Coalition of Women’s Health stakeholders calls for policy overhaul to deliver equitable access to reproductive services and support local economies

Bayer | Bayer

This article has been initiated and funded by Bayer plc who are fully responsible for the content. The article will be reviewed in January 2026.

The fragmented commissioning and underfunding of contraceptive provision, highlighted in reports such as the Faculty of Sexual and Reproductive Healthcare’s Hatfield Vision¹ and the Royal College of Obstetricians and Gynaecologists’ Left for too long report², has been highlighted as a driver of stark inequalities in women’s reproductive health outcomes.

Now, a coalition of 14 leading stakeholders, including parliamentarians, Royal Colleges, representative groups, and influential local experts, convened by Bayer, are calling for decisive policy changes to address the postcode lottery in access to reproductive healthcare.

Long-acting reversible contraception (LARC), including the coil and contraceptive injection, plays a crucial role in supporting women’s reproductive health and preventing unplanned pregnancies³. The intrauterine system (IUS) also supports women’s gynaecological health as a recommended treatment option for heavy menstrual bleeding (HMB)⁴, one of the most common reasons for referrals to a gynaecologist.

The value of LARC is significant and cost-effective – every £1 invested in the provision of LARC in primary care saves £48 in healthcare and non-healthcare costs over 10 years⁵. However, systems are not realising this significant return on investment.

Bayer recognises that health systems are under significant strain and facing competing priorities. We are calling for collaborative action to balance the pressures of today with the long-term gains that can be made from tomorrow. This is why Bayer welcomes the Government’s Women’s Health Strategy which set out a vision to drive collaboration across and Integrated Care System (ICS) with a key priority of expanding the Women’s Health Hub network⁶. This funded strategy will see each of the 42 ICS s set up a hub – whether physical or virtual – to function as a single front door for women’s health services, by the end of the year.

While this progress is welcome, structural issues remain and must be addressed for Women’s Health Hubs to be a success. Historic policy decisions have led to current siloed commissioning of women’s reproductive healthcare services, creating unnecessary barriers for women and girls seeking advice and treatment. This structural split has led to a complex system that hinders swift and early intervention in primary care.

LARC provision is a prime example, where changes to funding flows and pathways have caused disparities in access⁷. Government data shows that the most deprived communities are those most likely to face challenges accessing services⁸. This is particularly evident in the latest data showing substantial regional variations, revealing that GP-prescribed LARC rates (excluding injections) vary from under 1 to almost 75 per 1,000 women across different parts of England⁹.

Bayer has therefore convened a ‘consensus statement’ of 14 leading organisations and experts to escalate this issue and call for action.

The coalition is calling for a national framework to jointly commission LARC. They are urging the Government to consider implementing a nationally set, minimum fee for LARC in primary care, to ensure accessible and sustainable provision for every woman.

The signatories include:

• Bayer UKI
• The Faculty of Sexual and Reproductive Healthcare (FSRH)
• All-Party Parliamentary Group on Sexual and Reproductive Health (APPG on SRH)
• English HIV and Sexual Health Commissioners Group
• Royal College of Obstetricians and Gynaecologists (RCOG)
• Primary Care Women’s Health Forum (PCWHF)
• Royal College of Nursing (RCN)
• Drs for Choice UK
• Faculty of Public Health
• Wellbeing of Women
• MSI Reproductive Choices UK
• Dr Stephanie Cook, Clinical Lead for Liverpool Women’s Health Hubs
• Richard Scarborough, former Commissioning Manager for Sexual Health, Manchester City Council
• Tracey Elliot, Advanced Nurse Practitioner and Lead Nurse, Primary Care Women’s Health Forum
• Dr Amanda Britton, Hampshire

How the consensus statement recommendations can help to fulfil national policy priorities

Why is this so important? Sustainable and fair funding for fitting long-acting reversible contraception (LARC) will help make provision of treatment faster, fairer, and simpler for the women it serves. As highlighted by the Faculty of Sexual and Reproductive Healthcare, this issue is not restricted to just sexual health and has an impact on up to 51% of the population¹⁰.

The policy recommendations also align closely with some of the Government’s recent Women’s Health Strategy 2024 priorities:

1. Supporting the expansion of Women’s Health Hubs – improving LARC provision through expanding Women’s Health Hubs will increase training opportunities for the 89% of non- or never-fitters interested in providing LARC¹¹, but unable to access training, improving workforce experience and retention.
2. Improve support for menstrual and gynaecological conditions – enhancing LARC access in primary care minimises avoidable referrals to secondary care gynaecology services, bringing care closer to home for more women with heavy menstrual bleeding (HMB) as per NHS ‘Getting It Right First Time’ guidance,¹² and saving costs in the longer-term¹³.
3. Tackle disparities – ensuring every Women’s Health Hub can deliver contraceptive and gynaecological LARC as a core service will enhance access for women from all backgrounds, helping to eradicate the LARC postcode lottery¹⁴.

Future proofed-provision and a sustainable, long-term funding approach, must be in place in every locality to transform women’s outcomes, reduce pressure on secondary care – and Women’s Health Hubs – and realise the return on investment on offer.

Alongside experts in the women’s health industry, we hope to take forward these proposals and work with Government before and after the General Election to deliver on this ambition.

Job Bag Number: PP-PF-WHC-GB-1407

Date of article: March 2024

References

1. https://www.fsrh.org/news-and-advocacy/the-fsrh-hatfield-vision/, February 2024
2. https://www.rcog.org.uk/about-us/campaigning-and-opinions/left-for-too-long-understanding-the-scale-and-impact-of-gynaecology-waiting-lists/, February 2024
3. Public Health England, Health England, Extending Public Health England’s contraception return on investment tool, Maternity and primary care settings, July 2021
4. NICE, Heavy menstrual bleeding: assessment and management, last updated May 2021
5. Public Health England, Health England, Extending Public Health England’s contraception return on investment tool, Maternity and primary care settings, July 2021
6. https://www.gov.uk/government/news/health-secretary-announces-new-womens-health-priorities-for-2024, accessed February 20244
7. Primary Care Women’s Health Forum, On the brink: The reality of Long-Acting Reversible Contraception (LARC) provision in primary care, June 2023
8. Office for Health Improvement and Disparities, Public Health Profiles: GP prescribed LARC excluding injections / 1,000, February 2024
9. https://fingertips.phe.org.uk/search/LARC#page/3/gid/1/pat/15/par/E92000001/ati/502/are/E09000002/iid/91819/age/1/sex/2/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1/page-options/ine-yo-1:2022:-1:-1_ine-ct-146_ine-pt-0_tre-do-0_tre-ao-0, accessed February 2024.
10. https://www.fsrh.org/news-and-advocacy/the-fsrh-hatfield-vision/, February 2024
11. Primary Care Women’s Health Forum, On the brink: The reality of Long-Acting Reversible Contraception (LARC) provision in primary care, June 2023
12. NHS Getting It Right First Time, Maternity and Gynaecology: GIRFT Programme National Specialty Report , September 2021
13. Department of Health and Social Care, Women's health hubs: cost benefit analysis, July 2023
14. Office for Health Improvement and Disparities, Public Health Profiles: GP prescribed LARC excluding injections / 1,000, accessed July 2023

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