The news that pharmacies on the Isle of Wight have launched a scheme that will allow pharmacists to dispense a month’s worth of the progesterone-only contraceptive pill without a prescription has caught the attention of the nation.
Much of the furore has focused on the fact that the scheme is open to women over the age of 13, meaning pharmacists could supply under-16s with the pill without their parents’ knowledge.
The scheme was criticised in the national press, and at the height of hysteria the island’s Conservative MP Andrew Turner submitted an oral question to health minister Andrew Lansley over the plans, claiming: “Many of my constituents are horrified.”
With so much public unease, it’s easy to wonder what such a scheme actually brings for the profession.
The scheme on the Isle of Wight will mean that if a patient under the age of 16 presents at a pharmacy for EHC then they will be given one month’s supply of the contraceptive pill if the pharmacist deems it appropriate. They will also be referred to an outreach nurse or to their GP. Patients over the age of 16 will be referred to the sexual health service. And all patients will also be offered chlamydia screening and a supply of condoms.
The decision to offer the pill to women over the age of 13 differs from a similar scheme in Southwark and Lambeth PCTs, which only offers the contraceptive pill to women presenting over the age of 16, but it is in line with case law. A decision by the House of Lords in a 1985 case ruled that women under the age of 16 do have the legal capacity to consent to medical treatment without parental consent. And health secretary Andrew Lansley alluded to this in the House of Commons when asked about the scheme, stressing that young persons are competent to make such decisions.
Chief officer of Hampshire & Isle of Wight LPC Mike Holden says the negative publicity has not been helpful, but he says much of the commentary has been from ill-informed people. He says: “Everyone needs to understand it is not [primarily] aimed at people who are under 16. It is for people who are using EHC, so these are people who have already decided to engage in underage sexual activity.”
Pharmacist Cuthbert Chirinda completed training at Kings College London before he began offering the pill at his pharmacy as part of the Lambeth and Southwark PCTs pilot. He says that patients have been impressed by the opportunity to obtain the contraceptive pill at his pharmacy and he completed nearly 400 consultations during the one-year pilot.
Mr Chirinda says: “I think we have had a lot of improvement and patients were excited about it. We have done 400 consultations and patients like the fact that they didn’t have to book.”
Patients also appear to be benefiting from the scheme, as Mr Chirinda has seen a drop in the number of women presenting for EHC since he started the pilot. And 40 per cent of the patients receiving the pill in the pilot were first-time pill users, suggesting they would not have accessed long-term contraception elsewhere.
The patient benefits seem to be clear, but it still remains to be seen how much of an impact the negative coverage of the scheme will have on community pharmacy.
Industry leaders are convinced that patient confidence will not be affected by this latest pharmacy story, though. Chair of the RPS English Pharmacy Board Lindsey Gilpin says that she feels the backlash has more to do with attitudes to sexual behaviour in young people than people’s attitude towards pharmacists, but that the profession could do more to target those in positions of authority.
As Ms Gilpin says: “People do still trust their pharmacists.”
And a spokesperson from the NPA says the matter has been dealt with well by the Isle of Wight, adding: “The local NHS and pharmacy representatives on the Isle of Wight handled the matter with the confidence you would expect from people with the facts behind them.”
Mr Holden points out that the criticism seen last week came from a few uninformed commentators and says: “You can’t be tasked with making sure that people are informed before opening their mouths – and you can’t be held accountable for that.”
So whatever the latest coverage may have been, it seems that the Isle of Wight scheme could well be good for the sector as a whole.
If the public are convinced by the scheme, as patients were by the London equivalent, it could enhance the sector’s profile in the clinical services arena.
“This service has been provided with consummate professionalism.”
Sue Sharpe, CEO, PSNC
“Nowhere else, I am told, shares that approach. Many of my constituents are horrified.” Andrew Turner, Conservative MP, Isle of Wight
“The coverage of the service illustrates the need for attitudes and public awareness to be brought up to speed with developments in community pharmacy.”
Stephen Fishwick, head of external relations, NPA