Rachel Carter speaks to Amarachi Inechi, a pharmacist at Attwood Green Pharmacy, about delivering sexual health services in the heart of Birmingham.

Attwood Green Pharmacy is situated between two of Birmingham’s universities, and just a short walk from the bustling city centre. It was this prime location, surrounded by students, young families and young professionals, that made it an ideal contender for delivering sexual health services, says pharmacist Amarachi Inechi.

The pharmacy is commissioned by Umbrella, the city’s main sexual health provider and part of University Hospitals Birmingham NHS Foundation Trust. Umbrella won the contract approximately three years ago and invited local pharmacies who were interested in offering sexual health services to bid for the chance to do so.

Attwood Green is now one of 40 pharmacies delivering a ‘tier two’ sexual health service. This involves providing free condoms and emergency contraception, but also starting people on the contraceptive pill, supplying testing kits for sexually transmitted infections, and administering the contraceptive injection, Mr Inechi says.

‘Novel service’

The pharmacists attended an all-day training with a sexual health specialist to get them ready for delivering the service, which was largely focused on consultation.

'Giving the morning after pill is something that pharmacists do already, so this was much more about the conversations we would be having about a person’s sexual history, for example, or the importance of getting tested for STIs,' Mr Inechi says.

'We also discussed how we would make decisions about the type of contraceptive pill a patient should be started on and learned effective injection technique.'

Administering the contraceptive injection is also an element of the service that makes it feel 'novel', Mr Inechi says, adding that in his work as a locum pharmacist he’s not come across another area in the country where pharmacists are doing this.

‘Detailed and intricate’

The service is largely provided by the pharmacists at Attwood Green, but Umbrella did provide training for counter staff, so they can understand how it works in practice, Mr Inechi says, and assist with some of the more straightforward tasks.

For example, patients can go online and order a testing kit for STIs to be delivered to the pharmacy, where they present a collection code. The pharmacy staff can provide this kit to patients and explain how to use it, as well as hand out condoms.

'The pharmacist’s involvement is needed for the more detailed, intricate work, such as the injection or if someone comes in for the contraceptive pill,' Mr Inechi says.

Having now run the service for a couple of years, the team have worked out that they need two pharmacists on duty on one day per week, one to manage 'the everyday running of the pharmacy' and the other to handle the Umbrella requirements.

'If people need the injection or they want to start on the pill, then we try and schedule for them to come in on the day with two pharmacists,' Mr Inechi adds.

'We will never turn people away, but we just explain that if they come in on that day then there will be less of a wait - over time we’ve built up a relationship with our regular patients and so they know that Thursday is the best day to come.'

‘Financially rewarding’

Mr Inechi says one of the most valuable benefits for patients is the 'convenience' that the service offers - it has removed a long wait in a walk-in centre, or a visit to the GP, and people can now come into a pharmacy and be seen within 10 minutes.

As a result, the service has been very popular, with an average of 20-30 patients making use of it each week - and it has been financially rewarding, he adds.

All services are completely free of charge to the patient and the funding for the pharmacy is set up so that each individual sexual health service provided is worth a fee. For example, free condoms carry a smaller fee compared to starting a patient on a pill. The pharmacists record what services they have provided on PharmOutcomes and Umbrella send a payment at the end of each month.

There were also no start up costs, Mr Inechi says, because most of the products were already being dispensed on prescription anyway, or available for purchase - 'the only thing you’ve got to make sure you have is a suitable consultation room'.

‘Research your community’

Mr Inechi says his one piece of advice to other independent contractors looking to set up a sexual health service is to look at the community and environment they are working in to see if there is a local need, before making the decision to set it up.

'It’s definitely one of the best services I’ve been involved in as a pharmacist, because it takes you away from the everyday dispensing of prescriptions,' he adds.

'It gives you a more clinical role and you’re face-to-face more with customers, and so in that sense it is rewarding - and because it will cost you nothing, it’s rewarding both professionally and financially as well.'