Purpose

The reason for this decision is to extend the
delivery of Knowsley’s Women’s Health Hub pilot. As
part of the Women’s Health Hubs pilot, the Council agreed to
uplift and adjust the tariffs paid to GPs for the delivery of
Long-Acting-Reversible-Contraception (LARC) provision across the
borough for a six-month period from the 1 February 2025 until the
31 July 2025.
 
As part of the pilot, the Provider (GP
practices signed up to deliver the service) have been paid at the
following rates since the 1 February 2025:
 
Contraceptive implant fit    £60.18
Contraceptive implant removal     £63.20
IUD/IUS fit    £100
IUD/IUS removal     £38.09
DNA payment         
£24.83
Inter-Practice Referral Fee £10
Failed/attempted IUD/IUS fit        
£100
Failed/attempted IUD/IUS removal         
£38.09
 
 
As agreed in the MoU (see Appendix 1),
Cheshire and Merseyside ICB provided £0.010m to the council
for the reimbursement of 50% of the tariff for IUS insertion and
there is currently still funding available from this allocation.
The funding was provided on the primary basis that it contributed
towards LARC fittings for gynaecological reasons, as well as the
enhanced tariff. As such, there is an understanding that GPs should
continue to be paid at the enhanced tariff for all LARC
indications. Recognising that there cannot be a two-tiered tariff
in place for LARC provision across the borough, i.e. an enhanced
tariff for gynaecological LARC fittings and a lower tariff for
contraceptive fits, it is proposed that the Council allocates an
additional £0.007m to support an extension of the pilot until
the 31 March 2026.
 
It is evident that the pilot is having an
impact, and the desired outcome of increased LARC activity is
starting to take place. This can be evidenced in the data available
from the pilot so far, which shows that there have been 84 LARC
fittings between February and June 2025. This is compared to 111
fittings between April 2024 and January 2025, and 93 fittings
during 2023/24. It is acknowledged that six months is a short
period of time for the pilot to take full effect. Extending the
current pilot until the 31 March 2026 will provide 13 months’
worth of data, from which a full-scale evaluation can be conducted
to assess full effect and impact of the pilot.
 
An Equality Impact Assessment in relation to
the pilot is attached at Appendix 2.

Decision

That the Assistant Executive Director (Public
Health) approves:
 
(i)       The extension of the
Knowsley Women’s Health Hub LARC pilot to 31 March 2026;
and
 
(ii)       That an additional
£0.007m of Public Health Grant is set aside to fund the unmet
costs of extending the pilot.

Alternative options considered

No other options were considered. Due to the
specialist nature of the service, a retender exercise is not
applicable. The option to cease the pilot and revert to previous
tariffs could pose a potential risk to the successful roll out of
the Women’s Health Hub in Knowsley and potentially reduce the
LARC activity across Knowsley just as momentum is building. It is
anticipated that maintaining the current tariffs will continue to
support greater LARC activity across the borough and support a
successful roll out of the Women’s Health Hub in
Knowsley.