M. Bardsley et al., Estimating the balance of general practice versus family planning clinic coverage of contraception services in London, BR J FAM PL, 26(1), 2000, pp. 21-25
Objective. To compare levels of provision of contraception from general pra
ctice and family planning clinics for the populations of the 32 London Boro
ughs.
Method. Retrospective analysis of routine activity data, including the esti
mated numbers of first attendance, for 295 family planning clinics (managed
by 28 NHS Trusts) ann more than 1800 GP partnerships in Greater London, su
pplemented by data from cc survey of family planning clinics. The results w
ere expressed as the estimated percentage of women aged 16-49 obtaining adv
ice on contraception from GPs and family planning clinics. These results Lt
ere compared to those expected based oil results in the General Household
Survey
Results. Across London in 1995/96, 12% of women aged 16-49 obtained contrac
eption services from family planning clinics, and 24% obtained contraceptio
n services from a GP. At a borough level there was Variation from 11% to 25
% in coverage by family planning clinics, and from 11% to 41% in coverage b
y GPs, Estimates of the proportion of women in this age group not using NHS
-provided medical or surgical contraception ranged from 0 to 30%. Across al
l boroughs, there wins no consistent relationship between levels of GP acti
vity and family planning clinic activity
Conclusion. The results indicate substantial variations Between boroughs in
the proportion of women using NHS-provided medical or surgical methods of
contraception. The absence of any clear inverse relationship between activi
ty in family planning clinics and activity in general practice suggests tha
t changes to one will not De compensated by changes in the other More speci
fically, health authorities that opt to purchase lower levels of family pla
nning clinic activity cannot assume that women may opt to use GPs as an alt
ernative. Such a strategy may increase the likelihood that women who would
have used family planning clinic services will either not rise contraceptio
n at all, or will use less effective 'over the counter' methods.