- The proportion of main methods of prescribed contraception for B&NES residents attending Contraceptive & Sexual Health (CaSH) services in 2013 were 27.5% Long Acting Reversible Contraception (LARC) and 72.5% User Dependent Method (UDM). The proportion of prescribed LARC by age banding peaked in the 20-24 year old age group.
- Oral contraceptives accounted for the vast majority (83%) of contraceptive prescriptions in 2013.
- The proportion of each type of contraception prescribed through General Practices in B&NES is similar to that in the Avon Gloucestershire and Wiltshire PHE Centre area, and across England.
- B&NES is ranked 77th from 326 local authorities in England for the rate of GP prescribed LARCs during 2011 and 2013, with a rate of 72.2 per 1,000 women aged 15 to 44 years.
- 96% of General Practices (26 out of 27) in B&NES provide Intrauterine Devices (IUDs), Intrauterine Systems (IUSs) and contraceptive implants to patients.
What does the data say?
Approximately 30% of pregnancies in the UK are unplanned. Contraception can be used to prevent unwanted pregnancy and some forms will prevent transition of Sexually Transmitted Iinfections (STIs). Emergency contraception can be used when contraception was not used or failed to prevent pregnancy: some types of emergency contraception can be used up to 120 hours after sex.
Condoms prevent unwanted pregnancy and stop the spread of most STI’s. There is limited data on use available as most are just bought privately.
The oral contraceptive pill is usually just called "the pill". It contains artificial versions of the female hormones oestrogen and progesterone, which women produce naturally in their ovaries. When taken correctly it can prevent pregnancies but does not prevent transmission of STIs.
Long-Acting Reversible Contraception (LARC) are contraceptive methods that provide effective contraception for an extended period without requiring user action. There are four types of LARC available, which are:
- Contraceptive Implant;
- Contraceptive Injection;
- Intrauterine Device; and
- Intrauterine System.
The uptake of LARC is low in Great Britain, at around 12% of women age16–49 in 2008–09, compared with 25% for the oral contraceptive pill and 25% for male condoms. 1 However, the use of LARCs as a primary method of contraception amongst women has been slowly increasing. In 2013/14 they accounted for 31% of all women making contact with CaSH services for the first time in the year, compared to 18% in 2003/04. The percentage of women choosing LARCs as a primary method of contraception increases with age, from 18.5% of those aged under 15, to 43% per cent of those 35 and over. 2
The C-Card scheme is a coordinated approach to condom distribution which offers young people in B&NES free condoms and sexual health and relationships advice and information. All young people aged between 13 and 24 years of age who live in or access services in B&NES can use the scheme as long as those under the age of 16 years satisfy Fraser Competency Guidelines and there are no causes for concern. Upon receipt of the C-Card young people can access a wide range of venues for condom supplies.
In terms of C-Card usage, the number of new issues of C-Card has declined from 2009/10 to 2013/14 by 38%, with the number of repeat visits having increased by 4.6% (Figure 1). However, some of this drop may be accounted for by some services not be fully reporting back on the number of C-Card issues made.3
Figure 1: Number of C-Card new registrations and repeat visits, 2009/10 – 2013/14, B&NES B&NES (2015), Bath and North East Somerset Rapid Sexual Health Needs Assessment, Figure 5.3, p.106, available from Sexual Health
The age range of young people who accounted for all new C-Card registrations during 2013/14 spanned 13 to 24 years old, with the highest number of new registrants being 19 year olds (Figure 2).
Figure 2: Number of C-card new registrations by age, 2013/14, B&NES B&NES (2015), Bath and North East Somerset Rapid Sexual Health Needs Assessment, Figure 5.4, p.107, available from Sexual Health
Figure 3 shows the distribution of C-Card venues in and around B&NES.
