Dual provision or duplication? A survey of family planning provision

Background. Family planning has been delivered through dual provision by ge neral practice and community based clinics since its inception. This may be perceived as duplication of services and can be regarded as an ar-ea of po ssible disinvestment in a climate of rising health care costs. Aim. A survey of family, planning service provision across a health distric t was carried out to establish the potential To rationalise current service provision by studying the pattern of service provision in the district and the links between family planning clinics and general practices. Method. A postal questionnaire and covering letter were sent to all practic es and clinics in May 1997. Following analysis, results were fed back to cl inic staff and general practitioners through accredited meetings. Results. Basic family planning was universally available to the population at all practices and clinics. Clinics offered a wider range of services, es pecially specialist services for psychosexual counselling and hormonal impl ants. Very few separate services for young people were identified. Within t he primary care sector there was little 'out-of-hours' provision of contrac eptive services. Half of the practices responding had used or would use fam ily planning services as referral centres; implants and psychosexual servic es attracted most referrals. Conclusion. Art understanding of the complementary nature of the services i ii primary care and community FP clinics was achieved and agreement was rea ched that disinvestment ir? clinics locally was not appropriate, The need t o I raise public awareness of availability of all contraceptive services wa s identified. Services in general practice and community clinics are comple mentary and need to develop a joint strategy to ensure an effective, compre hensive service. Quality of care needs to be examined in future work.