including long-acting reversible contraception, will ensure women asking for routine or emergency contraception can make an informed choice. Helping women choose the method of contraception that suits them best, and increasing their awareness of how to use contraceptives effectively, will help to reduce unplanned pregnancies.

Quality measures

Structure

a) Evidence that accessible information is available about the full range of contraceptive methods, including long-acting reversible contraception, and the local services that provide them.

Data source: Local data collection.

b) Evidence of local processes and referral pathways to ensure that women asking for contraception from contraceptive services are given information about, and offered a choice of, all methods including long-acting reversible contraception.

Data source: Local data collection.

Process

a) Proportion of women who ask for contraception from contraceptive services who are given information about all methods, including long-acting reversible contraception.

Numerator – the number in the denominator who are given information about all methods, including long-acting reversible contraception.

Denominator – the number of women who ask for contraception from contraceptive services.

Data source: Local data collection.

b) Proportion of women who ask for contraception from contraceptive services who are offered a choice of all contraceptive methods, including long-acting reversible contraception.

Numerator – the number in the denominator who are offered a choice of all contraceptive methods, including long-acting reversible contraception.

Denominator – the number of women who ask for contraception from contraceptive services.

Data source: Local data collection.

Outcome

a) Contraceptive use in women.

Data source: Local data collection.

b) Uptake of long-acting reversible contraception.

Data source: Local data collection.

c) Women's satisfaction with their choice of contraceptive method.

Data source: Local data collection.

What the quality statement means for service providers, healthcare practitioners and commissioners

Service providers (including GPs, community pharmacies and sexual and reproductive health services) ensure that processes are in place to offer women information about, and a choice of, all contraceptive methods, including long-acting reversible contraception. Service providers work together so that they can refer women to a suitable alternative service if they cannot provide the preferred method of contraception.

Healthcare practitioners (including GPs, community pharmacists, sexual and reproductive health consultants and nurses) ensure that they give women who ask for contraception information about, and a choice of, all contraceptive methods, including long-acting reversible contraception. If they cannot provide the woman's preferred method of contraception they refer them to a suitable alternative service.

Commissioners (clinical commissioning groups, local authorities and NHS England) commission contraceptive services that provide information on all contraceptive methods, including long-acting reversible contraception, and offer all contraceptive methods to all women. Commissioners ensure providers work together to ensure women are provided with their preferred method of contraception.

What the quality statement means for women attending contraceptive services

Women attending a contraceptive service are offered a choice of all contraceptive methods, including long-acting reversible contraception, and the information they need to decide which method is suitable for them. If the service cannot provide their preferred method of contraception they tell them where they can get it from.

Source guidance

Definitions of terms used in this quality statement

Contraceptive services

Contraceptive services include those offered in education, GP services, pharmacies, maternity and postnatal care services, walk‑in centres, acute and emergency care, and the voluntary and private sectors. This includes open access contraceptive services that are available to everyone and provide walk‑in and appointment clinics.

[NICE's guideline on contraceptive services for under 25s, recommendation 3 and expert opinion]

Information about contraceptive methods

This information covers all contraceptive methods and includes:

  • how the method works

  • how to use it

  • how it is administered

  • insertion and removal (for implants and intrauterine devices)

  • suitability

  • how long it can be used for

  • risks and possible side effects

  • failure rate

  • non-contraceptive benefits

  • when to seek help.

[Adapted from NICE's guideline on long-acting reversible contraception and expert opinion]

All contraceptive methods

This quality standard focuses on all methods of contraception. These are divided into 3 groups:

Long-acting reversible contraceptives that need administration less than once per month. These are:

  • contraceptive implant

  • contraceptive injection

  • intrauterine system (IUS)

  • intrauterine device (IUD).

[Adapted from NICE's guideline on long-acting reversible contraception]

Methods that depend on the person remembering to take or use them. These include:

  • contraceptive vaginal ring

  • contraceptive patch

  • combined oral contraceptive pill

  • progestogen-only pill

  • male condom

  • female condom

  • diaphragm or cap with spermicide

  • natural family planning.

Permanent methods of contraception. These are:

  • vasectomy

  • female sterilisation.

[Adapted from the Faculty of Sexual & Reproductive Healthcare guidelines on barrier methods for contraception and STI prevention, fertility awareness methods, progestogen-only pills and combined hormonal contraception]

Equality and diversity considerations

Contraceptive options may be limited for women with a learning disability or cognitive impairment. Contraceptive services should make it clear to women why specific methods cannot be offered to them.

Age, religion and culture may affect which contraceptive methods the woman considers suitable. When discussing contraception, healthcare practitioners should give information about all methods and allow the woman to choose the one that suits her best.

If a healthcare practitioner's beliefs do not let them supply contraception, they should ensure that the woman can see another practitioner as soon as possible.