NHS Community Pharmacy Contraception Management Service Pilot: Access to Ongoing Management of Oral Contraception (Tier 1)

NHS community pharmacies are an accessible and convenient place for people to receive advice and support for contraception management. Through this pilot, people will have the option of being able to access their next supply of oral contraception directly from their pharmacist rather than from their GP or sexual health clinic. As part of this pilot, people can be seen by their pharmacist for management of their ongoing, routine oral contraception that was initiated in primary care or sexual health clinics. See where the pilot service is being offered.

The aim of the pilot is to create additional capacity in primary care and sexual health clinics for ongoing oral contraception access to be available through a community pharmacy to relieve the burden on wider primary care and sexual health clinics and provide improved access for patients.

Objectives:

  1. To test a model for community pharmacy teams to continue, review and supply the provision of contraception supplies initiated in primary care or sexual health clinics.
  2. To test an integrated pathway between existing services and community pharmacies to allow people greater choice and access when considering continuing their current form of contraception.
  3. Better access to services and support for high-risk communities and vulnerable patients.
  4. To identify a data set that should be shared with the community pharmacy to support the referral process and feedback loop to the GP-held patient record where appropriate (with relevant consent).
  5. To evaluate the Tier 1 service model exploring the experience of service users, pharmacy staff and primary care and sexual health professionals and the preferred care model of the service within community pharmacy.

Contraception management and why it’s important

The NHS Long Term Plan (LTP) Chapter 2 highlights the importance of NHS services complementing the action taken by local government to support the commissioning of sexual health services and exploring the future commissioning arrangements to widen access and create capacity where it is needed.

Public Health England resource for commissioners (2019) highlighted the role community pharmacy can play supporting ongoing contraception. In areas that do not already offer commissioned contraceptive services, appropriately trained and skilled community pharmacists could provide access to their repeat supply of their oral contraception to relieve the burden on General Practice and allow GPs to concentrate on more specialist services.

What the service will provide

A person may self-refer or be referred by their GP or sexual health clinic to a participating pharmacy to continue their contraception management in a community pharmacy setting. The pharmacist will conduct a confidential consultation with the person and, pending clinical appropriateness, issue the next supply of oral contraception.

How people access the service

People access the service by one of the following routes:

  • Identified as clinically suitable by the community pharmacy team;
  • Self-refer to a community pharmacy;
  • Referred by their GP practice as they have requested a repeat prescription, and a review is needed;
  • Referred from a sexual health clinic.

To be eligible to access this service a person must:

  • Be an individual presenting for repeat supply of their ongoing hormonal oral contraception,
  • Have already had an initial consultation with an appropriately trained practitioner and had a supply of ongoing oral contraception and the subsequent supply is needed.
  • Have consented to the referral where appropriate and to participate in the pilot service model.
  • Require a clinical check appointment before further supplies of an ongoing oral contraceptive are authorised.

People who wish to consult another healthcare provider for contraception support are still free to do so. People being referred into this service must have already agreed to be referred to community pharmacy as part of the pilot.

Note: Following positive evaluation, the pilot may expand to the following subsequent tiers:

  • Tier 2, which is initiation of oral contraception via a community pharmacist;
  • Tier 3, which is ongoing management of Long-Acting Reversible Contraceptives (LARCs, such as implants, vaginal rings, injections, patches);
  • Tier 4, which is initiation of LARCs via a community pharmacist.

Intra-uterine devices and systems (IUDs/IUSs) are not included as part of this service.