The new pharmacy contraception service will launch across England next week (24 April), but without agreement from the pharmacists’ negotiating body.
The Tier 1 Pharmacy Contraception Service will allow community pharmacies across England to use a patient group direction to manage the ongoing monitoring and supply of repeat oral contraception that has already been initiated by a GP or a sexual health service.
Pharmacies that sign up to provide the service will be paid a £900 set-up fee in instalments, as well as an £18 fee per patient consultation.
The service was agreed within the most recent Community Pharmacy Contractual Framework agreement in September, but its original January start date was delayed.
Last month the Pharmaceutical Services Negotiating Committee (PSNC) told the Department of Health and Social Care (DHSC) and NHS England (NHSE) that they must pause the rollout of new services, including the contraception service, because community pharmacies did not have the capacity to provide it.
And pharmacy leaders have this week reiterated warnings that the sector will not to be able to provide the service on a national scale.
PSNC said earlier this week that the announcement from NHSE that the service would start in just 10 days’ time was ‘in direct contradiction’ to its warnings that rolling out additional services was ‘neither feasible nor affordable’.
‘Clearly our view is not because contractors don’t see the benefit of the service. This is a much-anticipated service that could deliver real benefits to patients and community pharmacies are always eager to support public health initiatives,’ said Janet Morrison, PSNC chief executive.
‘But capacity in the sector is now so stretched that more money is needed to safely resource additional work.’
PSNC’s pharmacy pressures survey, published this week, found that just 7% of respondents considered their pharmacy business to be profitable, while 76% said their pharmacies were experiencing staff shortages.
More than four fifths (81%) of pharmacy staff said that they were struggling to cope due to workload pressures and 78% reported that their work was having a negative impact on their mental health.
Ms Morrison said that the negotiating body had repeated its concerns about the new service to DHSC in recent days ‘and reminded them of the potential for a properly funded community pharmacy sector to play a greater role in providing clinical solutions and relieving pressures elsewhere in primary care’.
Nick Kaye, vice-chair of the National Pharmacy Association (NPA) said that allowing patients to access repeat oral contraception prescriptions through pharmacies will ‘increase choice and improve access’, describing community pharmacies as ‘convenient and non-stigmatising places to access sexual and reproductive health services’.
But while the NPA has developed resources for members who do want to begin offering the service, Mr Kaye said that ‘the chances of a successful national rollout of the oral contraception service are much reduced by a decade of chronic underfunding which has brought pharmacies across England to crisis point’.
‘Rather than implementing new NHS services, pharmacy owners are being forced to apply most of their energy to keeping their business afloat’, he said.
Meanwhile, Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp) said that AIMp member pharmacies ‘have always been keen and proactive to deliver pharmacy services’, but said that the current model, ‘where pharmacies are asked to do more for less’, with no new money being added to the sector’s flat annual ‘global sum’ payment to fund additional services, was ‘unsustainable and cannot continue’.
She added: ‘It is disappointing to see that during these tough times when our sector is barely able to keep its ahead above the water and with our workforce being exhausted we are being asked to deliver more services without any additional funding or resource.’
Dr Hannbeck also condemned the imposition of and late announcement of the launch date, saying: ‘It is also clear that the current PSNC approach is not working and it requires change. It must also be understood very clearly by both DH and PSNC that whether negotiated or imposed pharmacies need time to understand, plan and integrate new services into the very busy, business as usual days.’
A spokesperson for the Company Chemists’ Association (CCA) said that while community pharmacy has ‘huge potential to meet the contraceptive needs of women, increasing access and creating much needed capacity across primary care’, ‘pushing through the rollout of this service, despite the warnings of the negotiator, representative bodies, and contractors shows a worrying disregard for the reality within the community pharmacy sector’.
They added: ‘The existing contractual agreement was finalised before the pandemic, rampant inflation, ever growing workloads, and continuing pressures on businesses. Whilst many pharmacies will no-doubt do their best to meet patient needs, the funding of community pharmacy is broken and needs to fundamentally change.
‘With ambitious commissioning, joint implementation with the sector, and the critical new investment needed, community pharmacy could make a huge impact on women’s contraceptive care. Pharmacy has a history of delivering at scale, and at speed. But the sector cannot continue on goodwill alone.’
DHSC and NHSE have been approached for comment.
Earlier this year, pharmacy leaders also criticised NHS England over a new ad campaign to redirect GP patients to pharmacies, for which they said community outlets did not have capacity.
A version of this story was first published by Pulse’s sister title The Pharmacist