ABSTRACT

General practitioners (GPs) and practice nurses are often best placed to offer good contraceptive advice because they already know the patient’s health and family circumstances. Some practices are excellent; others provide little beyond oral contraception and devote insufficient time and skill to counselling. The 2002 Sexual Health Strategy established that primary care should always supply at least Level 1 basic contraceptive services, and should consider also supplying services at Level 2. These include all the long-acting reversible contraceptive methods (LARCs). The National Institute for Health and Clinical Excellence (NICE) Clinical Guideline No. 30 (www.nice.org.uk, 2005) drew attention to the many contraceptive (and sometimes non-contraceptive) advantages of these, comprising injectables, implants, the latest copper-banded intrauterine devices (IUDs) and the levonorgestrel intrauterine system (LNG IUS). If not supplied on site, practices should have straightforward referral arrangements in place for the LARCs, and also when appropriate for Level 3 services such as male and female sterilization, and legal abortion.