Use of path analysis to predict changes to community pharmacy and GP emergency hormonal contraception (EHC) provision in England

Objectives In 2014/2015, 46% of community pharmacies were commissioned by local authorities to provide emergency hormonal contraception (EHC) free without prescription in England. Commissioning EHC services influences EHC prescribing from General Practice (GP)—greater community pharmacy provision reduces GP prescribing. This study aimed to examine predictors of GP and pharmacy EHC activity, describing them using path analysis. From this, commissioners and policy-makers may understand ways to influence this.Study design Cross-sectional study of routinely recorded data, obtained through freedom of information requests to local authorities.Setting Community pharmacies and general practices in England, UK.Participants All local authorities in England were included in the study (147 areas). The study population were all girls, adolescents and women aged 12–55. Of the 147 areas, data from 80 local authorities were obtained covering an eligible female population of 9 380 153.Primary and secondary outcome measures Correlation between community pharmacy and GP EHC activity.Results Data from 80 local authorities were analysed, representing 60% of the eligible female population in England. A significant negative correlation was found between rates of community pharmacy provision and GP prescribing (−0.458, p