In Lincolnshire, GPs can agree local enhanced service contracts with Lincolnshire County Council (LCC) to provide long-acting reversible contraception (LARC) methods to their patients, including intrauterine contraception (IUC) methods and contraceptive subdermal implants (SDI). GPs are paid by activity for each LARC insertion and removal they undertake in line with the service specification. Because some levonorgestrel intrauterine devices (LNG-IUDs) have additional potential gynaecological benefits, LCC and Lincolnshire ICB have an agreement in place which means GPs are reimbursed for providing LARC for both contraceptive and non-contraceptive (gynaecological) purposes.
For further information and to apply, please contact LARC@lincolnshire.gov.uk.
Service expectations are set out in the specification which can be requested from LARC@lincolnshire.gov.uk. Some key points about the service:
- Providers can choose to offer IUC or SDI, or both
- Providers will be paid for the following activity:
- IUC insertion: £92.52
- IUC removal: £20.00
- SDI insertion: £35.77
- SDI removal: £43.18
- Providers submit a LARC Claim Form each quarter to primarycarepayments@lincolnshire.gov.uk and are paid by LCC each quarter in arrears based on the recorded activity.
- Clinicians should hold the appropriate Faculty of Sexual and Reproductive Health (FSRH) Letter of Competence in Intrauterine Techniques and/or Subdermal Contraceptive Implants Techniques Insertion and Removal.
- Patients should receive their LARC service within 4 weeks. Providers offering copper intrauterine devices (Cu-IUDs) as emergency contraception should be able to do so within the timeframes set out in clinical guidance.
- Providers are encouraged to work with neighbouring practices and their PCNs to ensure good LARC access in their area.
Training and support
For information on FSRH Letter of Competence training and other support please contact LARC@lincolnshire.gov.uk.
FSRH offer a free online contraceptive counselling course: FSRH Contraceptive Counselling | FSRH
Useful resources
The Primary Care Women’s Health Forum (PCWHF) produces a range of useful clinical guidelines, top tips, webinars, and patient resources on contraception and women’s health: Resources - Primary Care Women's Health Forum (pcwhf.co.uk).
The Royal College of General Practitioners (RCGP) has a women’s health library of sexual and reproductive health resources: Course: Sexual and Reproductive Health | RCGP Learning
The Global INTRA (Intrauterine Contraception: Translating Research Into Action) group provide a guided six-step discussion with women to help them reach an informed decision where IUC is actively considered as a contraceptive option: Counselling patients in Women's healthcare (bayer.co.uk)
Brook and FSRH have created a tool to help people with their contraception choices: Best contraception for me: Quiz – Brook
NHS contraception video series: Contraception - YouTube
Choice Support’s Supported Loving network has advice and resources on how to support autistic people, people with learning disabilities and, or mental health needs with issues around sexuality and relationships, including a toolkit to support conversations on contraception: Choice Support | Contraception.
The Public Health team have produced a briefing for GPs on steps to encourage women to choose LARC.
FSRH and University College London have developed the Contraceptive Choices website to help people decide which contraceptive method suits them best: Home | Contraception Choices.