(2) what advice her Department has issued to pharmacy companies whose policy it is not to prescribe emergency contraception over the counter without prescription to under 16-year-olds; and if she will make a statement;
(3) which primary care trusts have made the prescription of the morning after pill to children under 16 years without parental authority a condition of granting a pharmacy licence; how many pharmacies have been refused a licence because of their refusal to comply with this condition; and how many (a) appealed against the decision and (b) were successful in such an appeal in the last year for which figures are available.
A primary care trust (PCT) decides applications to provide national health service pharmaceutical services under the NHS (Pharmaceutical Services) Regulations 2005 (SI 2005/641 as amended). Under Regulation 12, a PCT only grants an application if it is satisfied it is necessary or desirable to do so in order to secure the adequate provision of pharmaceutical services in a local neighbourhood. This is known as the control of entry test.
However, under the reforms we introduced in April 2005, certain types of application are exempt from that test (regulation 13), namely:
premises in an approved retail area which is over 15,000 square metres gross floor space and sited away from town centres;
premises which the applicant will keep open for at least 100 hours a week; or
premises within a new one-stop primary care centre.
It is only in respect of Regulation 13 applications that a PCT can directly specify that a pharmacy provides additional pharmaceutical services, from a list of services set out in the Pharmaceutical Services (Advanced and Enhanced Services) (England) Directions 2005 (as amended). The PCT must have specified what additional services are required in advance of the application. One such service a PCT may specify is the provision of emergency hormonal contraception (EHC) to females of child-bearing age. This is an enhanced service by virtue of Direction 4(1) (k) and possibly (m) if a patient group direction.
It is for the applicant to decide whether or not to make an application under one of these exemptions. If an applicant does not wish to provide the additional services specified by a PCT for an exempt application, it may instead apply to provide services under the conventional route in Regulation 12. This does not allow a PCT to specify additional services that applicants are to provide.
The Department does not collect data on the number of PCTs which have specified the provision of EHC as a required additional service for an application made under Regulation 13, nor the number of refusals of applications by PCTs on these grounds or subsequent appeals. However, The Information Centre for health and social care publishes general data on applications to provide pharmaceutical services and appeals annually. The next bulletin for the year 2005-06 will be published later this year.
The family health services appeal unit of the NHS Litigation Authority (NHSLA) deals with appeals relating to these regulations. The NHSLA produces an annual report every autumn. The website of the appeal unit at www.nhsla.nhs.uk reports details of appeal decisions, of which only one up until May 2006 related to EHC. This appeal was dismissed.
The information available is shown in the tables. Information on emergency hormonal contraception (EHC) supplied under a patient group direction (PGD) is not held centrally.
Family planning clinic services for Gloucestershire are provided by Cotswold and Vale primary care trust (PCT). The total number of occasions on which clinics run by this PCT prescribed post-coital contraceptives is published annually but the published figures include some instances where an intrauterine device was fitted. Cotswold and Vale PCT was created on 1 April 2002 and data for 2000-01 and 2001-02 relate to its predecessor organisations providing family planning clinic services, East Gloucestershire National Health Service Trust and Severn NHS Trust.
Number 2000-01 2,125 2001-02 1,652 2002-03 1,652 2003-04 1,462 2004-05 1,096 1 Data is collected by financial year Source: Information Centre for health and social care return KT31
Prescriber name 2002 2003 2004 2005 Cheltenham and Tewkesbury PCT 1,089 1,042 911 890 Cotswold and Vale PCT 1,472 1,501 1,354 1,155 West Gloucestershire PCT 1,404 1,475 1,345 1,265 1 The data show the number of times a prescription written by a prescriber for whom the PCT was responsible was dispensed either by a community pharmacy or by a dispensing doctor. 2 A full year’s data for 2001 is not available Source: ePACT