Asda Pharmacy
Orbital Shopping Park,
Abbey Meads,
Swindon
SN25 4YX
Dear Pharmacist
Swindon PCT: Local Enhanced Service Agreement for Sexual Health Services
I am pleased to invite your pharmacy to be party to Swindon PCT’s Local Enhanced Services Agreement for the provision of sexual health services through pharmacies.
We have worked closely with the LPC to finalise this Agreement, and the LPC supports this Agreement.
If you are interested in providing the Services, please sign the Agreement, and send a copy back to me as soon as possible and in any event by 15th August 2009.
Please give me a call on 01793 708753 if you would like to discuss/clarify any aspects of the Agreement before signing.
I look forward to having you on board with this new project.
Yours sincerely
Nevil Batra
Dr Nevil Batra
Interim Public Health Consultant
cc Fiona Castle
Chief Executive of the Local Pharmaceutical Committee
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04/08/2009 18:29 / Local Enhanced Service Agreement for the Provision of Sexual Health Services by Pharmacy ContractorsLocal Enhanced Service Agreement for
The Provision of Sexual Health Services
By Pharmacy Contractors
This Agreement is made on Tuesday, 04 August 2009
Between
(1) Swindon Primary Care Trust (the “PCT”) of North Swindon District Centre, Thamesdown Drive, Swindon, SN25 4AN
(2) Swindon Primary Care Trust Provider Services (the “PCT-PS”), of Civic Offices Euclid St, Swindon, SN1 2JH, which provides and coordinates sexual health services at Swindon Health Centre, Carfax Street SN1 1ED (the “SCSP”) under Section 75 of the National Health Services Act 2006; and
(3) Asda Pharmacy of Orbital Shopping Park, Abbey Meads, Swindon, Wilts, SN25 4YX (the “Provider”);
Where as
(A) This Agreement is made by the PCT and PCT-PS with the Provider to secure the provision of sexual health services by the Provider (the “LES Scheme”).
(B) The PCT and PCT-PS wishes to secure the provision of sexual health services for the population for which it is responsible and the Provider wishes to provide such services on the terms and subject to the conditions of this agreement (the “Agreement”).
1 Introduction
1.1 Swindon has high teenage conception rates, high abortion and repeat abortion rates, low Chlamydia screening uptake rates, low uptake of long acting reversible contraception (LARC), and higher than average sexually transmitted infection (“STI”) rates. This LES Scheme is part of Swindon Primary Care Trust’s sexual health strategy to make significant inroads into improving sexual health outcomes for Service Users in Swindon.
1.2 The PCT-PS has a target to: achieve 6,150 Chlamydia tests in 2009/10, (up from 2,663 in 2008/09) and 8,645 Chlamydia tests in 2010/11 (the “Chlamydia Targets”); increase uptake of LARC to over 44% from 11% by 31/03/10; and to reduce teenage conceptions to around 80 per year by 2010 from 160 per year as of 2007.
2 Aims and Objectives
2.1 The objectives of the LES Scheme are to increase:
(a) Access to EHC by females who have had unprotected sex and help reduce the number of abortions in Service Users;
(b) Access to free condoms to reduce STIs;
(c) Access to Chlamydia screening and treatment; and
(d) Service User knowledge, demand, and uptake for LARC;
IT IS AGREED AS FOLLOWS
3 Definitions
3.1 For the purposes of this Agreement:
(a) “Comprehensive Azithromycin Consultation” means providing Service Users free at the point of delivery with:
(i) Azithromycin 1g; and
(ii) Information, advice, and promotion of condoms to reduce STIs; and
(iii) Condoms; and
(iv) Partner notification and contact tracing for Chlamydia; and
(v) Information, advice, and/or referral for LARC;
(b) “Comprehensive EHC Consultation” means providing Service Users free at the point of delivery with:
(i) Levonorgestrel; and
(ii) Information, advice, and promotion of condoms to reduce STIs; and
(iii) Condoms; and
(iv) Chlamydia testing; and
(v) Information, advice, and/or referral for LARC;
(c) “Drug Tariff” has the meaning given to it by the Regulations
(d) “General Practice” means any contractor other than the PCT party to a GMS, PMS, APMS, or PCTMS contract with the PCT
(e) “Good Health and Social care Practice” has the meaning given to it by the Terms and Conditions for the Provision of Community Health Services. NHS Contract for Community Services – Multilateral. Department Of Health. 2009.
