It’s a busy community pharmacy. The dispenser takes a call. She says there’s a woman on the phone who wants to speak to the pharmacist. The pharmacist nods and takes the phone.
Pharmacist: Good morning. I’m Sam Smith, the pharmacist. How can I help?
Caller: Hi, I need the morning after pill.
Pharmacist: Can you come in please? We’re open till 10 pm. I can speak to you in the consultation area privately. I need to ask some questions before I can provide the medication.
Caller: I can’t get out today. I need a lift to get into town and there’s no-one here. Can I speak with you on the phone? I can get my uncle to collect it for me. He works near you and can drop it off at lunch time.
Pharmacist: I would normally have a face-to-face consultation and then provide the medication to yourself, not a third party. That’s not the usual process.
Caller: Please – I really need it. I can’t get out. I don’t want to get pregnant.
The pharmacist deliberates quickly and decides to ask some questions.
Pharmacist: Are you OK to have a consultation over the phone now?
Caller: Yes
Pharmacist: What’s your name please?
Caller: (after a slight pause) Sally. Sally Carter.
Pharmacist: How old are you, Sally?
Sally: (another pause) I’m 17, no I mean I’m 18. I just had a birthday.
Pharmacist: What is your date of birth?
Sally: I just said, I’m 18.
Pharmacist: Is the morning after pill for yourself?
Sally: Yes
Pharmacist: When did you have unprotected intercourse?
Sally: umm…
The pharmacist hears a male voice whispering ‘yesterday’.
Pharmacist: Is anyone else with you?
Sally: Uh no! I’m in the house alone…. I’ve got the radio on.
Pharmacist: OK, when did you have intercourse?
Sally: Yesterday
Pharmacist: Has it been more or less than 24 hours?
Sally: Um… more ….
Pharmacist thinks he hears a male voice whispering ‘less’.
Sally: Uh.. no … less … sorry!
The pharmacist believes that there is probably someone with the patient, guiding her responses, which flags significant safeguarding concerns for him.
He puts Sally on hold and checks out the guidance. A key section says:
“Be aware that, in some circumstances, requests for oral emergency contraception could be linked to abuse (non-consensual intercourse) of children or vulnerable adults. The Department of Health has published a document called Responding to domestic abuse: A handbook for health professionals, which provides practical advice on dealing with domestic abuse, keeping records, confidentiality and sharing information.” https://www.rpharms.com/resources/pharmacy-guides/oral-emergency-contraceptives-as-pharmacy-medicines
What should the pharmacist do?