Brighton & Hove Pharmacy Enhanced Service (PLES 12)
Sexual Health Service
- Service outline
This service is intended to increase the number of pharmacists who can provide a more knowledgeable sexual health service to young people by:
- Supplying Emergency Hormonal Contraceptive (EHC) via a Patient Group Direction (PGD) to young women who have had unprotected sex;
- As part of the EHC consultation, offering the chlamydia testing services;
- Providing chlamydia testing to young men;
- Where necessary, treating patients with confirmed chlamydia with antibiotics via a PGD;
- Providing free condom packs to young people who present with a c-card; and
- Provide information and advice to young people on sexual health issues; and
- Signpost young people on to other services for contraception, more specialist advice and/or treatment of sexual transmitted infections (STIs).
1.Objectives
1.1To improve access to emergency contraception, sexual health advice, condoms, chlamydia testing and treatment for young people.
1.2To refer clients, especially those from hard to reach groups, into mainstream contraceptive services.
1.3To increase the knowledge in young people of risks associated with Sexually Transmitted Infections (STIs).
1.4To refer clients who may have been at risk of STIs to an appropriate
service.
1.5To strengthen the local network of contraceptive and sexual health services to help ensure easy and swift access to advice to all young people who seek assistance.
2Service Description
2.1Service model and approach
2.1.1Pharmacies will offer a user-friendly, non-judgmental, client-centred and confidential service which links into existing networks for community contraceptive services for rapid referral.
2.1.2Provision of EHC, Chlamydia testing and treatment, condom distribution, information and advice should be offered as an integrated service where appropriate or individually as required.
2.1.3Young people under the age of 16 should be assessed under the Fraser guidelines and recorded.
2.2Emergency Hormonal Contraception
2.2.1Pharmacists will supply Levonorgestrel Emergency Hormonal Contraception (EHC) free of charge, when appropriate, to clients in line with the requirements of a locally agreed Patient Group Direction (PGD). (The age range specified in the PGD is women aged 25 or younger.)
2.2.2Except in exceptional circumstances, the women should take the dose of Levonorgestrel at the consultation.
2.2.3Clients excluded from the PGD criteria will be referred to another local service that will be able to assist them as soon as possible, e.g. GP, Community Contraception Service, or will be invited to purchase the Pharmacy medicine product if the exclusion from supply via the PGD is only due to an administrative matter, e.g. age range determined by the commissioner.
2.3Chlamydia test and treat
2.3.1The contractor should offer a chlamydia test to all young people requesting condoms or a pregnancy test or EHC.
2.3.2On presentation of a young person with a positive chlamydia test, the pharmacist should provide treatment in accordance to the relevant PGD, provide appropriate advice and record the supply.
2.4Condom distribution
2.4.1The pharmacy team should supply a condom pack to young people presenting with c-card.
2.4.2Sexual health advice and information
2.4.3The pharmacy will provide support and advice to clients accessing the service, including advice on the avoidance of pregnancy and STIs through safer sex, condom use, advice on the use of regular contraceptive methods and provide onward signposting to services that provide long-term contraceptive methods and diagnosis and management of STIs.
3.Terms and Conditions
For the Pharmacy
3.1The pharmacy contractor has a duty to ensure that pharmacists and staff
involved in the provision of the service have relevant knowledge, maintain patient confidentiality, offer a user-friendly and non-judgemental service and are appropriately trained in the operation of the service, including sensitive, client centred communication skills.
3.2The pharmacy contractor has a duty to ensure that pharmacists and staff are aware of and operate within the LES.
3.3The part of the pharmacy used for provision of the service provides a sufficient level of privacy (i.e. at the level required for the provision of the Medicines Use Review service) and safety.
3.4The Pharmacist will assess the need and suitability for a client to receive EHC, in line with the PGD, and where appropriate, a supply will be made. Where a supply of EHC is not appropriate, advice and referral to another source of assistance will be provided. Clients who have exceeded the time limit for EHC will be informed about the possibility of use of an IUD and should be referred to a local service as soon as possible.
3.5The service will be provided in compliance with Fraser guidance and Department of Health guidance on confidential sexual health advice and treatment for young people aged 16 years or under.
3.6Pharmacists are required to act according to relevant Child Protection and Vulnerable People procedures when advising young people on sexual health matters.
3.7Verbal and written advice on the avoidance of STIs and the use of regular contraceptive methods, including advice on the use of condoms, will be provided to the client.
3.8The pharmacy must maintain appropriate records to ensure effective ongoing service delivery and audit. Records will be confidential and should be stored securely and for a length of time in line with local NHS record retention policies.
3.9The pharmacy holds the various products required to deliver this service and will hand out such products as and when required. For free condoms, under the c-card scheme, young people should provide their registration card and staff should mark it accordingly to confirm a supply has been made.
3.10Pharmacists 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 to obtain permission of the client to share the information.
3.11The pharmacy will participate in an annual PCT organised audit of the service.
3.12The pharmacy will review its Standard Operating Procedures and the referral pathways for the service on an annual basis.
3.13 All pharmacists providing this service need to have completed the following training:
- CPPE Emergency Hormonal Contraception (copies can be ordered from CPPE at
- CPPE Module on Safe Guarding Children
- CPPE Module on Conception
- CPPE Module on Patient Group Directions
- CPPE Local Solutions workshop on Chlamydia test and treat
- Local competency test
- Attendance at a local workshop on the service
For the Brighton & HoveCity Teaching PCT
3.12The PCT will arrange at least one contractor meeting every year to promote service development and update pharmacy staff with new developments, knowledge and evidence.
3.13The PCT will provide a framework for the recording of relevant service information for the purposes of audit and the claiming of payment.
3.14The PCT will provide up to date details of other services which pharmacy staff can use for the referral of service users who require further assistance. The information will include the location, hours of opening and services provided by each service provider. (see )
3.15 The PCT will be responsible for the promotion of the service locally, including the development of publicity materials, which pharmacies can use to promote the service to the public.
3.16 The PCT will be responsible for the provision of health promotion materials, including leaflets on EHC, long-term contraception and STIs to pharmacies.
3.17The PCT to arrange with Worthing & Southlands Hospital Trust for the supply of Azithromycin to the community pharmacies signed up to the Local Enhanced Service.
4Payments for the service
4.1The training, accreditation requirements and data collection are reflected in the fee structure.
4.2Supply of EHC under a PGD £13.20
4.3Cost of LevonorgestrelAs perdrug tariff price + VAT
4.4Chlamydia tests received at the lab£5.00*
* Payment will only be made if the lab receives 10 or more tests per quarter which originated from the pharmacy.
4.5Supply of Azithromycin under a PGD£10.00
4.6Payment invoices to be submitted monthly via Webstar Health or manually to the Community Pharmacy Development Manager at the PCT on the appropriate invoice.
5.Paperwork
5.1Please see separate file attached.
5.2Copies can be obtained from the PCT on 01273 574699
5.3Contractors who have the Webstar Health software, follow the procedure as detailed by them for EHC.
Sexual Health LES
March 2010 1