Local Enhanced Service for Opportunistic Chlamydia Screening and Treatment in Community Pharmacies.

Type of service agreement / Cost per case contract
Service Commissioned: / Local enhanced service for opportunistic Chlamydia Screening in Community Pharmacy
Period of agreement / 1st November 2008– 31st March 2011
Purchasers / Medway PCT
7/8 Ambley Green
Gillingham Business Park
Bailey Drive
Gillingham Kent
ME8 0NJ
Contact / Medicines Management Team
Telephone/Fax / 01634 382950
Provider
Named Contact
Telephone

Service Level Agreement 2008/09

1.  Introduction

The purpose of this agreement is to set out a Local Enhanced Service (LES) for Opportunistic Chlamydia Screening and treatment in the community for the target population of under 25 year olds, as defined by the National Chlamydia Screening Programme. The agreement is in respect of the period 1st November 2008 to 31 March 2011 but may be extended subject to the agreement of both parties and may be subject to review in line with national guidance.

2.  Aims of the Agreement

The aim of this agreement is to remunerate contractors for providing an Opportunistic Chlamydia Screening and treatment service. This SLA sets out the process for contractors to:

·  Facilitate access to Chlamydia screening for under 25’s as part of the wider sexual health agenda

·  Provide appropriate treatment within primary care

3.  Scope of Service /Service Specification

This LES provides a consistent approach rewarding contractors equitably for:

·  Providing opportunistic Chlamydia screening test kits

·  Providing treatment services under a PGD for positive clients and their partners

Both these elements are essential in supporting the work of the local Chlamydia Screening Office whose involvement will be detailed below.

Contractors are encouraged to sign up to provide both elements of the service (A and B) but can sign up to only one if it best suits them.

The specifications for both elements are:

Part A (Test Initiation)

·  Placing of support materials within the contractor site to advertise the availability of opportunistic Chlamydia screening to the target age group (materials provided by Chlamydia Screening Office)

·  Ensuring Chlamydia Screening Test kits are available and provided on request to all under 25 year olds by appropriately trained staff (See Appendix A detailing training)

·  Offering consultation and advice on chlamydia testing by appropriately trained staff.

·  Ensuring young person is aware that all instructions are in the kit.

·  Advising the client on how to complete the form and return through the post.

·  Completing the form with the young person if they wish to do so.

·  Explanation to the young person of the results notification process (text or letter)

·  Production of a record of test issued as per completed form. This is to be used to enter details of tests issued onto Webstar which will enable prompt and accurate payment to contractors upon subsequent receipt of a result.

·  Pharmacy staff to undertake initial test initiator training and maintain their competence to provide their service by undertaking appropriate, ongoing continual professional development (CPD) where appropriate

·  The contractor must ensure that trained staff are accessible during all opening hours to ensure continuing provision of this service

·  Provide advice/leaflet on use of condoms and information on the Condom card scheme to prevent sexually transmitted infection. (All materials provided by Public Health)

Part B (Treatment for Positive Clients)

·  Contractors need to ensure consistency of service; if locums are used then they must be competent to provide the service. In the event that services cannot be provided,
a) in a normal week day, contact must be made with the Chlamydia Screening Office to determine the next course of action
b) outside normal working hours and at weekends, with recorded patient consent, contact alternative treatment provider to confirm ability to provide service, then signpost client to alternative treatment provider.

·  Ensure that partners of positive clients are given treatment, at the same time, in line with the PGD requirements (partner would need to be present in the pharmacy to be treated under the PGD).

·  Consultation with and assessment of client using individual consultation record forms including Fraser competency for clients under 16

·  Completion of individual client management form (CMF) for PGD/notification of treatment for Chlamydia positive clients and presenting partners. These forms will be used for audit purposes, and to enable the Local Chlamydia Screening team to confirm treatment has taken place. Payment will be authorised via Webstar upon receipt of completed CMF.

·  Provide follow up advice and guidance re: ongoing use of barrier contraception.

·  Pharmacists to undertake treatment training and maintain their competence to provide their service by undertaking appropriate, ongoing continual professional development (CPD) where appropriate (see Appendix A detailing training).

·  Complete all details of treatment notification via Webstar including treatment given and date of treatment

Role of the Local Chlamydia Screening Office:-

·  Provide all advertising, support materials, Chlamydia screening test forms, and Chlamydia testing kits male/female

·  Receive all notifications of clients test results

·  Notify all clients of their test result by the preferred method

·  Notify all clients who test positive their need for treatment by text.

·  Offer all Chlamydia positive clients a range of treatment sites (those contractors signed up to provide Part B)

·  Follow up non-attendees

·  Provide appropriate training and support

·  Confirm receipt of Client Management Form on Webstar.

4.  Eligibility to Provide Service

Contractors undertaking screening and treatment should have undertaken appropriate training as defined by the National Chlamydia Screening Programme under the direction of the Health Protection Agency/PCT.

Those pharmacists should have in place standard operating procedures (SOP). It is essential that all contractors wishing to undertaking the LES have had a satisfactory contractual visit and that outstanding issues raised at the contract review are actively being addressed.

