UK accident and emergency departments and emergency contraception: what dothey think and do?

Objectives-A postal questionnaire survey was conducted to assess what staff in UK accident and emergency (A&E) departments thought of providing an eme rgency contraception service, the degree of enthusiasm in and level of prov ision of the service, and staff attitudes to the introduction or continuati on of provision of the service. Methods-A questionnaire was sent to all 560 departments providing A&E servi ces in the UK. Results-Of the 560 units sent questionnaires, 355 (63.4%) replied. Half the units were located in small county towns, and a quarter in large towns. Re quests for emergency contraception were received by 96% of responding units , but only 57% provided treatment. Requests for emergency contraception in 84 of these units ranged between one and 50 per month. The A&E senior house officer (SHO) and the gynaecology SHO and registrar prescribed most of the pills. Nurses were more involved in nurse led or general practitioner (GP) led units. Initial treatment only was given by 77% of providing units whil e the remainder also discussed subsequent contraception. Follow up was arra nged with GPs by 92 units, and with family planning clinics by 66 units. In formation packs were available in only 37 providing units. A total of 155 o f providing units felt it was worthwhile and 56% of respondents thought eme rgency contraception should be provided by A&E departments. However, 91 uni ts could identify one or more groups within the hospital who were antagonis tic to provision by A&E departments, of which non-A&E medical staff formed the largest group. Over the counter availability of emergency contraception was not supported by 62% of respondents. Conclusion-The results show that while the female population appears to see a need for emergency contraception services to be provided in A&E departme nts, there is some reluctance by UK A&E departments to provide the service, Given the current interest in approaches to reducing unplanned pregnancies , especially in teenagers, provision of emergency contraception by A&E depa rtments requires a pragmatic approach to ensure their cooperation in provid ing the service when alternative sources of provision are not available.