Condom Distribution Guidelines for Non Health Professionals

NottinghamshireCounty Teaching PCT C-card Pick up point Community Pharmacy

Service Level Agreement

This Service Level Agreement (SLA) forms the basis of the agreement between the undersigned Nottinghamshire County Teaching PCT pharmacy and Nottinghamshire County Teaching PCT in line with the standard C-Card Scheme for the provision of condoms to young people (13-24) within youth settings, specifically in this case community pharmacies.

In response to the National Teenage Pregnancy Strategy and the Sexual Health and HIV Strategy, the C-Card Scheme was introduced aiming at reducing both unintended teenage pregnancies and the number of Sexually Transmitted Infections (STI) including HIV.

Aims of the C-Card Pick Up service:

To reduce the number of unplanned teenage pregnancies, especially those identified as being most at risk and vulnerable.

To reduce the risk of incidence of HIV and other STI’s in young people.

To reduce the associated barriers in accessing condoms, including financial cost and embarrassment.

To increase the availability, accessibility and acceptability of condoms.

To provide a service that empowers individuals to make sexual health choices.

To link individuals into mainstream services.

In short, young people enrolling into the C-Card Scheme will receive a credit card (C-Card) with their ID number on and will be able to obtain condoms from other agencies that are also involved in the scheme. Young people will therefore be able to access free condoms from a variety of settings that they feel comfortable with.

The undersigned pharmacyis committed to the above aims as part of an ongoing process at both a strategic level and via consultation with young people.

Building / environmental requirements

Participating pharmacies will have private consultation areas meeting the requirements for advanced services with regards to normal conversations not being overheard by either customers or staff. Additionally there needs to be arrangements that satisfy the PCT around the visibility of clients during consultations. Pharmacy staff may be visible to other customers but other arrangements such as a screen and the offering of the presence of a chaperone to suit the client e.g. a friend or another member of staff.

Quality and clinical Governance

The standards of the Essential part of the Community pharmacy contract will be met to the satisfaction of the PCT which could include meeting the timescale of an action plan following a monitoring visit.

All the standards of the essential part of the pharmaceutical contract that are relevant should be delivered during this service as well as standards relating to ‘Care Quality Commission Standards’ which includes good clinical governance, an annual clinical audit, recording of near misses and errors, risk assessment of service introduction and maintenance, a programme of maintaining appropriate Continuous Professional Development for staff involved in the service. Clients should be signposted or referred to C card registration points or other specialist sexual health services as appropriate in accordance with information provided by the PCT which includes PCT child protection leads.

The pharmacy will comply with ‘You’re welcome principles and display their competence information.

Complaints made about services will be responded to in accordance with NHS complaints procedures and local complaints process and the PCT will be provided with a summary of patient complaints and actions taken’

The chemist contractor shall notify the PCT immediately of any serious or untoward incident that affects the expected outcome of the treatment to a patient. A summary of all untoward incidents is also required as part of the performance monitoring report. Reports and notifications will be made in a manner which maintains patient confidentiality. The contractor shall use his/ her professional judgement to determine whether incidents are of a serious or untoward nature.

Monitoring Arrangements

The pharmacy must display posters and leaflets advertising the service and their compliance to the You’re Welcome principles.

The Pharmacy will display the times the c card service is available, if it is not continuous during opening hours.

Records of signposting and referrals relating to the C card scheme specifically, must be available for inspecting by the PCT.

The Primary Care Contracting Pharmacy Team at the PCT will monitor the accuracy of form completion.

The pharmacy will send in the monthly summary showing nil activity on any month where this is relevant.

The PCT will liaise with the Nottinghamshire Teenage Pregnancy Unit around developing monitoring arrangements in partnership with them.

Background or regulations, policy and practice

The service will be run maintaining confidentiality other than in the exceptional circumstances identified relating to child protection issues.

Equality and Diversity principles and regulations will be upheld where all clients will be treated equally and respectfully independent of their ethnicity, religion, sex, sexuality, disability status.

