Jacqueline Campbell – director, superintendent pharmacist and IP at Pritchards Pharmacy, Prestatyn – talks to Saša Janković about her oral contraception supply service.
Service type: Oral contraception supply
Name and location of pharmacy: Pritchards Pharmacy, Prestatyn
Name of superintendent pharmacist: Jacqueline Campbell
When did you start offering this service?
I qualified as an IP in October 2019 with oral contraception as my scope, and my prescription pad arrived in March 2020. It was quite timely as the local sexual health drop-in clinic had obviously closed, so I was getting asked to do video consults with lots of patients who would have normally gone there.
Why did you start offering this service?
We are part of Betsi Cadwaladr University (BCU) Health Board who are incredibly supportive of independent prescribing, and in fact our chief pharmacist would like an IP in every pharmacy. I was asked three years ago if I’d do the course, and the scope I was offered was contraception. One of my local surgeries was a managed practice and it was felt it would help them if I could take their contraceptive patients.
How much did it cost to set up the service?
My IP course was funded by the Health Board, but I had to self-fund the days out of practice – you have to do 90 hours with your mentor – and I had to go to Cardiff. It’s quite an investment to get qualified as an IP but I’ve always tried to be an early adopter and if the service is there to be offered we should take the opportunity to do it or another profession will jump in.
What, if any, training did you or other team members have to undergo?
The Health Board said anyone doing prescribing must also offer the acute conditions service so I trained in that as well. It was a lot of work but really rewarding. I’ve met great people and am part of a brilliant network of IPs in North Wales and a WhatsApp group across Wales to share stories and advice on our services.
In a nutshell, what does the service involve?
With the contraception supply, rather than just ordering a repeat patients are getting a full review from someone with an interest in contraception. It takes 30-40 minutes for a proper review, for a first appointment. I have to inform the patient about what I can supply and be very mindful of their choice, as if you give them something they want to use they are more likely to use it.
Also deprescribing comes into it. I’ve seen half a dozen women who I suggested stop the pill as they are over 35 and a smoker, or on the combined pill and getting migraines, and a thorough review brings these things up.
It’s been particularly useful during the pandemic, because if patients needed BP monitoring for the combined pill but couldn’t see an HCP in person for this then I could switch them to the progesterone-only pill (POP). Similarly, if they couldn’t get in for the contraceptive injection I could switch them to the pill, and they could come in to the pharmacy and pick them up.
Are there any opportunities to sell OTC or prescription products during or after the consultation?
The nice thing is that contraception links in with EHC so I can discuss regular contraception with EHC patients and start them on the pill if they want, and advise on the full range of contraception options.
How have patients responded to the service?
Patients find the oral contraception service really useful – in particular on a Saturday or out of hours when surgeries are closed or in the late afternoon when they have no appointments left. An appointment is not always necessary and I’m quite happy to see patients at the weekend. People wanting the pill are not poorly so they go to work Monday to Friday and don’t need to come in till the weekend, and of course I can do telephone reviews as well.
Roughly how often each month do you carry out the service?
The Health Board would like 15 a week but I probably only see half that. I’m working with the surgery to set up a pathway for them to refer patients to me rather than it being ad hoc referrals from them or self-referrals from the patient.
How much do you charge for the service?
It’s a NHS service commissioned by BCU so it’s free to the patient.
Would you recommend offering this service to other contractors?
We have the POP over the counter now, so we talk to patients all the time about contraception and there’s lots of information about it, but I’d still recommend oral contraception as an option for IPs to consider as it fits really well in pharmacy.
I see all age ranges but I find it very rewarding consulting with young people and it has really honed my skills in dealing with this age group. I also see a lot of women who have just had babies, and this is a great way to build relationships between them and our pharmacy.
I’m taking part in a paid CPD pilot for Healthcare Inspectorate Wales (HIW), and I’ve chosen to use this to review my contraception service with a view to expanding my scope by working with the mentor who took me through the initial IP training. My aim is to become more of a sexual health service offering STI screening, and linking in with midwives and health visitors.