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LARC use falls despite drive to raise uptake

GPs are offering fewer women long-acting reversible contraceptives than 18 months ago when NICE published guidance designed to drive up provision.

Figures obtained by Pulse have dashed the institute's hopes of significantly improving uptake, particularly of intra-uterine devices.

GPs blamed the failure to implement the NICE guidance on the desperate lack of training places for provision of contraception.

In October 2005, NICE published guidance encouraging GPs to offer long-acting reversible contraceptives to all women seeking contraception advice.

But the number of prescriptions issued has fallen from just over 390,000 then to fewer than 370,000 by February 2007, according to figures from Cegedim Strategic Data.

NICE had estimated that if 7.7 per cent of women switched to LARCs, there would be 70,000 fewer unplanned pregnancies in England every year, and cost savings for the NHS.

The anticipated increase in use of contraception implants and intra-uterine devices has also failed to materialise.

The figures show the number of Depo-Provera contraceptive injections across the UK fell from 350,000 to 313,000, and intra-uterine devices fitted also fell, from 8,640 to 5,520.

A spokesperson for NICE admitted that the uptake of the guidance was a cause for concern, adding: 'We will be carrying out our own research into the uptake of guidance on use of long-acting contraceptives and will publish a report.'

Dr Martyn Walling, a contraceptive expert and a GP in Boston, Lincolnshire, blamed the scarcity of training places on accreditation schemes run by the Royal College of Obstetricians and Gynaecologists.

'My great worry is that it is getting harder and harder for GPs to get training. I think that NICE put the focus on teaching and accreditation on PCTs, but didn't suggest how or provide any means or measures about how it should be done.'

Dr Margaret Safranek, a GP in Muswell Hill, north-west

London, who had to give up family planning clinics because she was unable to gain a place on an over-subscribed Faculty

of Family Planning training course, said: 'The problem is the training. It is a real scandal that it is so long and complicated.'

lanekwe@cmpmedica.com

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