Within the principles of information governance – no potentially sensitive patient data will be sent through standard Royal Mail but via NHS internal mail via health centres, by special post where post is maintained secure when during transit or by pharmacy risk assessed PCT approved courier, which includes all pharmacy based staff delivering forms, prescription and pharmacy wholesale delivery personnel.

Payment Schedule

£1.10 per transaction.(Visit where a C card holder is provided any condoms or lubricant)

Linked Local Enhanced Services

NHS PCT Chlamydia Test screening will be offered to those (in the 15-24 year old group) to all those using the C card scheme, provided the pharmacy is part of the scheme, but a record needs to be made once the take up has occurred so that the client isn’t asked again.

The Emergency Hormonal Contraception (EHC) scheme may be offered to clients using the scheme were there could have been condom failure, where the pharmacy provides the PCT service.

Who within the service will be able to distribute condoms?

Only staff that have been checked by the Criminal Records Bureau must be allowed to undertake the training and distribute condoms.

Only trained staff will be able to distribute condoms to young people aged 13-24 as part of the C-Card Scheme if they have received appropriate ‘C-card’ training in sexual health and young people’s issues provided on by the Teenage Pregnancy Unit for the PCT. Participants will receive a certificate, which will be displayed for young people to see.

Staff and volunteers will be offered this training through PCT training events and pharmacy on site training as new sites are identified. They will also be expected to participate in regular sexual health training updates.

The lead pharmacist (or technician if the pharmacy doesn’t have regular pharmacist cover)will take a lead role in keeping all staff and volunteers informed and up to date on training available. They will also monitor who has attended sexual health training, and they will identify training needs of staff and volunteers through supervision meetings. Training needs including requirements for new staff should be brought to the attention of the Community Pharmacy Development Advisor who will arrange appropriate training.

Who will be able to access condoms?

The C-Card Scheme is available for young people aged 13-24. Condoms can be given to young people within that age range if they already have a C-Card. This means that they have already registered onto the scheme at a C-Card registration point.

If a young person has not previously registered onto the scheme the following information is adhered to.

Confidentiality

All staff and volunteers have the same duty of confidentiality to under 16’s as to those aged 16+.

Confidentiality may only be broken in the most exceptional situations when the health, safety or welfare of the young person, or others would otherwise be at grave risk. If this is the case, Nottinghamshire County Teaching PCT Child Protection Guidelines should be followed. The PCT lead Nurse or Doctor should be contacted in case of queries or concerns or a social worker for Nottinghamshire Council’s children’s department.

If a young person discloses that they are having under age sex it is not itself a reason to break confidentiality. However, if a worker suspects that a young person is being abused or exploited and is at serious risk of significant harm which disclosure to an appropriate person could prevent, they should work with the young person to encourage them to allow the information to be passed on. If they refuse, and the worker believes the involvement of other agencies is essential in the young person’s best interest, they may consider disclosing the information without their consent. This should not be done without first telling the young person.

It is important to remember that it may be the trusting nature of the relationship with the worker, which enables a young person to take the first step towards disclosing abuse of exploitation. A hasty breach of confidentiality, made before the young person is ready, may result in their denying the disclosure and losing the opportunity to resolve the problem.

What is involved by being a C-Card Pick Up point?

‘Pick up points’ for the C-Card Scheme will not register young people onto the scheme.

This means that:

The undersigned pharmacy staff agree to publicise that they are a distribution point through their sexual health publicity, posters and stickers available on display at their pharmacy and where young people aged 13-24 attend. This information will include how and when to access workers who are able to distribute condoms.

The undersigned pharmacywill allow the Teenage Pregnancy Co-ordinator at the Teenage pregnancy Unit to advertise that they are a distribution point by passing on their details to the National Youth Sexual Health helpline Sexwise 0800 282930 and the Sexwise website

The undersigned pharmacystaff will complete the C-Card Monitoring Form (CCS101) when a young person accesses condoms with a C-Card. These will include the young person’s ID number, today’s date, and how many condoms the young person has taken. At the end of the month, the C-Card Monthly Claim Form (CCS102) needs completing which acts as the payment claim form.

