The progestogen-only pill (POP) should be reclassified to make it available over the counter without the need for a prescription and improve access for women across England, the All Party Parliamentary Group (APPG) on Sexual and Reproductive Health in the UK has recommended.
In a report, published on 10 September 2020, the APPG noted “a significant opportunity to expand the role of community pharmacists in supplying POP”, with independent prescribers and patient group directions (PGDs) already being used in some areas.
“Such initiatives are not only beneficial for women and alternate service providers, but evidence shows that they can encourage the use of contraception and a result may help reduce unintended pregnancies,” it said, adding that “an enhanced use of pharmacy independent prescribers or PGDs may be appropriate to increase access to contraception”.
The recommendations are the outcome of an inquiry originally launched by the APPG in 2019 in response to reports of women being unable to access contraception when needed, but which was then relaunched to understand the impact of the COVID-19 pandemic on women’s access to contraception in the spring and summer of 2020.
The APPG report said that the inquiry highlighted problems associated with funding, commissioning and workforce resulting in women having to travel “unacceptably” long distances or face long waiting times to access contraception.
It said that the inquiry had heard that “over 99% of people living in areas of highest deprivation” were within a 20-minute walk of a community pharmacy, and that there were “significant” opportunities to improve access to contraceptives in pharmacy settings, both to improve convenience and reduce the burden on other providers.
“We also heard a compelling case to change the classification of POP to make POP available over the counter, making it easier for women to access,” the report added. “As such this inquiry recommends the reclassification of the POP to make it available over the counter without a prescription as a pharmacy medicine.”
The change would bring the UK in line with many other parts of the world, where the POP is already available without a prescription.
The APPG also said that, given the “current discrepancies” in provision of emergency hormonal contraception, a single national commissioning specification for education, health and care services would be “beneficial”.
Finally, it said that guidance should be offered on the improvement of pharmacy settings to make it easier for women to access contraception, including more privacy for women to discuss needs; and on making information about contraception more visible in pharmacies.
“The restoration of services after the COVID-19 pandemic, along with the repurposing of the functions of Public Health England, provides a unique opportunity for national and local government to reshape contraceptive services according to the needs of women themselves and to make more efficient use of NHS resources,” the report said.