GPs urged to offer greater choice of contraception

GPs have been urged to improve patient access to and choice of contraception, particularly long-acting reversible contraception (LARCs), under new standards welcomed by GPSIs.

LARC use continues to rise (photo: Saturn Stills/SPL)
LARC use continues to rise (photo: Saturn Stills/SPL)

New standards from the Faculty of Sexual & Reproductive Health say GPs should ensure all patients have ‘open access’ to a full range of contraceptive services.

The measures encourage greater use of long-acting reversible contraception (LARCs), and call on GPs to provide evidence that women seeking this method are being offered appointments within two weeks.

Prescriptions for LARCs have been historically low relative to other forms of contraception, but use has increased in recent years and 1.3m prescriptions were made in 2012/13.

They now account for 30% of primary methods of contraception among women attending NHS community contraceptive clinics.

The faculty said better access to contraceptives would help minimise the risk of unintended pregnancy, benefiting health and reducing NHS costs.

The report, A Quality Standard for Contraceptive Services, says that ‘every individual requiring contraception to minimise the risk of unintended pregnancy should have access to contraception both from a GP and/or alternative open access specialist provider to whom GPs can also refer for specialist advice and care’.

GPs should provide contraception services to female and male patients ‘regardless of age, place of residence or GP registration’. They should be aware of open-access contraceptive services in their area so they can signpost patients effectively.

East London GP Dr Sebastian Kalwij, who has an interest in women’s and sexual health, said he welcomed the new standards which, if followed, would ‘provide a good choice for patients’.

He said it was important for GPs to discuss contraception regularly with patients. ‘In my experience patients are often open to try alternatives to what they have been using traditionally,' he said.

'As GPs, we provide continuity of care over many years. Different stages in a woman’s life may ask for different methods of contraception, or there may be a change in risk factors such as weight change or giving up smoking.’

LARC use encouraged

The report recommends that all GPs should offer LARCs to patients and help raise awareness about these effective and low-risk forms of contraception.

GPs should submit regular evidence that women seeking such treatments are offered appointments within two weeks of request, it said.

Dr Kalwij added that although training was required for some contraceptive methods, particularly LARCs, this could greatly improve patient satisfaction. ‘Many GPs who started offering [LARC] services report a high level of satisfaction amongst their patients but also amongst themselves. And it may be an interesting way for practices to get together and work in different ways, for example regarding opening hours and signposting.’

Professor Kevin Fenton, Public Health England director of health and wellbeing, said he supported the standards, adding: ‘Comprehensive and open access to the full range of contraceptive methods is fundamental to people’s health and wellbeing, and to that of their families.’

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