Figure 3: Location of C Card venues, providing free condoms across Bath and North East Somerset (December 2014) B&NES (2015), Bath and North East Somerset Rapid Sexual Health Needs Assessment, Appendix D, available from Sexual Health
The proportion of main methods of prescribed contraception for B&NES residents who accessed CaSH services in 2013 were 27.5% LARC and 72.5% User Dependent Method (UDM), 4compared to 34.2% LARC and 65.8% UDM, for residents in England.5 The proportion of prescribed LARC by age banding peaked in the 20-24 year old age group.6
The percentage of GP practices offering LARC in B&NES was 92.6% as of December 2014 [this was higher than the regional average of 69.9% and was the third highest in the region]. The rate of GP prescribed LARC in B&NES was 72.2 per 1,000 women in 2013 [this was slightly lower than the regional rate (72.6), but higher than the national rate (52.7); it was also a 14.4% increase on the rate in 2011 (63.1 per 1,000)].7
For more information on contraception in the Sexual Health Needs Assessment please refer to the 2015 Bath and North East Somerset Rapid Sexual Health Neads Assessment - available from Sexual Health.
What does the community say?
The Child Health-Related Behaviour Survey 8
The Health-Related Behaviour Survey developed by the Schools Health Education Unit (SHEU) is designed for young people of primary and secondary school age. The surveys have been developed by health and education professionals, and cover a wide range of topics. Data arising from the survey can be used to help inform planning and policy decisions as well being used in the classroom as the stimulus for discussion with young people. These surveys are carried out every two years.
When considering the results of the Child Health-Related Behaviour Survey in B&NES it is worth bearing in mind the level of participation in the survey, and thus how representative the responses are likely to be of children in B&NES as a whole. For more information see the Child Health-Related Behaviour Survey section in Children and Young People
As well as the local B&NES results, comparisons are made with national/aggregate figures from all the surveys conducted by the Schools Health Education Unit (SHEU) in the previous year from their publication “Young People into 2013”. The national sample used for the 2013 comparison consists of 43,014 young people aged 10 to 15.
When the Child Health-Related Behaviour Survey in 2013 asked secondary school children in B&NES in year 8 and 10 a number of questions about contraception:
- 50% of pupils responded that they know where they can get condoms free of charge, the same as the national SHEU rate.
- Only 22% (26% in 2011) of pupils responded that there is a special contraception and advice service for young people available locally, slightly lower than the national SHEU rate of 27%. 70% (67% in 2011) said they ‘don’t know’ if there is, higher than the national SHEU rate of 50%.
When asked about different contraceptive methods:
- 83% of year 8 pupils had never heard of/knew nothing about the coil (IUD), and 58% of year 10 pupils.
- 64% of year 8 pupils had never heard of/knew nothing about the injection and 45% of year 10 pupils.
- 70% of year 8 pupils had never heard of/knew nothing about the implant, and 38% of year 10 pupils.
- 48% of year 8 pupils had never heard of/knew nothing about the contraceptive pill, and 19% of year 10 pupils.
- 61% of year 8 pupils had never heard of/knew nothing about the female condom (femidom), and 31% of year 10 pupils.
- 61% of year 8 pupils had never heard of/knew nothing about emergency contraception (morning after pill), and 23% of year 10 pupils.#
- 70% of year 8 pupils had never heard of/knew nothing about the safe period/ rhythm method, and 49% of year 10 pupils.
- 65% of year 8 pupils had never heard of/knew nothing about sex without penetration, and 41% of year 10 pupils.
- 1. NICE (2005), Long-acting reversible contraception (update), NICE guidelines [CG30], October 2005, available from: https://www.nice.org.uk/guidance/cg30
- 2. HSCIC (2014), NHS Contraceptive Services: England, Community Contraceptive Clinics: Statistics for 2013-14, 30th October 2014, available from: http://www.hscic.gov.uk/catalogue/PUB15746/nhs-cont-serv-comm-cont-clin-eng-13-14-rep.pdf
- 3. B&NES (2015), Bath and North East Somerset Rapid Sexual Health Needs Assessment, p.106
- 4. B&NES (2015), Bath and North East Somerset Rapid Sexual Health Needs Assessment, p.123
- 5. Public Health England (2014), Health Protection Report vol. 18, no.24: Sexually Transmitted Infections and Chlamydia Screening in England 2013; PHE, London, available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/326935/hpr2414.pdf
- 6. B&NES (2015), Bath and North East Somerset Rapid Sexual Health Needs Assessment, p.123
- 7. Public Health England (2015), Sexual Health Quarterly Outcome Indicator Report - Bath and North East Somerset, Qtr1 2014/15
- 8. Schools Health Education Unit (2013) The Health-Related Behaviour Survey 2013, A report for BANES Secondary, Bath and North East Somerset Council