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Pharmacists deliver 1,400 consultations under contraception pilot

Just over a year since its launch, community pharmacists have delivered 1,400 consultations under the contraception service pilot, NHS England (NHSE) has revealed.

Pharmacies across seven primary care networks (PCNs) began piloting the NHS community pharmacy contraception management service in September 2021, with NHSE confirming in January this year that 44 pharmacies had signed up to provide the scheme.

The number of pharmacies involved with the pilot has grown since then, and as of October 14, 140 branches were offering this service, according to NHSE data.

In the year or so since its launch, 66 pharmacists have delivered more than 1,400 consultations, NHSE head of delivery and community pharmacy clinical strategy Pallavi Dawda – who had a hand in developing the pilot – revealed at the Pharmacy Show in Birmingham earlier this week (October 17).

Read more: PSNC unveils plans for new national pharmacy contraception service

“We’re hearing that pharmacists are really embracing the service and really enjoy doing the rollout,” she told the audience. “People using the service are really benefiting too.”

The Pharmaceutical Services Negotiating Committee announced last month that a new pharmacy contraception service will be rolled out nationally from January next year – with pharmacists initially using a patient group direction (PGD) to provide ongoing management of routine oral contraception that was initiated in general practice or a sexual health clinic.

 

Independent prescribing a “natural extension” to service

 

In the cases Ms Dawda described, supply of oral contraception was made via PGDs.

However, utilising independent prescribing pharmacists to make the supplies feels like a “natural extension” of the service, Ms Dawda suggested.

In NHSE’s engagement with pharmacists piloting the service, “it’s become apparent that there are independent prescribers…who are really keen to test this for us, and really would like to be involved”, Ms Dawda added.

One of the pharmacies that initially piloted the service in Portsmouth is in fact due to begin testing out how independent prescribing will fit into the service, she said.

The contractor there is an independent prescriber and two general practices have been engaged to work with the pharmacy.

Read more: Locations of 44 pharmacies piloting NHS contraception service in England

The pharmacy is “working collaboratively” with their local pharmaceutical committee and local medical committee “to understand how best to make this work for their population”, Ms Dawda explained.

“We’re really keen to see how this one progresses,” she stated. “And we’re hoping that in the next few weeks or months [it] will be up and running.”

NHSE hopes to get some “early learning” on how to incorporate independent prescribing into the contraception service, she said.

“We want to do this with strong evaluation behind it [by testing] the views of the people that are using the service alongside the people who deliver [it],” Ms Dawda emphasised.

 

Four tiers to rollout

 

The pharmacy contraception service rollout has four tiers, Ms Dawda told the audience. Under tier 1, pharmacists can supply an oral contraceptive pill to patients who have previously obtained it from their GP or sexual health clinic.

Under the national implementation of the service next January, tier one will be rolled out more widely, Ms Dawda said.

“This is really ideal for patients that come in for the morning after pill and are not using any kind of contraception” or for people who “don't get on” with the pill they are currently taking.

Read more: NHSE&I 'excited' by pharmacy contraception pilot, as it extends scheme

Under tier 2, pharmacies can initiate access to oral contraception, while under tier 3, they will be able to offer ongoing management of patients using long-acting reversible contraceptives (LARCs) – which according to NHSE include implants, vaginal rings, injections, and patches.

Finally, in tier 4, pharmacists will be able to initiate patients on LARCs following a “shared decision making conversation” with the patient about which contraception method works best for them, Ms Dawda added.

 

Pharmacists can identify patients beforehand

 

“The key bit to highlight on this is that this is a service that people can just walk into [without] a referral from general practice or sexual health clinics,” Ms Dawda said.

Some pharmacies piloting the contraception service have also started “identifying patients beforehand”, by sending them a text message advertising the service.

Other pilot sites are making the service available on an appointment basis.

 

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