As a guide it is recommended that between 3 to 6 condoms be given out per visit to encourage young people to return for supplies or access other sexual health services. This is also a safe guard forthe undersigned pharmacy staffas young people with only three condoms are less likely to give them to other young people who do not understand what they are for and how to use them (namely under 13’s).

In some circumstances where for example a pharmacy member of staff knows a young person well and is certain that the young person is sexually active and will return to the service or where the young person appears to be over 18 then more condoms can be provided. It is recommended that no more than 9 or 12 condoms are provided at any one time.

Monitoring information will be recorded after each client transaction , the completed C-Card Monitoring Form (CCS101) and the C-Card Monthly Claim Form (CCS102) will in turn be sent to Primary Care Pharmacy Contracting Team, Birch House, Southwell Road West, Rainworth, Mansfield, Nottinghamshire, Notts, NG21 0HJ. By the 5th of the month following the month of activity. If the completed forms are not sent to the Primary Care Contracting Team further supplies of condoms will not be issued and transaction fees cannot be paid..

Community pharmacy staff will order by post condoms and lubricant from the Nottinghamshire Teenage Pregnancy Unit, TeenagePregnancy
C/OSpecialCoaches
Unit1KingsMillWay
Mansfield,Notts,NG185ER
Phone:01623627322
using the C-Card order form provided (CCS103)(minimum orders will apply as per form)

Pharmacy staff will rotate stock to prevent condoms and lubricant going out of date and regularly date check these supplies. Any stock that goes out of date needs to be sent back to the Primary Care Pharmacy Contracting Team marked ‘Out of date’. Any excess stock build up can be returned marked excess stock to the Primary Care Pharmacy Contracting team.

Condoms and lubricant can only be supplied to C card clients producing a C Card within the target age group. These supplies are provided free to the pharmacy provided there is full stock level accountability, and stock levels can be requested at any time by the PCT. Any quantity of stock missing not accounted for in orders or documented supplies will have to paid for by the pharmacy at current trade price plus VAT.

Sachets of lubricant will be offered to a young person accessing the C-Card scheme per session.

What if a young person requests information about the C-Card Scheme from an untrained pharmacy member of staff?

Written information about where to access C-Card registration and pick up points will be passed on and a C-Card Scheme leaflet should accompany any literature given to young people. Pharmacy staff will identify where and when they can access a trained worker in that setting. They will also identify where the young person lives and find an appropriate C-Card point nearby.

Workers will explain to the young person what happens at a C-Card registration point and that they will not automatically be registered.

Nottinghamshire CountyTeaching PCT C-card Pick up point Community Pharmacy (04/10)

The agreement will be signed by representatives from both the Provider and the PCT. In signing this agreement the Provider and Pharmacist agree to provide the above service as per the service level agreement Copies to be signed by both parties. One copy to be retained by the Provider, the other copy to be retained by the PCT.

Provider Name (Chemist Contractor)
Address from which service will be provided

Names of trained pharmacy staff who have undergone CRB checks who will be involved in the scheme:

Declaration

I / we agree to provide this Service as outlined within the service level agreement.

Signature on behalf of the Provider: (Chemist Contractor)

Signature Provider / Contract Holder / Name / Date
Contact Tel: Email:

Signature of Pharmacist with Responsibility for Service Delivery:

Signature / Name / Date

Signature on behalf of the PCT:

Signature / Name / Designation / Date
/ Jon Holliday / Assistant Director of Primary Care / 29.03.2010

Upon completion please return this form to Tina McMullan, Primary Care Contracting Lead, Birch House, RansomWoodBusinessPark, Southwell Road West, Mansfield, Nottinghamshire NG21 0HJ