Pharmacies should offer under-16s direct access to contraceptive pill, says NHS report
Exclusive: Girls aged as young as 13 should have access to the contraceptive pill from pharmacies without the need for a GP prescription, an evaluation of a pilot in over-16s has concluded.
A report from the pioneering scheme across five pharmacies in Southwark and Lambeth found it had successfully reached young women who had never previously taken the pill – with 46% of women using the scheme first timers. It recommended the scheme – providing access under a patient group direction – be rolled out across the country, and that commissioners consider widening it to girls aged 13 to 16.
GPs warned there would need to be safeguards if the Pill was routinely made available to under-16s from pharmacies, and of the risks in prescribing it for the first time to young women without taking a full history.
Women aged over 16 have been able to obtain oral contraception without a GP prescription under pilots in Southwark and Lambeth since 2008. An evaluation found a quarter of women receiving the Pill under the scheme were under 19, and there was a significant drop at one pharmacy in the use of emergency contraception after its launch.
‘Consider expanding the scheme to appropriate pharmacies in Lambeth and Southwark, across London and nationally, to shift activity out of GP practices,' the authors said.
The Department of Health said it supported pharmacy access for under-16s, with proper safeguards: ‘[Pharmacists] should be fully satisfied young people understand all the issues before they prescribe any contraceptive, including encouraging the young person to talk to their parents.'
And Pulse can reveal NHS City and Hackney and NHS Croydon now have similar schemes in over-16s, and two pilots – in NHS Manchester and NHS Isle of Wight – have begun providing services to under-16s.
NHS Manchester extended its scheme to 13 community pharmacies last year, and a spokesperson said: ‘Any client under 16 must meet the requirements of the Fraser guidelines.'
The Isle of Wight scheme in 10 community pharmacies also provides the Pill to any girl over 13, although under-16s are also referred to a safeguarding nurse.
Kevin Noble, community pharmacy lead for NHS Isle of Wight, said it was discussing extending the scheme to all the island's pharmacies: ‘It's a shame other schemes have shied away from providing the Pill to under-16s.'
Dr Richard Ma, a GP in Holloway, north London, and London sexual health champion, was supportive: ‘There could be concern about pharmacists offering contraception to under-16s, but there is an unmet need.'
Dr Fiona Cornish, a GP in Cambridge and president-elect of the Medical Women's Federation, said she was ‘uneasy' about pharmacy distribution without GP assessment: ‘GPs check for safety and do the education side.'
Meanwhile, an Advisory Group on Contraception audit has found 28% of PCTs have no strategy to address unintended pregnancy.