Annex B2
South Gloucestershire Council Health & Wellbeing Division
Emergency Contraception Service Specification 2014/15
Programme Lead: Lindsey Thomas Tel: 01454 864664 Email: [email protected]
1. Service Background
The provision of sexual health services in community pharmacies contributes to the following key local and national health priorities:
reducing the rate of under 18 conceptions reducing STI rates amongst young people Increasing the number of Chlamydia diagnoses Outcomes indicated in ‘A Framework for Sexual Health Improvement in England’ (Department of Health 2013) Meeting the local Chlamydia screening target for 15-24 year olds.
All community pharmacies are required to provide some sexual health services as part of their essential services, e.g. promotion of healthy lifestyles, providing opportunistic sexual health advice in Public Health campaigns, signposting people to other services (including Contraception and Sexual Health Services [CaSH], Genito-Urinary Medicine [GUM] and maternity access), and support for self-care.
This specification for emergency hormonal contraception services in pharmacies builds on these essential services, to provide a full and co-ordinated range of sexual health services to young people.
This Service will operate from 1st April 2014 until 31st March 2015. It will then be reviewed in the light of any changes to pharmacy provision, success of the service and healthcare needs of the local population.
2. Service Aims
To improve access to emergency contraception and sexual health advice To increase the use of emergency hormonal contraception (EHC) by women who have had unprotected sex and help contribute to a reduction in the number of unplanned pregnancies in the client group To refer clients, especially those from hard-to-reach groups, into mainstream contraceptive services To increase the knowledge of the range of contraception methods available, including long acting reversible contraceptive (LARC) methods, and refer clients to suitable services, particularly clients from hard-to-reach groups To raise awareness of sexually transmitted infections (STIs) and provide support and advice to young people on safe sex, condom use, and advice on use of regular contraceptive methods, when required.
Page 1 of 6 To increase awareness of Chlamydia infection and transmission, its often asymptomatic nature, and potential for harm. To increase the uptake of the local Chlamydia Screening Programme, thus increasing the number of identified cases and increase the number of infected patients being treated.
3. Service Description
Community pharmacies participating in this service undertake:
To provide free emergency hormonal contraception via patient group direction (PGD) To provide a sample pack of free condoms to young people accessing emergency hormonal contraception To provide a sample pack of free condoms to young people presenting their C-card To offer free Chlamydia screening kits to 15-24 year olds To give advice on condom use, contraception, sexual health and sexually transmitted infections To signpost to services that provide reliable regular contraception and prevention and management of sexually transmitted infections To offer a user-friendly, non-judgemental, client-centred and confidential service, in line with the quality criteria of ‘You’re Welcome’, known as ‘Young People Friendly’ in our SW region.
4. Service Criteria
4.1 Pharmacists will supply free Emergency Hormonal Contraception (EHC) following an assessment of need and suitability for a client in line with the requirements of the South Gloucestershire Council Patient Group Direction (PGD) for Levonorgestrel, having explained all methods of emergency contraception available (hormonal and non-hormonal).
Supplies will be made free-of-charge to women aged up to 24 years old, or aged 25 years or over where no other access to EHC is possible, within 72 hours of unprotected sexual intercourse. There is no lower age limit, although young people aged under 16 years old must have been assessed as Gillick competent using Fraser Rules. Any child protection concerns must be recorded and discussed with the nominated child protection lead in the pharmacy organisation. Clients excluded from the PGD for supply will be signposted to another service that will be able to assist them, as soon as possible.
4.2 Irrespective of the provision of treatment or not, pharmacies will give advice and information on contraception, sexual health and sexually transmitted infections as well as the location of sexual health services. This will include advice on the use of condoms, as well as availability of the full range of contraceptive methods including reversible and long-acting reversible (LARC) methods.
4.3 Pharmacies will also provide a sample pack of 6 condoms and lubrication to young people requesting EHC or who present their C-card. Condoms (for this purpose only) can be ordered free from KRIS at The Greenway Centre, 0117 922 2290 Email: [email protected]
4.4 Pharmacies will provide access to opportunistic Chlamydia screening of young men and women aged 15-24, in accordance with the National Chlamydia Screening Programme (NCSP). Pharmacies will provide free-of-charge postal Chlamydia testing kits to people under the age of 25, for example when young people purchase condoms, when oral contraceptive pills are dispensed and supplied to patients, and when supplying EHC by OTC sale or PGD supply. Advice on how to use the kit, how to dispatch it for testing, and what will happen following completion of the test will be provided to the client. Supplies of further kits may be obtained by contacting the Avon Chlamydia Screening Programme on 0117 922 2265 or by emailing [email protected] .
Page 2 of 6 4.5 Pharmacists will need to satisfy themselves that treatment of, or provision to, any individuals under the age of 16 years is only after they have been judged to be Gillick/Fraser Rules competent. When a young person is judged not to be competent, she should be referred to, or advised to attend a Sexual Health Clinic or GP. Any child protection concerns must be recorded and discussed with the nominated Child Protection lead.
5. Pharmacy requirements
5.1 Pharmacies must have an appropriate consultation room which provides a sufficient level of privacy (at the level required for the provision of the Medicines Use Review service).
5.2 A Chaperone Policy must be produced by the pharmacy and be in place in the pharmacy consultation room.
5.3 The pharmacy will clearly display any logos that are developed to brand any part or all of the service.
5.4 The pharmacy must review its standard operating procedures and the referral pathways for the service on an annual basis.
