Providing NHS and public health pharmacy services

Community pharmacy is well established in the provision of locally commissioned contraception and sexual health services.

Chapter 2 of the NHS Long Term Plan (LTP) highlights the importance of NHS services complementing the action taken by local government to support the commissioning of sexual health services. The LTP also facilitates exploration of the future commissioning arrangements to widen access and create capacity where needed in sexual health services. Public Health England’s 2019 resource for commissioners and providers highlighted the role community pharmacy can play in supporting ongoing contraception. In response to this, and in line with the Community Pharmacy Contractual Framework (CPCF): 2019 to 2024 commitment to ‘test a range of prevention services’, a tiered pharmacy contraception service has been designed.

The Delivery Plan for recovering access in primary care (May 2023) highlighted the ambition to expand the PCS to increase access to and convenience of contraception services in line with the Government's Women's Health Strategy for England (August 2022) that flagged community pharmacy had a part to play in increasing choice in the ways people in can access contraception.

The aim of the Pharmacy Contraception Service (PCS) is to offer greater choice for people in terms of where they can access contraception services and create additional capacity in primary care and sexual health clinics (or equivalent) to support meeting the demand for more complex assessments.

This service will support the important role community pharmacy teams can play in helping address health inequalities. The service will help to provide wider healthcare access in local communities and signpost service users to local sexual health services in line with NICE guideline NG102.

What is good about the NHS Pharmacy Contraception Service?

What challenges have you overcome in providing the NHS Pharmacy Contraception service?

Top tips for delivering the NHS Pharmacy Contraception service

Managing professional anxiety

Objectives of the service:

Service objectives:

• To provide a model for community pharmacy teams to either initiate provision of oral contraception or continue the provision of oral contraception supplies initiated in primary care or sexual health clinics (or equivalent). Both models will be undertaken using patient group directions (PGDs) to support the review and supply process.
• To establish an integrated pathway between existing services and community pharmacies that provides people with greater choice and access when considering continuing their current form of oral contraception.

On this page, you will find a collection of resources to support you in your preparation for delivering this service. We recommend that you start by familiarising yourself with the service specification, which can be found under the first tab below, before considering the competency requirements and working through the recommended training modules where required. If you feel that you would benefit from further reading, we recommend that you access the further learning resources.

NHS Pharmacy Contraception Service - service specification

The first step in becoming ready to deliver this service is accessing and working through the Service Specification

Service specification

There is also a Toolkit (coming soon) associated with this service which will help with implementation, click on the link below to access this when available.

Competency requirements

Before commencement of the service, the pharmacy contractor must ensure that pharmacists and pharmacy staff providing the service are competent to do so in line with the specific skills and knowledge in paragraph 5.3 of the service specification and the relevant PGDs. This may involve completion of training.

Competency evidence

The pharmacy contractor must keep documentary evidence that all pharmacists and pharmacy staff involved in the provision of the service are competent with regards to the specific skills and knowledge that are appropriate to their role, and to the aspects of the service they are delivering.

Pharmacists providing the service will be personally responsible for remaining up to date with the skills and competencies identified in paragraph 5.4 of the service specification.

Recommended training modules

To deliver this service, the pharmacist should have evidence of competence in the clinical skills and knowledge covered in the training modules listed in the table below.