(f) “Remedial Action Plan” means a plan to rectify a failure to meet a Key Performance Indicator (“KPI”) under this Agreement, specifying targets and timescales within which such targets shall be achieved
(g) “Regulations” means:
(i) The National Health Service (Pharmaceutical Services) Regulations SI 2005 No. 641; and
(ii) Directions to accompany the regulations in paragraph 3.1(g)(i), as updated, amended and/or superceded from time to time
(h) “Provider” means any party other than the PCT that has a current contract with the PCT to deliver Essential and Advanced Services, as defined by the Regulations;
(i) “Service User” means any person aged 13 to 24 registered with a Swindon PCT General Practice who:
(i) is registered on the C Card condom distribution scheme;
(ii) may benefit from Chlamydia testing;
(iii) may benefit from Azithromycin, that presents with a Swindon PCT Chlamydia notification slip and a FIT systems number in accordance with the treatment pathway in Schedule 1 of this Agreement; and/or
(iv) may clinically benefit from Levonorgestrel (“EHC”)
(j) “Services” means supplying Service Users, in accordance with this Agreement:
(i) Condoms;
(ii) Information, advice, and promotion of condoms to reduce STIs;
(iii) EHC under Patient Group Directions (“PGD”);
(iv) Chlamydia testing;
(v) Over the counter (“OTC”) Azithromycin or Azithromycin via PGD; and
(vi) For females, information, advice, promotion and/or referral for LARC
(k) “Signpost” has the meaning given to it by the Regulations
(l) “You’re Welcome” has the meaning given to it by ‘You’re Welcome quality criteria: Making health services young people friendly’. Department of Health. Gateway Ref: 7972. March 2007
(m) “You're Welcome Self Assessment Toolkit” has the meaning given to it by the ‘You're Welcome quality criteria self-assessment toolkit’. Department of Health. Gateway Ref 11584, April 2009.
4 Services to be Delivered
4.1 The Provider shall provide free at the point of delivery to Service Users, at the Providers registered address, any of the Services according to the clinical needs of the Service User.
4.2 The Provider shall ensure that any female Service User seeking EHC due to unprotected sex is:
(a) Encouraged to undertake a Chlamydia test; and
(b) Provided with condoms to use in future sexual activity; and
(c) Given information, advice about the benefits, and/or a referral for LARC
4.3 The Provider shall:
(a) Provide user friendly, non-judgemental, Service User centred and confidential Services;
(b) Signpost Service Users:
(i) excluded from treatment to other appropriate local services as directed by the PCT from time to time; and
(ii) to appropriate local contraceptive and/or GUM services, when necessary;
(c) Refer 13-15 year old Service Users to the PCT-PS contraception outreach nurse team, after providing the Services, and notify the Swindon teenage pregnancy coordinator of the Service User details;
(d) Signpost suspected pregnant Service Users to the PCT-PS outreach contraception nurse team; and
(e) Explain to Service Users that information may need to be shared with other health care professionals and agencies in accordance with any locally determined confidentiality and child protection procedures, when appropriate;
4.4 If it is not appropriate to issue Azithromycin, condoms and/or Levenorgestral to the Service User, the Provider shall refer the Service User to an appropriate healthcare provider, if necessary.
4.5 Service User partners accompanied by a Service User for which the SCSP have notified the Service User with a FIT system number should be offered a Chlamydia test, and treated with Azithromycin (even if the partner has a negative test), and even if the partner is over 24 years old.
4.6 Partners who are not accompanied by a Chlamydia positive Service User and who do not have a Swindon PCT Chlamydia notification slip should be offered a Chlamydia test kit if aged 15 to 24.
4.7 If the Provider is unable to supply any of the therapy Services because they do not have any supplies in stock they should ensure that the Service User is directed to an alternative provider.
5 Provider Responsibilities
5.1 The Provider shall:
(a) Procure sufficient quantities of Azithromycin and Levonorgestrel to meet demand from Service Users;
(b) Only supply OTC Azithromycin for the Services until the PCT provides a valid PGD;
(c) Ensure that the Service complies with Good Health and Social care Practice, and Fraser Guidelines;
(d) Comply with an ‘acceptable system of clinical governance’ as defined by the Regulations; and
(e) Have regard to ‘You’re Welcome’ and self assess its Services using the You're Welcome Self Assessment Toolkit.
