FSRH Statement on The King’s Fund report: Understanding NHS financial pressures

Today The King’s Fund has released its report Understanding NHS financial pressures, which explores many of the current pressures facing the delivery of high-quality sexual health services across England.

Whilst this King’s Fund report gives an important overview of pressures that are being faced across GUM care, it is important to recognise that these pressures are being mirrored in the delivery of contraceptive care across England. Ultimately, this is resulting in restrictions of access to, and provision of, contraception and impacting upon the quality of care and breadth of choice patients are able to exercise over their sexual and reproductive health.

Since the Government’s 2015 £200million cut to the public health budget and announcement, a 3.9% year-on year cut to the budget over the course of Parliament (£600 million), Local Authorities are trying to achieve more for less. The Advisory Group on Contraception has found that more than one in six authorities (16 percent) decreased spend on contraceptive services during the financial year 2015/16 as a result of the unexpected £200m in-year cut to public health budgets in June 2015 and approximately 3.9 million women of reproductive age live in areas with some form of restriction on access to contraception, either due to age or place of residency. [1]

Likewise, complicated commissioning structures and funding mechanisms are resulting in women having to navigate fragmented pathways of care and missing opportunities to avoid unintended pregnancy. For example, in abortion care services women are unable to access contraceptive care and STI screening, failing to enable vulnerable women to make important choices about avoiding unintended pregnancy and taking control over their sexual and reproductive health.

In terms of workforce, less funding for contraceptive care means less opportunity to train healthcare professionals in skills-based knowledge required to fit long acting-reversible methods of contraception and address complex contraceptive care, meaning that women will be less able to access the full range of contraceptive options on offer in the UK.

Every £1 of expenditure cut to sexual and reproductive health could cost the UK as much as £86 further down the line[2], risking a reversal in, until now, largely successful efforts to reduce unintended pregnancy.

Read The King's Fund Report Understanding NHS financial pressures in full