QOF

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This indicator only applies to Females up to the age of 54.

Long-acting reversible method of contraception advice (Added in the last 15 months, the LATEST advice in the current QOF Financial year is selected)

8CAw. Advice about long acting reversible contraception

Combined oral contraception Codes (Latest in last 15 months and after 1/4/2009)

6147. Combined oral contraceptive
g8% COMBINED ORAL CONTRACEPTIVE - ETHINYLOESTRADIOL
g9% COMBINED ORAL CONTRACEPTIVE - MESTRANOL
gk : COMBINED ORAL CONTRACEPTIVE - ESTRADIOL VALERATE (v17)
gk1 : DIENOGEST (COMBINED ORAL CONTRACEPTIVE) (v17)
gk11 : QLAIRA tablets (v17)

Progestogen only oral contraception (Latest in last 15 months and after 1/4/2009)

6148. Progestagen only oral contrac.
ga1% ETYNODIOL DIACETATE [PROGESTOGEN ORAL CONTRACEPTIVE]
ga22. NORGESTON tablets
ga23. LEVONORGESTREL 30micrograms tablets
ga5% NORETHISTERONE [PROGESTOGEN ORAL CONTRACEPTIVE]
ga8% DESOGESTREL [PROGESTOGEN ONLY CONTRACEPTIVE]

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Contraceptive patch Codes (Latest in last 15 months and after 1/4/2009)

fh1q. ETHINYLESTRADIOL+NORELGESTROMIN 600micrograms/6mg transdermal patches
fh1r. EVRA transdermal patches

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Exception codes

9hK0. Excepted from sexual health quality indicators: patient unsuitable
9hK1. Excepted from sexual health quality indicators: informed dissent

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SH indicator 2

The percentage of women prescribed an oral or patch contraceptive method who have also received information from the practice about long acting reversible methods of contraception in the previous 15 months.

SH 2.1 Rationale

A woman’s contraceptive needs can change over her reproductive lifespan. Women requiring contraception should be given detailed information about and offered a choice of all methods, including LARC. This indicator seeks to encourage practices to review these needs on a regular basis and ensure that women are informed of advances in contraceptive choices.

All currently available long acting reversible contraception methods (LARC) are more cost-effective than the combined oral contraceptive even at one year of use. LARC methods include intrauterine devices, the intrauterine system, injectable contraceptives and implants. This is largely because their effectiveness is independent of patient compliance. Of the LARC methods, injectable contraceptives are the least cost effective. Increasing the uptake of LARC methods will reduce the number of unintended pregnancies. However, currently in the UK, about 8% of contraceptive users use LARC. Whilst international comparison is difficult, this percentage is very low.

Ref NICE guidance Long acting reversible contraceptives 2005.
www.nice.org.uk/Guidance/CG30

Information from the practice should be written and verbal. Leaflets can be obtained from a number of sources including the fpa, a UK-wide sexual health charity, which produces an excellent range of contraception leaflets including ‘Your Guide to Contraception’, which, amongst other things, indicates LARC and non-LARC methods clearly through the use of shading.
www.fpa.org.uk/Information/Readourinformationbooklets/guide

Faculty of Sexual & Reproductive Healthcare guidelines on contraceptive methods are available at www.ffprhc.org.uk

SH 2.2 Reporting and verification

The practice reports the percentage of those women prescribed oral or transdermal contraception who have a record of having been given advice on LARC methods in the past 15 months.

Verification – Practices should be prepared to demonstrate how patients are given such advice, examples of leaflets and any specific practice protocols.

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Prepared By Jean Keenan