“I need the morning-after pill — quickly, please”

An emergency-contraception request from a 16-year-old must deliver TWO things at once: prompt, barrier-free access to effective EC, AND a sensitive safeguarding assessment. On method, advise by timing/cycle — the COPPER IUD is the most effective EC (up to 5 days, and provides ongoing contraception), ulipristal acetate is preferred over levonorgestrel at ~72 h/mid-cycle (effective up to 120 h), and levonorgestrel up to 72 h; mind the practical points (CoSRH 2017, amended 2023: don’t mix ulipristal and levonorgestrel, repeat if vomiting within 3 hours, EC doesn’t cover the rest of the cycle, quick-start ongoing contraception, pregnancy test 3 weeks after the unprotected sex). At 16 she is presumed to have capacity (Mental Capacity Act 2005; Fraser criteria are for under-16s) — check understanding without obstructing a time-sensitive treatment she is entitled to. The examinable core is the SAFEGUARDING red flag — a 25-year-old partner met online — which, despite 16 being the age of consent, raises CSE/exploitation and coercion concerns to be explored gently and acted on per local pathways, balancing her autonomy/confidentiality with the duty to safeguard (honest about limits, ideally involving her). Address ongoing contraception and STI screening, and meet her need non-judgementally so she stays engaged. If clarified: the UPSI was ~72 hours ago, mid-cycle (higher conception risk). Method matters (CoSRH — formerly FSRH — Emergency contraception guideline, 2017, amended 2023): the COPPER IUD is the most effective EC (up to 120 hours after the first UPSI in the cycle, or up to 5 days after the earliest likely ovulation) and should be offered/recommended; oral options are ulipristal acetate (ellaOne, up to 120 h, more effective than levonorgestrel, especially mid-cycle/later) and levonorgestrel (up to 72 h). At ~72 h mid-cycle, ulipristal or the copper IUD are preferable to levonorgestrel.