The NHS Community Pharmacy Contraception Management Service pilot is “perhaps the one pilot we’re most excited about”, the director for primary care strategy and NHS contracts, Ed Waller, said at the Pharmacy Show in Birmingham on Monday (October 18).
Last month, NHSE&I announced that community pharmacies across seven primary care networks (PCNs) had been selected to join the pilot, allowing patients greater access to ongoing oral contraception.
The service was initially expected to run for one calendar year, but Mr Waller told Pharmacy Show delegates it will now be tested for at least two years.
The pilot aims to create more capacity in primary care and sexual health clinics by making ongoing access to oral contraception available through community pharmacies. It is hoped this will relieve the burden on wider primary care and sexual health clinics and provide improved access for patients.
Mr Waller told C+D it will expand shortly to encompass “different parts of the country”, adding: “I know there is a lot of demand on general practice at the moment, so making other avenues available is so important. It’s all about having wider access too and different avenues for patients to approach the NHS.”
“We will play it by ear”
Currently under the tier 1 pilot, pharmacists and their teams across seven selected PCNs will continue the supply and management of people taking oral contraception initiated in primary care and sexual health clinics.
In the new four-tier structure outlined on Monday, tier 1 will see pharmacists provide ongoing repeat oral contraception provision through a patient group direction (PGD) or repeat prescription including the necessary clinical check and annual review.
Tier 2, which is expected to begin at the start of April 2022, will involve the initiation of oral contraception through PGD or prescription.
While tier 3, which is also expected to start from April 2022 “in local areas”, will allow patients access to long-acting reversible contraception (LARCs), such as implants, injections or patches, administered through the community pharmacy.
Pending a positive evaluation, community pharmacies may also be able to initiate LARCs from April 2023, under tier 4.
Training and pharmacy professionals’ views
Progression to tiers 2 and 3 and access to training of community pharmacists to support the prescribing and administration of LARCs “are dependent on successful evaluation of tier 1”, Mr Waller said.
Also speaking at the Pharmacy Show on Sunday (October 17), NHSE&I head of pharmacy integration Anne Joshua presented the results of an IPSOS MORI survey of 1,018 pharmacists and pharmacy technicians. They were asked how comfortable they would feel providing any of the contraception pilot tiers “following specialist training”.
The survey revealed that while 94% of respondents said they are “comfortable” in offering tier 1 of the service, as many as 37% would not feel comfortable providing tier 4 – which includes the initiation of LARCs.
Mr Waller told C+D: “We will play it by ear. When we have enough evidence behind us…all of these pilots are in play for future commission”.
The scheme will be paid for through the Pharmacy Integration Fund (PhIF), which was established in 2016 to accelerate the integration of pharmacy across health and care systems.
Pharmacy should “completely” take control of contraception services
“The idea is that the ongoing supply of contraception for now is being arranged in pharmacies using PGDs, potentially leading to more prescribing capability,” Mr Waller told delegates on Monday.
“In the long run, we’ll start to increase the complexity as we move up through the tiers. Eventually we could see community pharmacy involved in contraception completely.”
