Is there a role for digital healthcare to transform sexual health services like contraception by improving access, and thus reducing the burden on the NHS? Probably, but I suspect with caveats.
In 2017/18 in England, 817,018 women used Sexual and Reproductive Health (SRH) services to access contraception.  However, SRH services are declining.
Between 2015 and 2019, almost half of all councils in England will have reduced the number of sites providing contraception services. GP services are already under pressure and would be stretched to provide access for the patients now unsupported by local services.
Natika H Halil, Chief Executive of the sexual health charity FPA, highlighted what this shortfall in SRH service provision means to patients and public health: “Contraceptive and sexual health (CASH) services are at a tipping point due to budget cuts, with many struggling to cope. Closures, fragmented services and reduced opening times mean restricted access leaves the public at greater risk of sexually transmitted infections and unplanned pregnancies.”2
Cue digital healthcare. In 2017, the NHS in England dispensed 6.95 million prescriptions for oral contraception.1 During the same period, LloydsPharmacy Online Doctor issued 57,607 contraception prescriptions in the UK. That’s a significant number of patients that have been supported online by a single digital provider, without using a GP appointment.
Imagine if all oral contraception prescriptions were handled digitally, it could liberate a significant amount of GP and SRH time and appointments. Online healthcare gives patients access to clinically sound, evidence-based advice at any time, informing patient choice.
Yet digital healthcare has limitations – patients must be digitally literate and enabled for it to work. Online providers cannot offer Long Acting Contraceptive Devices (LARCs) as these require a face-to-face appointment, and robust safeguarding procedures are needed to identify patients at risk. This poses a challenge for providers without a ‘bricks and mortar’ presence. LloydsPharmacy Online Doctor is connected to a network of pharmacies that check and record patients’ biometrics before dispensing contraception. Local pharmacies have a role to play in digital healthcare as well.
While digital healthcare is not the silver bullet to solve all the challenges facing the NHS, it offers real opportunities. Digitising contraception provision saves both patients and clinicians that most coveted resource – time. This is a powerful tool that’s already improving patient access to treatment and freeing-up physical consultations to those who need them the most. More encouraging still, this digital transformation is just beginning.
Dr Anup Jethwa
Clinical Lead for Transformation and Innovation
LloydsPharmacy Online Doctor, London, UK