Rewarding GPs for prescribing long-acting reversible contraceptives (LARCs) led to more than 100,000 additional prescriptions in the three years after the incentive was introduced through QOF, a study of nearly 600 practices in England suggests.
Researchers looked at prescribing data for a random sample of 581 practices before and after the introduction of three QOF sexual health indicators – SH1, SH2 and SH3 – in 2009, which awarded GPs points for providing women with advice on LARCs.
The results – published in the journal PLoS ONE – showed LARC prescribing rates were relatively stable over the years 2007/08 and 2008/09, but then rose by 4% each year over the period 2009 to 2012.
The Imperial College London team, led by Dr Sonia Saxena, calculated that this would be equivalent to 8,700 more women being prescribed LARCs over this period compared with the pre-QOF period – which, if extrapolated to the whole population aged 15 to 44 years, would mean around 110,000 additional women would have been prescribed a LARC.
The researchers concluded: ‘Our findings suggest that pay-for-performance incentives for contraceptive counselling in primary care with women who are on oral contraceptives or those requesting emergency contraception have increased uptake of the more effective LARC methods.
‘Widening this policy has potential to result in a reduction in unintended pregnancy but has resource, training and cost implications.’
However, some GPs have expressed concern that the removal of one of the QOF indicators on providing LARC advice – now called CON002 – could undermine the benefits seen through the QOF initiative. Dr John Ashcroft, Derbyshire LMC deputy chair, recently told Pulse he has submitted a motion to this year’s LMC annual conference calling for the indicator to be reinstated.