SOP– Procedure for Supply of Emergency Hormonal Contraception (EHC) under Patient Group Direction(PGD)EXAMPLE

Procedure for supply of EHC working under PGD
ACTION / SUPPLEMENTARY ACTION
Clientpresents to pharmacy staff requesting EHC or ‘Morning after Pill’ /
  • Ensure staff are trained – sensitive handling of request; non-judgemental; re-assuring.
  • Escort client to consultation area
  • Ask Pharmacist to attend – tell client expected waiting time
  • NB: staff to signpost to alternative EHC provider if trained pharmacist not available & free service is required – via sexhelpglos website/ local info

Begin consultation process as directed by EHC training under PGD – using proforma to record information /
  • Ensure confidentiality mentioned
  • If friends attend, check whether appropriate to stay in consultation, or ask them to step out
  • Consider chaperone requirement/door ajar
  • Warm & friendly attitude
  • Assess UPSI event
  • Record information on proforma

If under 16 yrs ensure Fraser Guidelines have been assessedand any child protection issues /
  • Assess client competence
  • Adult/parental involvement
  • Boyfriend’s age & relationship
  • Phone for help if client falls outside PGD as per training or Safeguarding concerns

If pregnancy suspected following discussion, carry out pregnancy test /
  • Follow SOP for pregnancy testing
  • Patient to produce sample on site or asked to return with sample
  • Sign post onto appropriate services if a positive result obtained (GP, PAS, and Teenage Pregnancy Midwives).

Supply EHC –Levonelle 1500 where indicated, following PGD – client to take pill/s during consultation with water provided /
  • Complete proforma
  • Pharmacist signature
  • Discuss side-effects; failure; after care; contraception
  • If antiemetic indicated follow PGD for Domperidone – dispense dose into a pill pot/cup to take stat – record supply on proforma
  • If client refuses to take – suspect 3rd party request
  • Phone for help if client falls outside PGD and at risk, as per training – note outcome on proforma

Always discuss IUD as alternative EC –and consider risk factors for client /
  • Assess risk – mid-cycle; time since UPSI; does not want to risk pregnancy
  • Sign post to appropriate service – make telephone call if needed to facilitate referral (ellaOne/ IUD) – note on proforma

Give appropriate leaflets & condoms where needed, and any follow up advice /
  • STIs discussed
  • Chlamydia test kit given & for partner/s
  • Signpost to further contraceptive services
  • Discuss follow up as per PGD

Store proforma for 8 years or upto age 25 if under 16 /
  • Follow valid PGD – check date of expiry
  • Make monthly returns to PCO
  • Keep CPD updated on EHC (FSRH) & related topics

Authorised by:……………………………………………Date of preparation: ………………………………….

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