As the NHS Pharmacy Contraception Service hits the one year milestone this month, pharmacist Zoe Chan from Boustead Pharmacy in Jarrow, Tyne and Wear reflects on how the use of the service has increased over the past 12 months and how the team have implemented it, including working collaboratively to deliver reception staff training within local GP practices.

The start of the service

The NHS pharmacy contraception service was first launched as an advanced pharmacy service back in April 2023 as part of a concerted effort to try to deliver NHS clinical services through community pharmacy. The aim of the service is to offer people greater choice and access when considering starting or continuing their current form of oral contraception and supports the important role community pharmacy teams can play in helping address health inequalities by providing wider healthcare access in their communities.

The original launch of the service was limited to the ongoing supply of oral contraception but from December of that year it was expanded to include both initiation of oral contraception and to provide ongoing supplies.

Since then, community pharmacy teams in England have delivered over 240,000 consultations for this service. These consultations represent a positive patient journey through community pharmacy – people getting the right treatment at the right time in the right place. Just over a year later, the service continues to grow with thousands of pharmacy teams signed up to offer it to their patients.

We have been delivering the service since it first started and from a slow beginning we’re now seeing a very steady flow of those patients coming back in to use the service. Most of these are patients that we’ve seen before, they’ve come originally to us and now are back for the ongoing supply.

“Although a shortage in doctors is more often talked about there is often a shortage in practice nurses as well. The service is helping with this and increasing patient accessibility to the practice.”

Spreading the news

When we first started, our main goal was trying to get the word out there – what the service is about and identifying patients that could come to the pharmacy initially for ongoing supply and monitoring.

As Primary Care Network community lead in South Tyneside, I knew that working together with general practice colleagues was vital. We worked very closely with the GP practices nearby – we delivered staff training directly to the reception staff, because we recognised right from the very start that they are the people that will be most likely signposting and referring to us.

We focused on helping them identify patients that would benefit from the service and who they could send to us in community pharmacy. For example, patients that might need a review very soon, or who are receiving limited quantities, for example a month’s supply, regularly because they can’t make their review appointment with the GP. Also those that are calling up on the day with a need for an emergency prescription for on oral contraceptive.

We also did some work to demonstrate how easy it was for patients to get booked for a same day, next day or routine appointment depending on the urgency of the request and showed how this helped the practice workflow.

At our pharmacy we also identify patients, looking to see who might be due for a prescription. We attach little reminder cards to the bags so they know that when their next prescription is due, in six months’ time for example, they can consider coming directly to us and not the GP. This might be a useful tip for any pharmacies that don’t currently provide the service but will be doing so in the very near future.

We also let nearby pharmacies know that we provide the contraception service as well. At the time we first started, there were very few pharmacies that were offering it, and we didn’t want patients going around the houses and ending up back at the GP having had a really poor patient experience and becoming reluctant to use the service in the future. With this in mind, while we were building the service we would always try and squeeze in anyone walking in, knowing that the vast majority would still be on an appointment basis, depending on how urgently they need the medication.

Supporting patients and staff with decision making

To support patients thinking about long-term contraception we provide decision aids in the pharmacy including leaflets that outline all the different types of contraception available. We found that there are lots of good online resources for patients which they can refer to when having discussions with their pharmacist about the most suitable contraceptive for them.

To help give our team confidence in this new area we created simple crib sheets to help guide consultations – laying out the various oral contraception options available, the inclusion and exclusion criteria and how to commence treatment.

To help your expertise and confidence I would also recommend pharmacists speak to their local GP practices and ask to sit in with the practice nurses in a contraception consultation That might not always be practical, but we found our local GP practice team were very happy to let us sit in on those consultations just for that learning experience which will be of mutual benefit.

These very simple measures have helped us build our numbers up. The patient feedback has been great. They’ve realised how convenient it can be being able to have a consultation and receive a supply of an appropriate medication from one place and all done the same day in the majority of cases, avoiding lengthier wait times within general practice.

Heba Elsafy, a patient who recently used the pharmacy contraception service at our pharmacy, is a great example, She said:

“Coming to the pharmacy to have the consultation and then to actually receive it in the same visit was very convenient.

“I was able to get an appointment the same day. The pharmacist took me into a private consultation room, and I was able to talk about my requirements in confidence.  I left the pharmacy with a supply of my oral contraceptive.”

A mutually beneficial service

For ongoing supply consultations our staff tend to check what oral contraceptive pill a patient is on when they’re making the booking just to make sure there are no stock issues. This can make the process a little bit smoother for patients. Community pharmacy tends to be a lot quicker and more flexible because we are often open later hours, open at weekends etc and that really helps with getting patients seen more quickly. We can also offer ongoing patients up to a 12-month supply where appropriate, which can be much more convenient.

As our local GP surgeries might not have non-urgent appointments readily available, they’re really happy that we’re offering this service – it’s really opened out their capacity to offer appointments to other patients who perhaps have more complex needs.

Although a shortage in doctors is more often talked about there is often a shortage in practice nurses as well. The service is helping with this and increasing patient accessibility to the practice. This is quite a key point when engaging with local practices – it’s not just the patients that come to the service that will benefit, there’ll be other patients that will benefit as well.

For more information about the NHS Contraception Service visit NHS England » NHS Pharmacy Contraception Service

Pharmacist Zoe Chan