Reducing teenage pregnancy – How community pharmacy and local government collaboration has driven progress
Teenage pregnancy has long been a marker of health inequality in England. The provision of locally commissioned sexual health services, including those provided by community pharmacies, has been part of local authority efforts to tackle local health inequalities and improve outcomes.
A report from the Local Government Association (LGA) highlights how local government working with community partners, like community pharmacy, have worked together to reduce under-18 conception rates. It looks at evidence, challenges, and opportunities for further progress.
The LGA report, also explores how integrated, youth-centred approaches have reshaped access to sexual health services.
Examples of community pharmacy involvement
The report highlights two areas, Liverpool and Barking and Dagenham to demonstrate how pharmacy-led services and youth engagement have contributed to reductions in teenage pregnancy.
Liverpool
Liverpool City Council has worked with its local pharmacies to develop an enhanced offer around sexual health. Commissioning 18 pharmacies to offer STI testing and chlamydia treatment and initiate oral contraception prescriptions for routine contraception. A further 76 pharmacies provided emergency contraception.
Liverpool has nearly halved its under-18 conception rate — from 35.6% in 2012 to 18.2% in 2022 (according to local government data); through its efforts to improve access to sexual health services.
Most recently, Green Lane Pharmacy’s pilot of contraceptive implant services in Allerton, Liverpool marks a UK-first — showcasing how pharmacies can expand their role in frontline sexual health care. The initial 12-month pilot has been developed with the aim of increasing uptake of long-acting reversible contraceptive options and reducing rates of unintended pregnancies in Liverpool.
Commenting on local partnerships, Matt Harvey, Chief Officer of Liverpool LPC said:
“Community Pharmacy Liverpool has worked very closely with Liverpool City Council over many years. We were able to steer the sexual health service contract to have a large pharmacy offer. Once the contract was awarded to Axess Sexual Health, we worked collaboratively with the commissioners and the new service to embed multiple services within the city’s pharmacies.”
Barking and Dagenham
Once among the highest in London for under-18 conceptions, Barking and Dagenham has achieved a 73% reduction between 2011 and 2021 through coordinated efforts by the council and health partners. One such partnership was through the commissioning of community pharmacies to provide a condom distribution scheme.
The council’s use of young inspectors allowed a co-design approach to be included into its condom distribution scheme. The initiative empowered young people to play a role in shaping a service that affects their lives. Enabling the youth health programmes coordinator to have an open dialogue with pharmacies about their performance on the locally commissioned condom distribution scheme. This approach supported several improvements to the service, informed by the intended beneficiaries and most important stakeholders, young people.
Ongoing relevance
While there has been a sustained decline in teenage pregnancy rates, progress has slowed. The latest available data from 2022 shows a slight increase, highlighting the need for continued focus despite rates remaining below pre-pandemic levels. Regional disparities persist — with a seven-fold difference between the highest and lowest local rates.
This signals a need for continued vigilance. While a nationally commissioned NHS Pharmacy Contraception Service will now assist with reducing the variation associated with locally commissioning services, continued local investment in youth-informed, pharmacy-led local sexual health services is still essential to sustaining progress and addressing regional disparities.
Councils have a critical opportunity to build on proven models, to work with local pharmaceutical committees to review and, where possible, repurpose funding previously used to provide locally commissioned emergency contraception and oral contraceptive services to further improve sexual health services and ensure equitable access to sexual health support.
