Community pharmacy has an ‘important role to play’ in helping to increase the use of long-acting reversible contraception (LARC) to support a reduction in unintended pregnancy rates and costs to the NHS, a conference has heard.

Delegates at this year’s Pharmacy Show in Birmingham tuned into a presentation by superintendent pharmacist and clinical director Deborah Evans on the potential use of the contraceptive implant in community settings.

Having recently completed LARC fitting training herself, she talked to community pharmacists about how she believed having this qualification could help change the way they are seen by clients and patients.

The coronavirus pandemic had an impact on the fitting of implants, coils and other LARCs, noted Ms Evans – a situation that hasn’t yet ‘fully recovered’.

A recent analysis by our sister publication Nursing in Practice found that a lack of specialist nurses who are trained to fit LARCs was having a detrimental impact on patients who were facing long wait times or having to travel miles to have LARCs fitted.

However, the National Institute for Health and Care Excellence (NICE) recommends that in all contraception consultations, regardless of the setting, that they include ‘information around LARCs being the most effective method of contraception’, noted Ms Evans.

NHS England’s ‘vision’

The NHS Pharmacy Contraception Service was launched in April this year and allows pharmacists to manage the ongoing monitoring and supply of repeat oral contraception prescriptions, and will be extended to allow pharmacists to initiate oral contraception via a Patient Group Direction (PGD) from October 2023.

Ms Evans said this was ‘a bit of a game changer for community pharmacy, in establishing ourselves in the minds of our clients and patients as being a really important setting for contraception’.

And she highlighted that the vision of NHS England was to potentially see community pharmacies involved in ongoing monitoring and management of repeat LARCs – but not including coils. And a fourth tier of this project could potentially see pharmacists initiate LARCs such as injections and implants.

‘So, the vision is there from an NHS commissioning point of view,’ she told delegates.

She added: ‘The reason for this advice and this intent around the delivery of LARCs is because they are highly effective forms of contraception.’

The implant was ‘the most reliable form of contraception’ and ‘because it is so effective in preventing unintended pregnancies, it is highly cost effective’, noted Ms Evans.

‘The strategy is to increase the use of LARCs to reduce the unintended pregnancy rates and reduce costs overall to the NHS,’ she said.

‘So, I really believe that community pharmacy has an important role to play in this.’

Ms Evans highlighted examples where patients may struggle to access an implant on the NHS because of a lack of LARC fitters in rural settings, but also because of the ‘huge demand’ for the service in urban settings as well.

‘Giving access to this type of contraception is really important and is a priority,’ she added.

She talked pharmacists through the process of how to train to become an implant fitter in order to offer the service privately, including with the Faculty of Sexual and Reproductive Healthcare and a nurse trainer, and through examinations.

This training ‘is a significant commitment, but it’s also hugely rewarding’, she noted.

‘I think it will change your practice in terms of how you’re seen by your clients,’ said Ms Evans.