NB – packages that are highly recommended are indicated by an asterisk *

Safeguarding Level 3 (MANDATORY see service specification 3.7 for more details). Pharmacists must complete one of the Safeguarding level 3 training materials below OR have direct access to professional advice from someone who can advise on Safeguarding at Level 3.
elearning for healthcare Safeguarding Children and Adults Level 3 for Community Pharmacists - video	This is a recording of the Level 3 Safeguarding webinar tailored specifically for staff working in community pharmacies hosted by NHS England’s Community Pharmacy and Safeguarding teams. The session was led by Kenny Gibson MBE, National Head of Safeguarding, who was joined by Ade Williams, Superintendent Pharmacist at Bedminster Pharmacy, Victoria Steele, Superintendent Pharmacist at Lloyds Pharmacy, and Marc Donovan, Chief Pharmacist at Boots UK. The panel discussed the signs of abuse and what to do if these signs are recognised in community pharmacy.	This learning takes an estimated one hour to complete.
or
elearning for healthcare Safeguarding Children and Young People – Safeguarding Children Level 3	Safeguarding Children and Young People Level 3 covers a wide range of topics including management of sudden or unexpected death in childhood, parental risk factors, unexplained injuries, neglect in a disabled child, fabricated and induced illness and adolescents presenting with suspected sexual assault.	This learning takes an estimated five hours to complete.
Consent and history taking
elearning for healthcare Sexual and Reproductive Health (e-SRH) - section 2: Consent and history taking	The following subsections of the Faculty of Sexual and Reproductive Healthcare (FSRH) Sexual and Reproductive Health (e-SRH) Consent and history taking unit, and associated assessments: 02_01: Health history and risk assessment: This unit looks at the taking of a medical history, including sexual history. It also discusses risk assessment for sexually transmitted infections (STIs) and pregnancy. 02_02: Confidentiality, chaperones, and consent: This unit discusses the principles of confidentiality in sexual and reproductive health and the provision of a chaperone for intimate examinations. It also looks at the consent requirements for tests and examinations or procedures.	This learning takes an estimated one hour and 30 minutes to complete.
Emergency contraception *
CPPE Emergency contraception e-learning and associated e-assessment	This e-learning and associated assessment will help you to identify who may need advice and support, show how you can give that support and help you find the best course of action. It includes information on emergency hormonal contraception, and the intrauterine device.	This learning takes an estimated three hours to complete.
Contraception *
CPPE Contraception e-learning and associated e-assessment	This e-learning and associated assessment will equip you with the up-to-date skills and knowledge that you need to confidently support and advise patients who use or might use contraception.	This learning takes an estimated six hours to complete.
CPPE Shared decision making on initiation of contraceptive pills – Top tips.	In response to the launch of the NHS Pharmacy contraception service, we have created this video, Shared decision making on initiation of contraceptive pills – Top tips. It introduces topics around shared decision making on initiation of contraception, within this service. These include the choice of pills, and practical considerations for running the service. The accompanying PDF contains links to references that are included in the video.	This learning takes an estimated half an hour to complete.
­or
elearning for healthcare Sexual and Reproductive Health (e-SRH) - section 3: Contraceptive choices, and associated assessments	The following sub-sections of the Faculty of Sexual and Reproductive Healthcare (FSRH) Sexual and Reproductive Health (e-SRH) Contraceptive choices unit, and associated assessments:   03_01: Mechanism of action, effectiveness and UKMEC: This unit will give an overview of the contraceptive choices that are currently available and explore their effectiveness. It will outline the principles of assessment so that safe contraceptive choices can be offered using evidence-based guidance. The session will also discuss the mechanisms for initiating and switching methods. 03_02: Choosing contraceptive methods: This unit will discuss the principles, practical application and various ways of exploring an individual’s preference when wanting to start or change their method of contraception. 03_03: Combined hormonal contraception: This unit looks at the use of combined hormonal contraception (CHC) methods containing oestrogen and progestogen. It gives an overview of the advantages, disadvantages and possible side-effects, as well as how to counsel individuals wishing to commence or continue using CHC. 03_04: Progestogen only methods (oral and injectable): This unit details the oral and injectable progestogen-only (PO) contraceptive methods, their advantages and disadvantages, including side-effects and contraindications. Safe prescribing and administration will also be discussed. 03_07: Barrier Contraceptives: This unit will discuss barrier methods of contraception, including their efficacy, advantages and disadvantages. It also explores how to undertake a consultation with an individual, considering barrier methods of contraception, including counselling, information-giving and practical aspects.	Depending on prior experience, it is estimated that this will take you approximately three hours and 30 minutes to complete.
and
Faculty of Sexual and Reproductive healthcare. Sexual Health (PWP) - External resources section - FSRH Contraceptive Counselling e-learning	This e-learning programme aims to support you to deliver effective contraceptive care. It features a range of case studies, video content and additional reading resources to support your learning.	This learning takes an estimated two hours to complete.
Sexual health *
CPPE Sexual health in pharmacies e-learning and associated e-assessment	This e-learning and associated assessment aims to support the community pharmacy team in developing and providing a sexual health service. This programme focuses on sexually transmitted infections (STIs).	This learning takes an estimated six hours to complete.
