The Pharmaceutical Journal Vol 264 No 7078 p44
January 8, 2000 News

Emergency contraception trial in Manchester pharmacies

Sixteen community pharmacies in Manchester, Salford and Trafford - a health action zone area - are taking part in a pilot scheme for the supply by designated pharmacists of hormonal emergency contraception under a group protocol. The project started on Christmas Eve in order to be operational over the millennium holiday, when HAZ officers feared that there could be an upsurge in unwanted pregnancies. The project has its roots in a joint meeting of the Manchester local pharmaceutical committee and Salford and Trafford LPC which was held to identify new service areas for pharmacies. Local pharmacists were most keen to get involved with medicines management, but it was emergency contraception that the HAZ wanted to take forward. Mrs Karen O'Brien (community liaison pharmacist, Manchester health authority) told The Journal on January 4 that a group protocol for pharmacists had been devised from protocols used at Brook advisory centres and other local family planning clinics. The protocol was then approved by Dr Rosemary Kirkman (consultant, Palatine Centre, Manchester) as the medical practitioner who would take responsibility for the supply of the PC4 emergency contraception treatment.

Emergency contraception is now available for worried women at 16 Manchester pharmacies (posed by model)

Before they were allowed to join the scheme, all the pharmacists involved had to complete the Centre for Pharmacy Postgraduate Education's contraception course and undertake a further half day of local training, which included an examination. The training included when to supply PC4, when to refuse it, when to refer the client to another agency and what other information and advice on contraception should be provided.
Local dissemination of information on the availability of the pilot service was through posters in public places and the National Health Service's West Midlands NHS Direct telephone helpline.
Mrs O'Brien said that at least another 50 local pharmacists wanted to join the scheme. They would shortly be receiving a letter advising them to take the CPPE course, after which further local training would be arranged.
Mr Paul Benson (chairman, Manchester LPC) said that when a woman requested emergency contraception at a participating pharmacy, the designated pharmacist would take her to an area where privacy could be assured (this might be the dispensary). During a consultation that would take about 10-minutes, the pharmacist would establish whether the client fitted the protocol for supply of PC4. If she did, then both the pharmacist and the client would sign a form and the supply would be made. The client would be encouraged to take the first two tablets immediately under supervision and the precise time when the final two tablets were to be taken would be agreed.
Advice on future contraception would also be given. Participating pharmacists received a £10 fee per consultation, plus the cost of the PC4.
The pilot is to run until the end of March, when it will be evaluated prior to a wider roll-out in the area.
Mr Benson said that the pilot service was a fantastic breakthrough. "We hope that this sets a precedent," he said.
It is already known that at least five supplies of PC4 were made by participating pharmacists in the first 12 days of the service.
Mrs O'Brien added that local pharmacists had identified 13 new services that they would like to provide. She wanted to get three of these up and running before April.
"PC4 was not the pharmacists' top choice, but this was a window of opportunity that could not be missed" Mrs O'Brien said. "We have got to be able to expand our repertoire of services. Pharmacy is moving in the direction of services. Nurses have already done it, and so must we."