We thank Drs Baird and Webb for their considered response1 to our article2 and for opening up a constructive debate on provision of different methods of emergency contraception (EC).

We are aware of the evidence regarding the relative efficacies of the three EC methods and that Faculty of Sexual & Reproductive Healthcare (FSRH) guidance3 is that all women, subject to eligibility, should be offered all options from which to make their own informed choice. However, services do work within constraints that inevitably impact on what can be provided and that must be considered in the development of protocols. As we have indicated, our study was a pilot testing a pragmatic approach to method selection and was subject to restrictions requested by our local Medicines Management team. It also predated current FSRH guidance.

When ulipristal acetate (UPA) was granted a UK licence in May 2009 our Primary Care Trust (PCT) placed it on their ‘Red List’ of drugs (i.e. not funded). Four years on it is still there, albeit with exceptional use in …