or
elearning for healthcare Sexual and Reproductive Health (e-SRH) - section 9: STIs, and associated assessments	The following sub-sections of Faculty of Sexual and Reproductive Healthcare (FSRH) Sexual and Reproductive Health (e-SRH) Sexually transmitted infections (STIs) unit, and associated assessments: 09_01: Epidemiology and transmission of STIs: This session describes the epidemiology, risk factors, signs, symptoms and complications of common sexually transmitted infections (STIs) in the UK. 09_02: STI testing: This session will cover testing for common sexually transmitted infections (STIs) and blood-borne viruses (BBVs). It will explore current testing options for these in the community and home testing and when to refer to specialist services. This session looks at the diagnostic methods used for vaginal discharge. It describes asymptomatic screening for STIs in men and women. 09_03: STI management: This session gives an overview of the current management of commonly encountered sexually transmitted infections (STIs). 09_04: Partner notification: The session will explore the principles, practical application and various ways of carrying out partner notification (PN) when dealing with sexually transmitted infections (STIs).	Depending on prior experience, it is estimated that this will take you approximately three hours to complete.
Managing side-effects and problems
elearning for healthcare Sexual and Reproductive Health (e-SRH) - section 5: Contraception: managing side-effects and complications, and associated assessments	The following sub-sections of Faculty of Sexual and Reproductive Healthcare (FSRH) Sexual and Reproductive Health (e-SRH) Contraception: managing side-effects and complications unit, and associated assessments:   05_01: Managing Bleeding Problems in Women using Contraceptives: This unit examines the short and long-term bleeding patterns associated with various methods of contraception and explores the management of women experiencing problematic bleeding. 05_02: Managing Contraceptive Side-effects: This unit will identify the side-effects associated with the use of hormonal contraceptives and offer guidance on how to manage these side-effects to encourage concordance with the method of choice. 05­_03: Managing Side-effects and Complications of IUD and IUS: This unit outlines the side-effects and complications of intrauterine device (IUD) and intrauterine system (IUS) use. It discusses both immediate side-effects on insertion and problems that arise with long-term use. It also outlines the management plan when a complication arises.	This learning takes an estimated one hour and 30 minutes to complete.
Other training to support clinical practice
CPPE Documenting in patient clinical recordse-learning	Pharmacy professionals, as an integral part of the NHS Long Term plan, are now routinely working in GP practices, care homes, secondary care, community and commissioning in a multidisciplinary team. This growing infrastructure demands the need for effective communication between healthcare professionals working in different sectors. This programme will support you with documenting in patient clinical records, to enable continuity of patient care in integrated local services.	This learning takes an estimated six hours to complete.
CPPE Remote consultationse-learning	This e-learning is for all pharmacy professionals undertaking virtual consultations. It has been developed to support you in applying your existing consultation skills when undertaking consultations via video and over the phone.	This learning takes an estimated two hours and 30 minutes to complete.
elearning for healthcare Patient Group Directions e-learning	The aim of this e-learning programme, which was developed by the NHS Specialist Pharmacy Service (SPS), is to support healthcare professionals and organisations who are considering, developing, authorising and using patient group directions (PGDs) to deliver healthcare services, in line with legislation and the NICE medicines and practice guideline (MPG2).	This learning takes an estimated one hour to complete.
CPPE Consultation skills for pharmacy practice: taking a person-centred approach distance learning programme and associated e-assessment	This is a downloadable programme that enables you to describe the key communication and consultation skills and techniques required for person-centred care. You will learn how to explore a person’s beliefs, ideas, concerns and expectations and tailor the consultation to help them get the best from their medicines and to make informed health and lifestyle choices. The programme also develops your skills in engaging the person in shared decision making and enabling them to be a true partner in the consultation.	This learning takes an estimated ten hours to complete.

 

Online tools to support contraceptive choices

Pharmacists must be familiar with at least one online contraception consultation tool. You will use these tools to support shared decision making in the contraception consultation. Suggested tools are:

• Brook
• Your contraception guide (NHS website)

Further learning resources

If you have identified further learning needs or would like to learn more about this topic to support your service delivery, then you may benefit from accessing the following learning resources.

Measuring blood pressure

Most pharmacies will have their own standard operating procedure for the measurement of blood pressure. There are several resources that you can use to develop your competence to measure blood pressure.

CPPE blood pressure monitoring video

This is a CPPE video to support you to measure blood pressure using an automated device.

Click here to download a transcript for this video.

British and Irish Hypertension Society resources
The British and Irish Hypertension Society (BIHS) offers a variety of different poster and video resources, including: How to measure blood pressure and Ambulatory blood pressure monitoring

Please note that the BIHS are unable to answer contractor questions about stock availability and other questions relating to equipment, such as price.

If you would like further information about this service, you can access Community Pharmacy England's information pages.