BEYOND BARRIERS: REIMAGINING ACCESS TO POST-PREGNANCY CONTRACEPTION THE CASE FOR CHANGE
• All other provision is ‘business as usual’, including the outreach within the integrated sexual health service • Public health lead on overview of the programme and reducing inequalities through equitable opportunities. In Bradford Teaching Hospitals Foundation Trust (BTHFT): “To date, provision of contraception and training has relied on ad hoc funding.” This makes the PPC service highly exposed to cuts or withdrawal of funding as responsibility for its provision is so unclear. For example, in Derbyshire the service is no longer able to provide any form of PPC service due to withdrawal of public health grant funding, something they find “really concerning”. Additionally, in South Tees, the £30 fit fee the PPC service received from the local sexual health service had been planned to contribute towards training the next cohort of staff delivering the PPC. However, it was subsumed into the local ICB budget as PPC is not a mandatory requirement and was therefore not deemed a local priority. Often these healthcare professionals had spent a huge amount of time and effort to secure sustainable funding but instead found arrangements siloed and challenging: “There is currently no funding from maternity for this service and no funding for maternity staff time or training to provide contraception.” Particularly in a climate where ICB budgets are being reduced substantially, contributors were highly concerned about the future of PPC services. “We have been trying to get this established for years
Overall, with no one clear part of the health system responsible for providing PPC, commissioning, provision and funding is highly precarious. Contributors were in absolute consensus that this was the most significant obstacle to the provision of PPC, and urged for a ‘Once for England’ approach to standardise services through national guidance and clarification to support their strategic plans locally.
but ICB colleagues are not able to commit to funding or even jointly funding this.” Local authority responding to EHSHCG’s survey
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