5.2 The Provider shall ensure that:
(a) Any Provider staff legally barred from working with children or vulnerable adults do not deliver any of the Services at any time, and do not have access to any personal details of any Service User;
(b) The PCT is immediately notified if any Provider staff are legally barred from working with children or vulnerable adults; and
(c) Pharmacists and support staff delivering any of the Services have a satisfactory enhanced Criminal Record Bureaux (CRB) check prior to delivering any of the Services to Service Users.
5.3 The Provider shall ensure that:
(a) Its staff:
(i) have sufficient knowledge, skill, and competence to promote and to discuss with Service Users the benefits of the Services; and
(ii) consistently deliver the Services to a high standard;
(b) Any information provided to the PCT and PCT-PS is complete, timely, and accurate;
(c) Its staff attend at least one PCT meeting that is organised to ensure the Provider is up dated on any PCT related sexual health developments and/or requirements.
6 PCT-PS Responsibilities
6.1 The PCT will be responsible for:
(a) Supplying the Provider with:
(i) Chlamydia test kits with a Provider unique identifier (the “Code”); and
(ii) Condoms;
(b) Providing up to date details of other services which Provider staff shall use to refer Service Users, if necessary. Information will include the location, hours of opening and services provided by each provider;
(c) Promoting the Services locally, including developing any publicity materials, which pharmacies shall use to promote the Services to the public;
(d) Notifying the Provider each month of the number of Chlamydia test kits that have been processed by the laboratory with the Providers Code.
7 PCT Responsibilities
7.1 The PCT will be responsible for:
(a) Administering and paying for any CRB checks;
(b) Providing the Provider with valid PGDs to deliver the Services; and
(c) Paying the Provider subject to paragraph 8 of this Agreement
8 Payments
8.1 The PCT shall:
(a) Recover any payment made to the Provider which should not have been made;
(b) Ensure that any such recovery of an overpayment is without prejudice to any investigation of any alleged breach of the LES Scheme; and
(c) Have the right to set off against any amount payable to the Provider, any amount:
(i) owed by the Provider to it, or
(ii) which it is entitled to withhold under the terms of this LES Scheme (including terms of the Drug Tariff applied by this LES Scheme).
8.2 The Provider shall receive the following “Payments” for the Services:
(a) £20 per year per Service User registered on the Swindon C Card condom distribution scheme that use the Providers premises as the distribution outlet;
(b) £3.00 for each Service User tested for Chlamydia using a test kit with the Providers Code;
(c) £10 for each Comprehensive Azithromycin Consultation;
(d) £20.00 for each Comprehensive EHC Consultation; and
(e) the Drug Tariff basic price plus VAT for any Levonorgestrel and Azithromycin medicines dispensed;
8.3 The Provider shall complete forms in Schedule 2 and Schedule 3 of this Agreement, and return them to the SCSP for authorisation of payment by the PCT.
8.4 The PCT shall make monthly Payments to the Provider on receipt of an accurately and fully completed invoice in Schedule 3, by the 15th day of the month.
8.5 At no cost to the PCT and without any liability to the Provider, the PCT shall have the right to instruct the Provider to suspend Chlamydia testing for Service Users if the PCT reaches its Chlamydia Targets specified in paragraph 1.2(a) of this Agreement.
9 Service Quality Monitoring
9.1 The Provider shall:
(a) Report to the PCT its performance on the KPIs in Schedule 4, using the pro-forma in Schedule 5, by the 15th of the month after the quarter;
(b) Cooperate with any PCT requests for evidence of compliance with this Agreement; and
(c) Provide copies of any records requested by the PCT concerning compliance with this Agreement within 5 working days of being requested by the PCT.
10 Termination
10.1 This Agreement shall expire on 31st March 2011. Termination prior to the expiry date by any Party shall be made by giving the other Party 1 month written notice.
11 Signatures
11.1 These terms and conditions constitute the entire Agreement between the Provider and Swindon PCT for delivery of the Services until 31st March 2011.
11.2 IN WITNESS WHEREOF the Parties have signed this Agreement on the date first above written:
Name of the Provider: / Asda PharmacySigned on behalf of the Provider / Name: / Date: 04 August 2009
Signed on behalf of the PCT / Name: Frances Mayes / Date: 04 August 2009
Signed on behalf of PCT Provider Services / Name: Julie Paterson / Date: 04 August 2009
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Asda Pharmacy of Orbital Shopping Park, Abbey Meads, Swindon, Wilts, SN25 4YX
04/08/2009 18:29 / Local Enhanced Service Agreement for the Provision of Sexual Health Services by Pharmacy ContractorsSchedule 2. Services Delivered Form