Exclusive: PCTs block LARCs in bid to cut costs

Only 42% of practices offer full range of contraceptives as PCTs squeeze costs.

Less than half of practices in England are offering patients a full range of contraceptives, as PCTs look to limit their use to cut costs, GP newspaper can reveal.

The finding, based on responses from 86 PCTs to a Freedom of Information Act request, comes despite a DoH drive to increase uptake of long-acting reversible contraceptives (LARCs) to cut high teenage pregnancy rates.

The QOF now includes three sexual health indicators aimed at improving advice and choice of contraceptive methods.

But many GPs are unable to offer LARCs to patients as PCTs look to restrict their use.

Dr Sarah Gray, a GPSI in women's health in Cornwall, told GP that in parts of the country PCTs cap the number of coils in order to save money.

'There is a huge cost agenda for PCTs,' she warned.

Dr Gray added that many PCTs offered no training for GPs on IUDs and implants and there was a shortage of trainers.

Just 42 per cent of the 4,623 practices covered by the investigation were found to be offering patients a full range of contraceptives, including LARCs.

Also, 46 per cent of PCTs did not monitor contraception use among patients and were unaware of what the most popular forms of contraceptive were.

The postcode lottery in contraceptive services was worst in London, despite it having some of the highest rates of teenage pregnancies in the country.

Just one out of 49 practices in Lewisham offered patients a full range of contraceptives, while none of the 36 practices in Tower Hamlets offered LARCs. Haringey PCT reported that just seven out of 56 of their practices prescribed a LARC in the 12 months to September 2008.

Julie Bentley, chief executive of the fpa, formerly the Family Planning Association, said the findings showed contraceptive services were below par.

'It is vital every person can choose from all 15 methods of contraception. PCTs must offer comprehensive services.'

North London GP Dr Richard Ma, of the RCGP's sex, drugs and HIV working party, called for greater investment in contraceptive services. 'There is no way we can reverse the trend in teenage pregnancies without access to LARCs.'

sanjay.tanday@haymarket.com

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