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Case study: What's it like to offer the pharmacy contraception service?

There have been delays to the national rollout of the pharmacy contraception service. But one Stoke-on-Trent pharmacy piloting the scheme is already seeing the benefits

Last year, the NHS community pharmacy contraception management service was piloted, with 44 pharmacies chosen to test the service.

According to the service specification, tier one of the advanced service aims to establish a model for community pharmacy teams to continue providing oral contraception under a patient group direction (PGD) to patients who were first prescribed it via primary care or sexual health clinics.

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

Under tier two, pharmacists will be able to initiate the supply of oral contraception via a PGD.

Tier three will involve the “ongoing monitoring and management of repeat long-acting reversible contraception, excluding intrauterine systems and intrauterine devices”, while the fourth phase will include the initiation of long-acting reversible contraception.

However, in December last year it was announced the national rollout would be delayed from January to “early 2023” as community pharmacy IT system suppliers needed time to develop support for the service.

In the same month, two pharmacies in England announced they had embarked upon tier two of the pilot, including Lloydspharmacy’s Cobridge branch in Stoke-on-Trent.

Read on to find out more about the service, and a pharmacy manager's experience of offering it to patients.


What does the service involve?


Pharmacies that sign up to the service can prescribe and administer oral contraceptives to women without patients needing to see their GP.

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

Consultations must include a conversation with each patient regarding “alternative and more effective forms of contraception”, according to the service specification.

For combined oral hormonal contraception, pharmacists need a record of the patient’s body mass index (BMI) and a blood pressure measurement to supply a repeat prescription.

Although the specification mandates that only pharmacists can complete the consultations, it said that “a suitably trained pharmacy technician” could take a patient’s blood pressure and BMI before the consultation.

These can also be taken by the pharmacist during the consultation or be self-reported by patients.

Pharmacists can issue repeat prescriptions for oral contraception for up to 12 months. However, this should be made in line with a patient’s previous supply, the specification said.

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

Meanwhile, the service specification confirmed that participating pharmacies will receive £18 per consultation and a set-up fee of £900, paid in instalments, while any oral contraceptives supplied will be reimbursed in line with the Drug Tariff.


Who is eligible?


Patients who have commenced their first menstrual cycle and are aged 50 and under are eligible to enrol in the service if they have already been supplied an oral contraceptive by a GP or sexual health clinic.

“People who have had a gap (of any duration in length) in their oral contraception cycle cannot be re-initiated on their original prescription as part of this service,” the specification said.

Read more: Increased use of community pharmacy ‘essential’ to NHSE 2023/24 priorities

Pharmacies participating in the service must respond to anybody requesting a repeat supply of their contraceptive “as soon as is reasonably possible”, it added.

“If the pharmacy is unable to offer a consultation within the time needed to meet the person’s ongoing contraception need, they should be signposted to an alternative pharmacy or other service for a consultation,” it said.


What’s it like to offer the service?


Lloydspharmacy’s Cobridge branch in Stoke-on-Trent is one of the pharmacies now offering tier two of the service under the pilot scheme.

The store’s lead pharmacist Ioana Tudor recalls the moment she was first told the pharmacy would take part in the pilot scheme.

“Our manager informed us that we would participate in the oral contraceptive pilot scheme, and we participated in a webinar where we found out more information,” she says.

She continues: “We were happy to [participate] and we began learning how we could provide the service and all the details.

Read more: NHSE announces pharmacies can dispense COVID-19 antivirals from April

“At the beginning, we were a bit stressed because we didn’t know what to do [or] where to go but after we sorted all this and participated in a webinar, to be honest it’s not something very major to add to other services.”

Ms Tudor adds: “Women can also buy [contraceptives] over the counter if they want, as well as being referred.

“We’ve probably had around 10 in the past two months – not too many. But we are not the only pharmacy in Stoke offering this.”


How popular is the service?


Ms Tudor says she has definitely seen an uptick in women asking about oral contraception since the pharmacy joined the scheme.

“Before this, we weren’t getting women coming in asking about the oral contraceptive pill. We don’t have so many women [coming in and asking about this] at the moment as we only started a couple of months ago, so people might not be aware of our service,” she says.

Ms Tudor explains that the process is “quite straightforward” as women are referred to the service by the GP practice or sexual health clinic.

She adds: "We use a private consulting room in our pharmacy. There are some questions we have to ask, we have to check the blood pressure, BMI and things like that but it doesn’t last too long.

“Of course, they have to wait if there are other people in front of them just like any other patient – but it’s quite straightforward. It isn’t too bad in terms of taking up too much time. It’s like providing a flu jab or the emergency hormonal contraception service.”


Is the service worth it?


Ms Tudor says she thinks the service is a good idea.

“It’s good we can do this and be involved more. We can help people more by providing more services and it helps us, too – you can’t just check prescriptions all day; it becomes really boring! It’s great for us to be more involved.”


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