6. Pharmacist requirements
6.1 Pharmacists must have read, signed, and understood the South Gloucestershire Council Patient Group Directions for Levonorgestrel. Up to date copies of the PGD should be held, and be available for reference, in each pharmacy offering this service. The pharmacist must ensure that their professional indemnity cover includes the supply of medicines through patient group directions.
6.2 The pharmacy contractor has a duty to ensure that all pharmacists and staff involved in the provision of the service are aware of and operate within appropriate Standard Operating Procedures (SOPs) which must be in place.
6.3 Pharmacists may need to share relevant information with other health care professionals and agencies, in line with locally determined confidentiality arrangements, including, where appropriate, the need for the permission of the client to share the information.
Pharmacist Training
6.4 The pharmacy contractor has a duty to ensure that all pharmacists and staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the service, including confidentiality, sensitive patient-centred communication skills, and data protection.
6.5 All pharmacists and staff involved in the provision of the service must attend a sexual health training session organised by South Gloucestershire Council, Bristol City Council, or North Somerset Council.
6.6 Pharmacists providing this service must have completed, and provide a copy of certification of, the CPPE course in Emergency Contraception.
6.7 Pharmacists providing this service must have completed, and provide evidence of, level one training in Safeguarding Children and Vulnerable Adults. Examples of such training are that provided by South Gloucestershire Council, Bristol City Council, North Somerset Council, or CPPE.
6.8 South Gloucestershire Council also recommends the completion of the following self-learning packages as additional resources: Centre for Pharmacy Postgraduate Education (CPPE) ‘Sexual health’ CPPE: ‘Contraception’ CPPE: ‘Dealing with Difficult Discussions’.
Page 3 of 6 7. Monitoring
7.1 An assessment of need and suitability for a client to receive EHC Levonorgestrel must be recorded using PharmOutcomes.
7.2 A summary of the outcome of the consultation for EHC must be recorded using PharmOutcomes.
The PGD relating to the service may be downloaded from the LPC website.
8. Equalities
Equalities - South Gloucestershire Council is committed to ensuring that it is operating fairly and equitably through services delivered directly by the Council and through those it commissions.
Commissioned services are expected to determine the appropriate level of monitoring required in order to ensure that an effective analysis can be undertaken to inform both the ongoing delivery of that service and future commissioning intentions. All relevant sections of the patient information form must be completed in relation to the required data sets: age, gender, ethnicity, and postcode Commissioners will utilise this information collected to undertake an analysis of the data gathered in relation to these specific issues.
9. Review and Audit
The pharmacy must maintain appropriate records to ensure effective ongoing service delivery and audit. Records will be confidential and should be stored securely for 8 years if the client is believed to be aged over 16, and until the client’s 26th birthday if they are believed to be aged under 16.
The pharmacy will co-operate with any locally agreed assessment of service user experience.
The pharmacy will participate in a periodic South Gloucestershire Council audit of service provision and usage.
10. Contact Details
Lottie Lawson Department for Children, Adults and Health PO Box 298, Health & Wellbeing Division Kingswood Civic Centre, High Street, Bristol, BS15 0DQ Email [email protected]
11. Financial Details
In 2014/15 each pharmacy contracted to provide this service will receive:
A payment of £10 per sexual health consultation (whether suitable for supply of medication under PGD or not, providing paperwork and signposting completed). A payment of £5 per ‘completed’ Chlamydia test received by the lab for testing will be paid. A ‘completed’ test is where the sample yields a positive or negative result. This payment will be made following information received by South Gloucestershire Council from the Chlamydia Screening Office. A payment of £6 per individual Levonorgestrel supply under PGD. One supply is 1 x 1500mg Levonorgestrel tablet.
Page 4 of 6 Claims must be submitted monthly to South Gloucestershire Council using PharmOutcomes. Any claims made over 3 months from when activity was undertaken will be voided and not paid. Payments will be made quarterly.
12. Clinical Incident Reporting
To ensure that the information contained in the training and scheme agreements for this service are sufficient we would encourage contractors to feedback any adverse incidents that occur to the Programme Lead, South Gloucestershire Council Health & Wellbeing Division.
13. Future Amendments to, or De-Commissioning of, the Service
Pharmacies may choose to discontinue their involvement in this service at any time provided they give South Gloucestershire Council three months notice in writing.
South Gloucestershire Council may choose to decommission this service, provided they give the pharmacies one month notice in writing.
Any future amendments to the service by South Gloucestershire Council will be notified in writing
Page 5 of 6
Signature Sheet Emergency Contraception 2014-15
This document constitutes the agreement between the pharmacy and South Gloucestershire Council, Health & Wellbeing Division, in regards to this service. Please note that no payment can be made until this form is completed, signed and returned.
Parties to the agreement:
1. The ‘Provider’ is the Pharmacy providing the Supervised Consumption service
2. The ‘Commissioner’ is South Gloucestershire Council, Health & Wellbeing Division
Signature on behalf of Pharmacy
Pharmacy FCS code:
Pharmacy Name/Stamp:
Pharmacy Signatory: Date:
Position:
Signature on behalf of South Gloucestershire Council
Name:
Position:
Signature: Date:
In addition to the signed Agreement Sheet, please return this completed and signed form to:
Lesley Robinson, Technical Admin & Contracts Officer, South Gloucestershire Council, Department for Children, Adults and Health, PO Box 298, Health & Wellbeing Division, Civic Centre, High Street, Kingswood, Bristol, BS15 0DQ
Page 6 of 6