Recommendations Recommendations for Government:
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Support for post-pregnancy contraception should be clearly articulated and embedded into Government’s national health plans, including a reiterated commitment in any future updates or phases of the Women’s Health Strategy, and future work on maternity and neonatal safety, such as the national action plan. a. This should include support for developing a ‘Once for England’ approach to PPC provision, reflecting the efforts in other UK nations to help standardise the PPC offer and facilitate local areas meeting the needs of their local communities. We know that newer PPC services may need to target specific patients at first, to build a strong business case for wider funding and coverage. However, universal access and the standardisation of PPC should be the ultimate objective, so that every woman can access this crucial service no matter where they live. The merging of NHS England (NHSE) and the Department of Health and Social Care (DHSC) and the Government’s focus on integration, accountability and clarity in the health system, presents an ideal opportunity to fix the fragmented commissioning of women’s health and contraception: a. The DHSC should ensure that each ICB has a named individual who is accountable for the joined-up commissioning of contraception and women’s health services, including post-pregnancy contraception, in collaboration with local authority partners. This role should carry clear responsibility and authority to coordinate service delivery. This accountability is essential to empower ICBs to plan and deliver the services women need. b. The DHSC should support and promote co-commissioning of PPC services, and create a national forum to share examples of best practice with ICBs. c. Local Women’s Health Champions and the Women’s Health Ambassador/National Clinical Director for Women’s Health should maintain national oversight of commissioning decisions to ensure the needs of women are met throughout the life course. d. Merging NHSE and The DHSC creates an opportunity to bring together the expertise of the women’s health and reproductive health policy teams which currently sit separately. This will enable joined-up policy around the holistic needs of women across the life course. e. In conjunction with these changes at national level, local commissioning bodies should share budgets and contractual mechanisms to improve outcomes and facilitate simple solutions where capacity, priority, timing and relationships enable this to happen. i. Local Authority Health and Wellbeing boards or Overview and Scrutiny boards should hold parties to account for local decisions and any potential risks or issues.
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The Government should consider conducting an audit of the current gaps in PPC provision across England.
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The Government should work closely with the CoSRH and local PPC champions to establish a national resource database on PPC to share best practice of provision centrally. a. This should include the national counselling framework with scripts, and resource packs to support midwives and nurses in delivering high-quality and timely information. This should start in the antenatal period for those in maternity care and, where possible, prior to the end of pregnancy for those who need contraception after other pregnancy outcomes. The Government should build a repository of information to enable healthcare practitioners and all birthing people and their support networks to improve health literacy of the population around fertility, pregnancy, maternity and reproductive health. a. The NHS website and NHS app should be updated to include information about all PPC options.
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