Blog: Why contraception in England needs national commissioning approach

The walk of shame or the stride of pride? Often the conversation about access to emergency contraception is positioned in these types of value-laden terms rather than consistent access to fundamental healthcare.  

Emergency Hormonal Contraception (EHC) is available in pharmacies across the country. However, the exact specifications of the service can vary widely, depending on criteria such as your age or where you live.

The CCA was pleased to have the opportunity to give evidence today at the All-Party Parliamentary Group (APPG) on Sexual and Reproductive Health’s inquiry into access to contraception. Almost six years since local authorities became responsible for contraception services, the APPG has growing concerns about fragmented commissioning of these essential services.

These differences can even manifest in two pharmacies on the same street (if they are on the boundary of two local authorities). A woman could pick up free EHC from one pharmacy as part of a commissioned service, yet by walking a few minutes down the road, she may have to pay up to £30 for the same treatment if a service is not available or she is deemed ineligible for it. The varying experiences of women getting EHC from their pharmacy can cause unnecessary worry and stress. At a time when people may feel concerned or anxious, it is particularly important that consistent care is readily available in the community.  

I was pleased to be able to coordinate the CCA’s written response to this inquiry, in which we call for a single national commissioning specification to be used by all commissioners in England. Valuable insight from our members highlighted the many variants and inconsistencies in EHC commissioning around the country.

Because of these differences, women may be too young, too old or lacking the required postcode to be eligible for free EHC from a community pharmacy. In fact, even if they are the ‘correct’ age and live on the ‘right’ street, there are then inconsistencies in what product is offered as part of the service (i.e. if the treatment is effective up to 120 hours after intercourse or not).

Compared to our Scottish and Welsh neighbours, England is lagging behind when it comes to consistency of emergency contraception access. Scotland and Wales have their own nationally commissioned services for EHC, meaning that women of any age can get emergency contraception free of charge at any community pharmacy. I think that this consistent care provision throughout the country is hugely beneficial to the public and the healthcare professionals delivering the service.

Contraception is a fundamental right for all people and community pharmacies, as the health and wellbeing hubs of every community, are perfectly placed to deliver the care the public needs and deserves.

I believe that addressing the inconsistencies in EHC services available in pharmacies will be hugely beneficial to the health and wellbeing of the public. Wherever they are, women should be confident in the knowledge that they can access free EHC and expert advice when they walk into any community pharmacy.

Mary Gough

Policy & Communications Officer

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