Priority 6 from the Contraception PSP

UNCERTAINTY: Does pharmacy provision of contraceptive services increase uptake and/or continuation of contraception? (JLA PSP Priority 6)
Overall ranking 6
JLA question ID 0049/6
Explanatory note Since 2013 the responsibility for commissioning contraceptive services moved to local councils. A report  from the Advisory Group on Contraception (AGC),  details that half the councils had cut their budgets  and - 1 in 3 councils in England has closed services since 2015. The majority of individual who use community sexual health clinics are women (9 out of 10) younger women use the services most, the majority of visits are about contraception (3 out of 4). Oral contraception is the most commonly prescribed method (47%), The NATSAL3 suggests overall  1 in 6 pregnancy is unplanned but this is almost 1 in 2 in women aged 16-19years old. Against a background of reduced funding and difficulty accessing services women and healthcare providers are keen to reduce barriers and look at cost effective ways for women to access free contraception.  Internationally contraception can be brought over the counter, in the UK emergency contraception is available at pharmacies and is free to young women,  but there is concern about the high price charged by pharmacies for emergency contraception. The overall impact on accessibility is uncertain. NHS prescriptions for EC have been falling since it was made available over the counter. There is overlap between this question and priority 13.
Evidence

Pharmacy-based interventions for initiating effective contraception following the use of emergency contraception : a pilot study. Michie L , Cameron ST , Glasier A , Larke N , Muir A and Lorimer A, Contraception, 2014, 90(4), 47.10.1016/j.contraception.2014.05.004
Health Research Classification System category Reproductive Health and Childbirth
Extra information provided by this PSP
Original uncertainty examples

“Can a pharmacist dispense any form of contraception?  (HCP) “  ~  "study the effects of pharmacy-issue of repeat pills on continued use of oral contraception vs switching to LARC or reverting to less effective methods/stopping contraception despite not wishing to conceive (compared with GP-issue)” (both)      “I'd like to better understand how the oral contraception pill can be accessed on repeat prescription” (Patient). 
Submitted by Healthcare Professionals x 19~Patients x 19~Both x 10
PSP information
PSP unique ID 0049
PSP name Contraception
Total number of uncertainties identified by this PSP. 57  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 April 2017