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How councils are cutting GP sexual health services


York City Council have given GPs notice that they will be cutting the contracts for LARCS, alongside other public health services including Health Checks, from April.

It said in a statement: ‘All GP practices were notified of the council’s commissioning intentions in writing and were given an opportunity to raise concerns.

‘The council listened to the concerns and issues raised and were able to respond by revising the proposals to… allocate funding for the joint commissioning of Long Acting Reversible Contraception in primary care with the Vale of York CCG, pending their agreement.’


Under the London Sexual Health Transformation Programme, 19 London boroughs are putting LARCs contracts out to tender.

Its website explains that the programme has been set up in response to ‘the continued squeeze on public sector finances, and specifically public health budgets’ and aims to ‘design, agree and procure a system that will deliver measurably improved and cost-effective public health outcomes, meet increasing demand and deliver better value’.

Dr Andrew Howe, director of public health in Barnet and Harrow and programme director of the London Sexual Health Transformation Programme, said: ‘The programme is a partnership of 28 London boroughs working together to set up a new online triage, advice and testing service to improve access and provide better outcomes for patients.

‘We are currently looking in detail at capacity and demand to help our planning but we would hope that more services will be provided in primary care settings in the future. As well as being convenient for many patients this will free up clinic and hospital time for complex cases. The exact model for delivering future contraceptive services is a matter for local authorities and will depend on local needs.’

Devon and Torbay

The local Councils have cut the number of LARC procedures undertaken by GPs to switch to a cheaper ‘nurse-led’ approach.

The plans mean some GP practices will only be funded for six GP LARC fittings, with the rest paid for at a nurse hourly rate.

Torbay Council told Pulse: ‘The revised price [for LARC] has resulted in a reduction in the payment given to Torbay practices for providing this service and an increase in the payment given to practices providing this service within Devon County Council area.

‘The payments allow for GPs to retain their clinical expertise in providing this service, if they chose to do so, but encourages the practices to adopt a nurse led service which is not only more efficient, but frees up valuable GP time. This pricing mechanism fully recompenses the practices for the time taken to deliver the service and ensures that practices in Torbay and Devon are paid the same price for the same service.’

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