Third of practices are still denied LARC access

One in three practices have still not been enabled to provide long-acting reversible contraceptives (LARCs) by their PCT, a GP investigation shows.

Responses from 111 PCTs to a freedom of information request by GP revealed that 35 per cent of practices are not able to provide LARCs.

Almost all PCTs have made efforts in 2009/10 to improve provision of LARCs. Most (51 per cent) have increased training in administering LARCs and 19 per cent have introduced local enhanced services (LESs).

In addition, 26 per cent have either increased funding for LARC services or audited current provision. But access varies widely across PCTs. In 5 per cent of trusts less than 25 per cent of practices can provide LARCs while in 15 per cent all practices can.

Access to contraceptive services has improved since last June, when GP revealed that just 42 of practices were offering patients a full range of contraceptives, including LARCs.

But Dr Sarah Creighton, genito-urinary consultant for City and Hackney PCT in north London, said access still needed to expand.

'We should aim for virtually all GPs to provide some form of LARC,' she said. 'LARCs are cost-effective and the injectable preparations require a minimal amount of staff training to administer.'

But she stressed that PCTs' efforts so far to increase access should be recognised.

'PCTs have prioritised LARC provision in primary care, providing training opportunities and financial incentivisation,' she said. 'This increase should be welcomed.'

London GP Dr Sebastian Kalwij, who has an interest in women's health, said it was 'good news' that LARC provision has expanded. 'Failure rates are very low with LARCs and that is why more and more women rely on them.'

The fact that these forms of contraception are reversible and do not affect future fertility was an important benefit to explain to young women, he said.

Dr Kalwij said that, although training would be needed to learn how to insert implants, other LARCs, such as depo-provera and intrauterine devices were easier to administer.

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