The following resources may be useful then deciding on appropriate contraception:
- BNSSG formulary - contraception page - has advice about cost effective contraception methods including combined and progesterone only pills.
- Unity Sexual Health website - is an excellent resource for patient information about contraception.
- UKMEC summary sheets - give information on safety of contraceptive methods in various scenarios. See the UKMEC home page for complete guidelines.
Oral emergency contraception can be obtained from:
- Pharmacy - patients can find out where the nearest pharmacies that provide emergency contraception are by texting ‘Pharmacy emergency contraception [and their post code]’ to 80011
- Walk in centre
The BNSSG formulary - contraception page has advice on emergency contraception including links to an emergency contraception algorithm.
The Unity Sexual Health Clinic also offer an emergency contraception service including fitting of a copper IUD if this is required. See the IUD section of Remedy for further advice and downloadable referral form.
Coil fitting and removal
Replacement/removal/insertion IUD/IUS should be done in primary care or in the sexual health clinic. Referrals to secondary care are subject to a criteria based access procedure:
Intrauterine coils should be fitted and removed by primary care (including sexual health clinics) and not secondary care unless: 1. There are specific medical issues which prevent fitting or removal by primary care (including sexual health clinics if contraception also required) OR 2. It is to be fitted as part of contraception provided in conjunction with termination of pregnancy OR 3. The decision to fit an intrauterine coil is made as part of an operative procedure.
In the first instance, Remedy would suggest referral to Unity Sexual Health Clinic to their LARC clinic. Patients can usually self refer:
A referral letter will also be accepted, but needs to go directly to Fay Webb (LARC referral administrator), Unity Sexual Health, Central Health Clinic, Tower Hill BS2 0JD (we are not currently able to process as an e-referral, I'm afraid). Of note, in the case of lost threads, the Unity Sexual Health Team has informed us that they rarely fail to remove an IUS/IUD in clinic, but do have access to ultrasound scan if needed for difficult cases. However, an ultrasound scan report from the last 6 months (confirming IUS/IUD in situ) is required to accompany referrals for lost threads.
If you still feel that this patient should be seen in secondary care and criteria are met then a referral via eRS can be made.