EHC services are currently provided by an estimated 90% of local authorities in England, but only about 48% of community pharmacies are involved in these programmes
In a unified effort to improve women’s healthcare, four leading organisations—the Company Chemists’ Association (CCA), the National Pharmacy Association (NPA), the Royal Pharmaceutical Society (RPS), and the Faculty of Sexual and Reproductive Healthcare (FSRH)—are calling for the commissioning of a National Emergency Hormonal Contraception (EHC) service in England.
They are proposing that this service be provided free of charge through community pharmacies to women of all ages across the country.
They emphasised that such a service would “not only transform access to care for all women, but directly tackle health inequalities and vastly improve health outcomes.”
Ending the postcode lottery
The pharmacy bodies have also highlighted the need to end the "postcode lottery" that currently restricts equal access to these services.
They pointed out that EHC services are already widely commissioned by an estimated 90 per cent of local authorities in England, but only around 48 per cent of community pharmacies are included in these services.
Moreover, the lack of standardization and local variations in service provision mean that access to EHC services can depend heavily on one's postcode.
Some pharmacies have to determine the level of care they can offer to a woman based on the patient's postcode.
“Patchy and inconsistent local commissioning has created a postcode lottery of access for a service which clearly has significant national demand,” they noted.
Therefore, the CCA, NPA, RPS and FSRH are urging the government to eliminate this postcode lottery and ensure that all women, regardless of age, can access a nationally commissioned EHC service at their local community pharmacy.
Highlighting key issues with the current arrangements, they noted “an incomplete understanding of the availability of free at-the point access EHC services.”
Furthermore, they pointed out that since these services are commissioned by local authorities, they cannot be promoted nationally; and there are no national standards and training requirements for pharmacists and pharmacy teams to support the service.
All of these issues, they argued, could be resolved through the commissioning of a nationwide EHC service, mirroring the successful approaches adopted in Scotland and Wales.
EHC services in Scotland and Wales
For many years, national EHC services have been commissioned in Scotland and Wales, leading to significantly fewer women seeking EHC from General Practice and resulting in lower abortion rates per 10,000 female population in both nations.
Despite a growing number of innovative routes to purchase EHC through pharmacies, including online private pharmacies, the organisations stressed that the greatest barrier to accessing the service and tackling health inequalities remains the cost.
“NHS commissioned services, free at the point of use, would ensure that women who need the service, can access it with ease, irrespective of their personal circumstances,” they stated.
The CCA, NPA, RPS, and FSRH are urging the government and the NHS to follow the successful examples set by Wales and Scotland and commission a national advanced EHC service in England.
They believe that additional investment in EHC and contraception services through community pharmacy would support the newly published Women’s Health Strategy, whilst also dramatically improving access, and setting higher standards of care across the country.
Unplanned pregnancies are more prevalent in areas with higher deprivation, they highlighted, citing the Department of Health & Social Care data indicating that girls, adolescents, and women in the most deprived areas are more than two times more likely to have a termination than those in the least deprived.
They warned that unplanned pregnancies may lead to an increased risk of adverse health outcomes.
Acknowledging the issue, NHS England recently launched a Pharmacy Contraception Service, enabling women to obtain the oral contraceptive pill free of charge and further expanding the role of pharmacies in women’s health.
