College calls for clarity on referral pathways to secondary care where necessary
24-hour helpline must be fully operational by January 1st
The Irish College of General Practitioners, the professional and training body for Irish GPs, has issued its interim clinical guidelines to members who wish to provide termination of pregnancy services once it is legalised.
Clinical guidelines are the guidance for GPs for new services to facilitate high quality safe care for patients. They are issued to members, and are accompanied by elearning resources and training workshops.
The College has trained an initial group of GPs who are in a position to provide termination of pregnancy services under the Health (Termination of Pregnancy) Bill 2018. There are also additional training and educational supports available on the College website. Further training will be available in the New Year.
The interim clinical guidelines will be available to all members of the College via the website www.icgp.ie
They set out the steps under which GPs can carry out a medical termination of pregnancy. The law states that GPs can carry out a termination via medication, for women with a pregnancy of under 9 weeks' gestation.
The guidelines outline three consultations with a GP, with a 3-day delay between the first and second consultation. At the second consultation, a woman is given her first medication at the doctor's surgery or clinic, and a second medication to be taken at home up to 48 hours later. She is advised of possible complications, and encouraged to return. Long acting reversible contraception (LARC) is offered. The third consultation, usually within two weeks of the second, is to confirm that the cycle is completed, and offer counselling or contraception, and management of any complications.
Should the GP be unsure of the gestation dates, the GP must be able to access an ultrasound facility for dating, or complications. If the gestation dates are over 9 weeks, the woman is referred to a relevant hospital for a surgical termination.
"These detailed clinical guidelines map out the process for GPs who wish to provide this service," said Dr Tony Cox, Medical Director of the Irish College of General Practitioners.
"The ICGP will continue to provide training workshops and online support, as well as mentoring, in the coming year", Dr Cox added.
The ICGP has written to the Minister to express its concerns at the lack of clarity around referral pathways to secondary care when required throughout the country.
Furthermore, the ICGP has highlighted the concerns of those members with conscientious objections to providing this service.
The ICGP has reiterated that the 24-hour helpline, and the community supports to facilitate safe care for women, must be in place and fully operational by the January 1st deadline.
"The 24-hour helpline, and communications campaign, will help women access a community provider who can offer the service, but we need further clarity on a number of issues," Dr Cox said. "It is essential that the public know that this is an opt-in service for GPs, i.e. only those doctors who plan to provide the service will be contracted to do so."
"No doctor is obliged to provide the service if they do not wish to do so," Dr Cox added.
The 24-hour helpline serves a three-fold purpose, as chosen by the woman. It is a gateway to non-directive counselling, information about a contracted community provider, or a triage service for advice on possible complications.
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