Improving access to oral contraception through GP–community pharmacy collaboration: a proof-of-concept pilot

The NHS pharmacy contraception service enables community pharmacists to initiate and continue oral contraception^​1–3​. Despite this additional pathway, many patients continue to request routine repeat prescriptions from general practice. This may create avoidable administrative and clinical workload while commissioned pharmacy capacity remains underused.

A collaborative proof-of-concept pilot was developed by Community Pharmacy Surrey and Sussex and a general practice-based Women’s Health Hub in Worthing, West Sussex. The project examined whether proactive identification and targeted communication could encourage suitable patients to use community pharmacy for ongoing contraception supply.

General practice clinical-system searches identified patients with an established oral contraception method who were receiving repeat prescriptions, including users of combined oral contraceptives and progestogen-only pills. Searches were repeated from September 2025 to April 2026. The cohorts included some patients who had already received a 12-month supply and were unlikely to need an immediate further supply.

Identified patients received an SMS describing the service and directing them to the NHS pharmacy postcode finder. The message presented pharmacy as an optional additional pathway and preserved patient choice.

GP and pharmacy teams agreed escalation and communication processes. Pharmacy consultations included the assessments required by the service specification. For combined oral contraception, these included blood pressure measurement, clinical history and body mass index assessment. Elevated BP readings triggered the agreed escalation pathway. A GP authority letter allowed participating pharmacies to undertake ambulatory blood pressure monitoring — where appropriate — through the NHS hypertension case-finding service. Patients were referred back to general practice when clinical concerns required medical review.

Across seven monthly search cohorts, 1,935 SMS messages were sent and 158 patients subsequently attended community pharmacy, representing an overall observed attendance of 8.2%. Monthly attendance ranged from 6.1% to 10.9%. This measure should be interpreted cautiously because the searches included patients who were not yet due for another supply.

Of the 158 attendees, 156 received oral contraception (85 received a progestogen-only pill and 71 received a combined oral contraceptive). Two patients taking combined oral contraception required further investigation after elevated blood pressure readings and were not included in the supply totals.

The attendees represented a broad adult age range and several ethnic groups. Most were recorded as white/British, consistent with the local population profile. The highest engagement was observed among patients aged 31–35 years.

The escalation pathway was tested in two cases involving elevated blood pressure. One patient had an initial reading of 130/90mmHg; pharmacy-led ambulatory monitoring produced an average of 126/77mmHg and combined oral contraception was continued. A second patient had a reading of 152/95mmHg and underwent ambulatory monitoring at the surgery after declining the pharmacy option. These cases showed the value of clear consent, escalation and information-sharing arrangements.

This pilot indicates that proactive GP identification combined with concise SMS communication can make patients aware of community pharmacy as an additional route for contraception care. It also demonstrates that general practice and pharmacy teams can establish workable governance arrangements for clinical assessment and escalation.

The results do not establish causality or quantify workload savings. There was no control group, the cohort searches included patients not yet due for supply, and attendance was observed over a relatively short period. Data collection consistency across sites was also a challenge. Accordingly, the attendance rate should not be interpreted as the proportion of patients who chose pharmacy at their next renewal opportunity.

Several practical lessons emerged. Messages should be concise, action-focused and timed close to the patient’s anticipated next supply, ideally within three months. GP endorsement may increase confidence in the pharmacy pathway.

Future evaluation should use patient-level follow-up, distinguish patients due for renewal from those holding longer supplies, measure changes in GP prescription activity and workload, and capture patient experience. Comparison with usual care would strengthen assessment of effectiveness and transferability.

Proactive signposting from general practice to community pharmacy is a feasible approach to increasing awareness and use of the NHS pharmacy contraception service. In this pilot, 158 patients attended pharmacy after targeted communication, and agreed pathways supported safe management when elevated blood pressure was identified. Wider adoption should retain patient choice, use timely messaging and be supported by clear clinical governance and robust evaluation.

Marie Hockley, deputy chief officer at Community Pharmacy Surrey and Sussex

Suneeta Kochhar, clinical director at NHS Surrey and Sussex