Dear Community Pharmacy colleague

Supplementary Guidance for the supply of Emergency Hormonal Contraception (EHC) from Community Pharmacies.

Scottish Government circular PCA (P) (2015)20 Community Pharmacy : Public Health Service Emergency Hormonal Contraception Updated Directions and Service Specification advises that from 1st October 2015, ulipristal 30mg can be supplied to patients requesting emergency contraception within 120 hours of unprotected sexual intercourse (UPSI) or contraceptive failure. There is no requirement for a PGD as ulipristal 30mg has been reclassified as a P medicine.

A PGD remains in place for supply of levonorgestrel 1500microgams for EHC within 72 hours of UPSI.

The circular states that “The pharmacist should refer to guidance on first line therapy as determined by the local NHS Board ADTC’s prescribing formulary, taking into account clinical need”.

Lothian Joint Formulary emergency contraception recommendations are:-

First Choice

·  Copper Intra-Uterine Device (where service available) (within120 hours of unprotected sexual intercourse or up to 5 days after predicted day of ovulation)

·  Levonorgestrel 1500micrograms (If IUD not available and within 72 hours of unprotected sexual intercourse)

Second Choice

·  Ulipristal 30mg (within 120 hours of unprotected sexual intercourse)

The table below compares the two oral EHC options within the Community Pharmacy Sexual Health Service

Levonorgestrel 1500 micrograms / Ulipristal 30mg
PGD required / Yes / No
Legal status / POM version to be supplied via PGD / P medicine (ellaOne®)
Licensed use for emergency contraception / Up to 72 hours after UPSI / Up to 120 hours after UPSI
Recommendations in Lothian Joint Formulary / See LJF section 7.3.5 Emergency Contraception http://www.ljf.scot.nhs.uk/LothianJointFormularies/Adult/7/7.3/7.3.5/Pages/default.aspx
Mandatory training required for pharmacists to provide service from 1 October 2015 / Yes – NES e-learning modules - Contraception Sept 2015 & *Child Protection 2013
http://www.nicpld.org/online/contraception_nes/#m0-introduction
http://www.nes.scot.nhs.uk/media/2115152/nesd0095_child_protectionenb.pdf
Type of prescription used / CPUS prescription
How to claim payment for service / Via monthly PHS Claim Form

* If the Child Protection 2013 NES e-learning module has already been completed and the assessment undertaken satisfactorily there is no requirement at present to repeat the learning

Attached is a sample proforma which can be used for emergency contraception consultations, this will also be available on the NHS Lothian area of the community pharmacy website www.communitypharmacy.scot.nhs.uk

Regards

Stephen

Stephen McBurney

Primary Care and Community Pharmacy Co-ordinator

NHS Lothian