This week marks Sexual Health Week. As a new member of CCA staff who joined from the sexual health charity FPA, (formerly known as the Family Planning Association), it seemed like a good opportunity to think about the role of community pharmacies in the provision of sexual health services.*
In the sexual and reproductive sector, fragmented local authority commissioning, and cuts to public health budgets leading to services closures and reduced access to contraception, are common. At the same time, GPs face unprecedented demand for appointments. Specialist sexual health services are struggling to cope with record demand and a rise in the number of sexually transmitted infections. Between 2009 and 2018, for example, PHE figures show that rates of gonorrhoea increased by 249% and cases of syphilis increased by a staggering 643%.
While concerns about funding, commissioning and demand are by no means unique to the sexual and reproductive health sector, it has got me thinking about the role community pharmacies play in supporting good sexual and reproductive health.
As we all know, community pharmacies are one of the most frequented healthcare settings in the UK. They are often open in the evenings and weekends and located in the heart of communities, with over 99% of people living in areas of highest deprivation within a 20-minute walk of one. This convenience, combined with the relative anonymity provided by community pharmacies, makes them an ideal location for many people to access sexual and reproductive health services.
From the provision of emergency hormonal contraception (EHC) to the distribution of condoms, many community pharmacies already play an important role in making sexual and reproductive health support accessible.
However, community pharmacists have been playing an increasingly clinical role in the provision of care over the last few years. The direction of travel, with regards to their clinical responsibilities, has been clearly outlined in the new pharmacy contract and the role of community pharmacy in Primary Care Networks.
This suggests that, with the right funding and a creative approach to commissioning, community pharmacies could help reduce pressure on the NHS and support the evolving needs of patients, by going further in the provision of sexual and reproductive health services.
Many community pharmacies already provide a range of contraceptive services and STI treatment and testing. There are numerous examples of this, not least the Umbrella service, operated by University Hospitals Birmingham NHS Trust, which provides sexual and reproductive health services across Birmingham.
Community pharmacies are a core element of the service model and 174 community pharmacies, including many CCA pharmacies, offer either tier 1 or tier 2 sexual and reproductive health services. The more basic services consist of EHC, condoms and STI self-sampling kits, whilst those commissioned to offer more advanced service provide this, as well as oral contraception (both start up and continuation), the contraceptive injection, STI kit initiation, chlamydia treatment and Hepatitis B vaccinations.
Many community pharmacies face growing pressure and such an approach to sexual health relies on a long-term strategic vision as well as sufficient funding and holistic and collaborative approaches to commissioning.
However, at time when traditional services are so stretched that many women report struggling to access contraception, one third of births in England are unplanned or ambivalent, and syphilis rates are at levels not seen since World War 2, the role of community pharmacies in supporting good sexual health has never seemed as crucial.
*Sexual Health Week 2019 is run by Brook, the young people’s sexual health charity. The theme for this year’s awareness week is relationships, sex and disability. Community pharmacies have an important role to play in making sexual health accessible for all people, including those with disabilities.
Emily James
Policy and Programmes Manager