Family planning in Britain. A local authority service in Bradford
Lumb, K.M.
Ippf Medical Bulletin 6(6): 1-3
1972
ISSN/ISBN: 0019-0357 PMID: 12276361 Document Number: 45486
This is a report of the ways in which the National Health Service Family Planning Act of 1967 (by which the Local Health Authorities in England and Wales were empowered to offer direct family planning services) has been applied by Bradford Local Health Authority. Bradford, a city of approximately 292,000, had a live birthrate of 19.8 per 1,000 in 1971, 13% of the live births were illegitimate. Local Authority (LA) started family planning clinics in April 1968 and patients were referred by midwives, health visitors, social workers, gen eral practitioners, and other hospital and LA personnel. A nurse working in the family planning clinic started to do the home visiting. The LA has seen approximately 4,000 family planning patients in a period of 4 years (the first 1,000 patients in a period of 24 months, the second 1,000 in 9 months, the third 1,000 in 8 months and the fourth 1,000 in 6 months). Generally, patients are seen at least once at the clinic. All patients are given an appointment card stating the date on which their next visit to the clinci is due; the follow-up appointments are kept at the clinic, too. Doctor participation in home family planning is only occasionally necessary provided always that the doctor and nurse work closely together. Thus, the home visits done by the family planning nurse can have one of following reasons: initial visit to discuss contraception and make clinic appointment; follow-up visits to patients who fail to keep initial clinic appointments, or to patients on oral contraceptives who default return appointments; visits to transp ort patients to clinic; visits to patients with positive cervical smears who have defaulted follow-up appointments. Bradford LA is also responsible for field work training of student health visitors and midwives. The pattern of referral is changing since many of the most needy women have been seen. The majority of new patients are now postnatal mothers referred by the midwives. Also there is a change in the clinic population from high parity patients of low social class to low-parity patients of higher social class. The LA service now offers contraception to all postnatal patients in the city and all women who need advice on medical or social grounds.