Contraception: LARC for people using emergency contraception
Indicator
The percentage of women, on the register, prescribed emergency hormonal contraception 1 or more times in the preceding 12 months by the contractor who have received information from the contractor about long acting reversible methods of contraception at the time of or within 1 month of the prescription.
Indicator type
General practice indicator for use outside the QOF.
Corresponding QOF indicator CON003 was retired from the QOF in 2019 as data showed average numbers of eligible patients per practice to be less than 20 per year.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Introduction
Long-acting reversible contraceptive (LARC) methods are defined as contraceptive methods that require administration less than once per cycle or month. LARC methods include copper intrauterine devices, progestogen-only intrauterine systems, progestogen-only injectable contraceptives, progestogen-only subdermal implants and combined vaginal rings. The uptake of LARC during 2017/18 (as reported in NHS Digital's Sexual and Reproductive Health Services data for England) was 41% (all age groups), compared with 42% for oral contraceptives and 14% for male condoms. Overall, take-up of this form of contraception has been steadily rising during the last 10 years.
The effectiveness of the barrier method and oral contraceptive pills depends on their correct and consistent use. By contrast, the effectiveness of LARC methods does not depend on daily concordance.
Rationale
The aim of this indicator is to encourage uptake of long-acting emergency contraception as it is often possible (and in many cases ideal practice) to start an ongoing method of contraception at the same time as prescribing emergency hormonal contraception. Practices should provide long-acting hormonal contraception information at the time of emergency contraception, or within 1 month. A similar NICE indicator provides information on LARC being given to women receiving oral or patch contraceptives (IND148).
Source guidance
Long-acting reversible contraception. NICE guideline CG30 (2005, updated 2019), recommendation 1.1.1.1
Specification
Numerator: The number of patients in the denominator who received either advice on LARC (non-specific code) or written and verbal advice on LARC (specific written and verbal advice codes) within 31 days of receiving emergency contraception.
Denominator: The number of women aged 54 or under who were prescribed emergency hormonal contraception 1 or more times in the preceding 12 months (register).
Calculation: (Numerator/denominator) * 100.
Exclusions: None.
Minimum population: The indicator would be appropriate to assess performance of collaborations or networks of GP practices serving populations of around 30,000 to 50,000.
ISBN: 978-1-4731-5787-3