The pharmacy providing the treatment element of the service (Part B) must have a consultation room that meets the specifications for provision of advanced services (MUR)

5.  Monitoring & Evaluation

Contractors providing opportunistic Chlamydia screening and treatment services as part of this LES will ensure that the information, records and documentation of this SLA are maintained at all times, to effectively monitor the performance.

Monitoring of this SLA will be undertaken via Webstar and contractors agree to ensure that recording of all required data is thorough and complete. The PCT may periodically review the pharmacy’s arrangements for complying with this agreement including monitoring visits by the Chlamydia screening teams where evidence of effective standard operating procedures would be assessed.

If less than 50% of tests issued by a pharmacy are not returned by the client and therefore do not generate a result the pharmacy will receive re-training in test initiation.

6.  Financial Arrangements

Under the agreement, the contractor will receive a fee according to the contracted Part (Part A, Part B or Both):

·  Part A (Test Initiation) – Fee of £10 per test that generates a result as identified on Webstar by Chlamydia Screening Office.

·  Part B (Treatment for Positives) – Fee of £10 per Client Management Form (CMF)

and reimbursement of cost of treatment upon receipt of CMF by Chlamydia Screening Office.

In the event of the contractor not being able to dispense under the PGD a completed PGD individual consultation record form demonstrating contact and reason for non-treatment will be accepted as a valid claim.

On completion of Chlamydia Screening services Pharmacies should enter required details via Webstar after each episode of care to enable the PCT to monitor activity effectively via Webstar.

Failure to submit data promptly may result in non-payment, as it is important for the PCT to monitor financial arrangements and to include all payments within a financial year.
Please note that incomplete forms will not be processed, so pharmacies are advised to provide all necessary information.

Payment will be made through the Prescription Pricing Division as part of combined Local enhanced services payment

7.  Clinical Governance

Under the conditions of this agreement the contractor must ensure that:

·  The contractor has staff that has the necessary skills and experience to carry out the contracted procedures. Only those trained for the opportunistic Chlamydia screening services should carry out the services

·  Pharmacies should maintain training records and names of individuals signed up to the pharmacies standard operating procedure

·  The pharmacists carrying out the contracted procedures are able to provide satisfactory evidence, on demand, of their qualifications, registrations and membership of appropriate professional bodies

·  The contractor will indemnify the PCT against all acts of clinical negligence arising from their acts or omissions in providing the service. Such indemnity will be limited to the amount of indemnity provided by the Contractor’s underwriter

·  The contractor will maintain a safe and suitable environment for patients and staff and comply with all appropriate relevant statutory requirements, legislation, and guidance e.g. as detailed in Department of Health Guidance and Professional Codes of Practice, Standards for Better Health (www.dh.gov.uk/en/publicationsandstatistics/publicationsandguidance/DH_4086665) , Health and Safety regulations, Consent and Chaperone polices.

·  The staff carrying out the contracted procedures will attend and participate in appropriate audit meetings, to ensure regular update of skills and expertise.

·  The contractor will agree that access to records and documents containing information relating to individual patients treated under the terms of this Service Level Agreement will be restricted to authorised personnel and that information will not be disclosed to a third party. Both parties will comply with the Data Protection Act, Caldicott Guardian and any other legislation covering access to confidential patient information.

·  Representatives of the PCT have the right to visit the pharmacy at any reasonable time, having regard for the provision of services and the patient’s right to privacy and dignity.

8.  Termination of Agreement

Both the contractor and the PCT may terminate this agreement by giving not less than 3 months notice in writing to the other party. However, if for any reason the PCT has cause for concern over the competencies to provide a Local Enhanced Service for Opportunistic Chlamydia Screening, then the PCT will withdraw its accreditation and terminate the agreement with immediate effect.

9.  Agreement

Under this agreement does the pharmacy wish to:

Provide test kits to under 25 years olds with appropriate support to

complete and return (PART A) YES

Day / Times when service is available
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Provide Treatment under the specified PGD (PART B) YES NO

Day / Times when service is available
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Signed……………………………………..…. Date………./…………/

(For and on behalf of contractor)

Name:…………………………………………

Signed……………………………………..…. Date………./…………/

(For and on behalf of PCT)

Name:…………………………………………

Pharmacy Stamp
Appendix A

Example of Training Schedule for Opportunistic Chlamydia Screening Programme

Training for Test Initiation:

Maximum 1.5 hrs depending on number of staff and questions.

Can be delivered on site/centrally

Topics covered:

·  National Chlamydia Screening Programme update

·  Chlamydia profile/local data

·  Who is eligible for screening

·  Offer of Test

·  Test equipment demonstration

·  Completion of form

·  Results notification

·  Who to contact for further information

·  Record of tests issued

·  Completing test information on Webstar

·  Payments

Training for PGD: Offer of Treatment

Topics Covered:

·  Text notification for clients with positive result

·  Client Management Form

·  Pharmacist responsibilities under PGD

·  Completing treatment details on Webstar

·  Payment/claim system

Contact Details of the Chlamydia Screening Office: Katrina Brown, Chlamydia Screening Coordinator, Kent HPA, Preston Hall, Aylesford, Maidstone, Kent ME20 7NJ Tel: 01622 713108

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