Long Acting Reversible Contraception (LARC) Key Clinical Indicator (KCI)
Year ending 31 March 2021

About this release

This release by Public Health Scotland reports on the prescribing rate of long acting reversible methods of contraception (LARC) to women of reproductive age in primary care and sexual health settings. This includes the contraceptive implant, intrauterine device (IUD) and intrauterine system (IUS). The most recent year (1 April 2020 - 31 March 2021) shows the impact the COVID-19 pandemic has had on overall LARC prescribing in Scotland.

Main points

In primary care and sexual health settings combined in 2020 to 2021:

• Prescribing of LARC was significantly impacted by the COVID-19 pandemic and this affected all NHS board areas and all types of LARC.
• The overall LARC prescribing rate decreased from 54.3 per 1,000 women in 2019/20 to 32.1 per 1,000 in 2020 to 2021. These rates are the highest and lowest in the eight year reported period.

• The contraceptive implant remained the most common type of LARC prescribed with rates of 15.8 per 1,000 women compared to 11.9 and 4.3 per 1,000 for the IUS and IUD respectively.
• NHS Dumfries & Galloway had the highest rate of prescribing amongst the mainland NHS Boards at 46 per 1,000 women, while NHS Lanarkshire had the lowest at 10.3 per 1,000.

Background

This report focuses on very long acting methods of contraception; namely the contraceptive implant, IUD and IUS. Contraceptive injections are also reported on but are presented separately. As multiple contraceptive injections are required per year, it is difficult with the current information to determine person level data. As such, while rates are shown to allow comparison between NHS Board areas, caution should be taken interpreting these rates. The overall data for LARC combined are given in Table 5 - LARC prescribing rate.

In typical use, the 'long acting' methods of contraception have a lower failure rate than alternative reversible methods such as the contraceptive pill or condoms.

In August 2011, the Sexual Health and Blood Borne Virus Framework 2011-2015 (external website) was launched, followed in 2015 by the Sexual Health and Blood Borne Virus Framework 2015-2020 Update (external website). Both of these support the use of LARC and the 2015 to 2020 update states that work has been carried out to improve access to such contraception. In August 2021, Reset and Rebuild: A Recovery Plan for Sexual Health and Blood Borne Virus Services (external website) was published. This paper details the impacts of the COVID-19 pandemic on sexual health and blood borne virus services in Scotland.

Further information

The next release of this publication will be September 2022.