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  • UK faces significant rise in abortion and sexually transmitted infection (STI) rates
  • New report reveals short-sighted NHS efficiency savings could add £612.8[1] million to NHS costs by 2020
  • Increasing restrictions to contraception services could take overall costs of unintended pregnancies to £124.7bn

Short-sighted reforms to vital contraception and other sexual health services could lead to a significant increase in the number of unintended pregnancies and sexually transmitted infections (STIs), the consequences of which could saddle the UK with a £136.7[2] billion NHS and welfare burden by 2020 according to a report out today.

Commissioned by the UK’s leading sexual health charities, Brook and FPA (Family Planning Association), Unprotected Nation paints a stark picture for the UK if increasing restrictions to contraception and other sexual health services continue unabated.

Unprotected Nation Executive Summary (PDF).

Unprotected Nation full report (PDF).

With clear evidence NHS efficiency savings are already undermining the quality of contraception services available today, through postcode and age based restrictions[3], limited services offered by PCTs[4] and changes to commissioning structures[5], the Unprotected Nation report predicts a bleak future resulting from the continuation of these restrictions across the country as commissioning structures change and budgets are cut.


  • £298.6 million in additional NHS health costs between 2013 and 2020, resulting from an increasing number of unintended pregnancies[6] – including the provision of 22,036 more NHS abortions a year by 2020.
  • A cumulative increase in wider public spending of up to £124.7bn by 2020, equivalent to 10% of all welfare spending, due to the subsequent increased live birth rate accounting for spending in areas such as social welfare, personalised services, housing and education[7].
  • The restriction of other sexual health services could also lead to an extra 91,620 STIs per year by 2020, due to increased restrictions, fragmentation of services and reductions in the effectiveness of education and awareness raising programmes. Of these, 76,840 cases are expected to be chlamydia.
  • Increased infection rates alone could place an additional cumulative burden of £314 million on the NHS by 2020 and could see incidences of chlamydia account for 40% of NHS treatment costs for STIs between 2013-2020.

The report makes clear that at a time when the NHS is struggling to make £20 billion of efficiency savings before 2015, restricting contraception and sexual health services is not only a false economy but has a real impact on people’s health, lives and families.

Dr Audrey Simpson, OBE, Acting Chief Executive, FPA, said;
“Unplanned pregnancy and STIs have obvious costs to people’s health and well-being, but the heavy financial costs to the NHS and welfare state are also real and serious. The wheels of this crisis are firmly in motion. Investment in sexual health saves money, but if national and local government ignore the warnings and continue stripping away services, advice and information, the bleak predictions in this report will come true.”

Simon Blake OBE, Brook’s Chief Executive, added;
“The national sexual health and teenage pregnancy strategies have ended and the NHS is under intense pressure to make savings. However, this report makes very clear just how short-sighted restrictions to contraception services are – particularly for young people who have to navigate this void alongside a black hole in sex and relationships education programmes.”

Anne Connolly, GP: Ridge Medical Practice, Bradford, and Chair of the Primary Care Women’s Health Forum, said;
“There is a clear danger that imminent changes to commissioning could significantly undermine the good work that professionals are doing. Maintaining progress requires investment and if we are brave enough to invest money at a time when there is pressure to disinvest there are massive cost savings as well as quality of life savings to be made, as this report clearly illustrates.”


The report also projected the economic impact of improving access to contraception services. When compared to the costs associated with the potential impact of increased restrictions, policy changes that removed restrictions in evidence today could:

  • Reduce the cumulative total of NHS costs associated with unintended pregnancies by 4% (£196m) by 2020.
  • Reduce cumulative wider social expenditure costs by 14.4% (£3bn) by 2020.
  • Cut £4.4bn cumulatively from public health spending by 2020.

In response to reports of restrictions to contraception across the UK Brook and FPA joined forces earlier this year to launch XES – We Can’t Go Backwards, a major awareness campaign. Brook and FPA are calling on people in the UK to join the campaign and rate and share their experiences of contraception and sexual health services, good and bad, through the UK’s only interactive online sexual health map.

Unprotected Nation Executive Summary (PDF) [^]

Unprotected Nation full report (PDF).



  1. Combined cumulative costs to NHS between 2013-2020 resulting from STIs (£314.2m) and unintended pregnancies (£298.6m), should restrictions to services increase.
  2. £136.7bn is the projected overall cumulative cost associated with unintended pregnancies between 2013 -2020 should restrictions to contraceptive services increase. This includes NHS treatment costs for unintended pregnancies, wider public sector costs and STI treatment costs for the NHS.
  3. Healthy Women, Healthy Lives report (PDF)
  4. Healthy Women, Healthy Lives executive summary (PDF)
  5. Enhanced Services Commissioning Factsheet, NHS Commissionaing Board (PDF)
  6. An unintended pregnancy is a pregnancy that is mistimed, unplanned, or unwanted at the time of conception.
  7. Wider public sector costs include expenditure on social welfare programmes, personalised social services, housing, education of children as a result of unintended pregnancy during the relevant periods between 2013-2020, housing costs and anti-poverty programmes.



The report projects the economic and social impacts arising from increasing restrictions to contraception services in the UK. The projection of cost implications were made by modelling three future scenarios for rates of unintended pregnancy. These consisted of a reference case i.e. maintaining current rates, removing restrictions and increasing restrictions already in evidence across the UK.

The report was compiled by Development Economics using data and information from a range of sources including the Office for National Statistics, Departments for Health, the Department for Education, the Department for Work and Pensions, HM Treasury, The Scottish Government, National Assembly for Wales, agencies such as the Health Protection Agency , academic research from the United States and Australia, and World Health Organization, The Organisation for Economic Co-operation and Development and European Union health protection and statistical agencies.

Development Economics Limited is a company that specialises in the economics of regeneration and social development policy. The report author is Stephen Lucas, Co-Founder and Managing Director of Development Economics. Stephen is an economist with 20 years’ experience in economic, demographic, social policy and regeneration consulting. Recent government clients include: The Department for Communities and Local Government, The Department for Work and Pensions and The Scottish Government.


Brook is the UK’s leading provider of sexual health services and advice for young people under 25. The charity has over 45 years of experience working with young people and currently has services in England, Scotland, Northern Ireland and Jersey. Brook services provide free and confidential sexual health information, contraception, pregnancy testing, advice and counselling, testing and treatment for sexually transmitted infections and outreach and education work, reaching more than 294,000 young people every year.
Ask Brook helpline 0808 802 1234.


The sexual health charity FPA provides straightforward information, advice and support to all people across the UK on all aspects of sexual health, sex and relationships. FPA educates, informs and supports people through our work in the community, our helpline and information service, our counselling service, our training and publications and our public awareness campaigns.
FPA helpline 0845 122 8690



If you would like to find out more about the campaign please contact Brook and FPA’s press offices.


Tel: 020 7284 6046


Tel: 020 7608 5265

Mob: 07958 921060 (out of hours)


Tel: 020 7284 6046