Local Enhanced Service Specification for screening and treatment for Chlamydia trachomatis under Patient Group Direction (Reference: LESS Chd)

Contents:

  1. Introduction
  2. Aim of the Service
  3. Service Outline
  4. Strategic Plan and links to other services
  5. Access, Referral and Discharge Arrangements
  6. Record Keeping
  7. Information Collection
  8. Training and Accreditation
  9. Adverse Incidents
  10. Clinical Governance
  11. Quality Indicators
  12. Financial Details
  13. Signature Sheet
  14. Review

1. Introduction

The supply of screening kits or the offer of an on-site screen provided by a small number of pharmacies in Trafford. The same pharmacists are also accredited to supply appropriate antibiotic treatment to Chlamydia positive clients under a PGD.

This SLA must be read in conjunction with the Trafford Chlamydia Service Guidelines

2. Aim of the Service

The aim for this service is to reduce the pool of undiagnosed, untreated genital C. trachomatis infection in young sexually active women aged 25 or under by offering urine testing for genital C. trachomatis infection.

In addition the screening and treatment consultations will provide an opportunity to promote good sexual health to this population group

3. Service outline

The screening service is available to any young people aged 25 and under who present to a participating registered community pharmacy in Trafford. A on-site screen may be provided, or the supply of a postal kit with appropriate education and information for correct use of the kit.

The treatment service is available to young people aged 25 and under who present to an accredited pharmacist working in a registered community pharmacy in Trafford. The pharmacist is accredited to supply and administer a Prescription Only Medicine (POM) under a patient group direction (PGD). The PGD contains explicit inclusion and exclusion criteria, with which the accredited pharmacist must comply.

4. Strategic Plan and links to other services

Primary Prevention

To reduce the number of undiagnosed Chlamydia (and gonorrhoea) infections to prevent long term complications associated with these infections. In addition raise awareness of Sexually Transmitted Infections (STI)s.

Preventative Treatment, Reducing Complications

To raise awareness of the consequences of these infections and the complications arising from unsafe sexual practices.

Reducing Health Inequalities

The service is free and available to all young people aged 25 and under irrespective of their place of residence within Trafford , ethnicity or religious persuasion.

More Effective Care

To increase the equality of access to a service providing free screening and treatment and sexual health advice.

True Partnerships, Professionals, Patients and the Public

The accredited community pharmacists work closely with the National Chlamydia Screening Office and regional RU Clear office.

The scheme is managed byTrafford PCT who maintains a list of names, address, contact details, opening hours, sex of the pharmacist and languages spoken. The list is circulated to:

  • All community pharmacists
  • NHS Direct
  • GP Practices
  • Accident and Emergency Departments of local NHS Hospitals
  • PCT website
  • RUClear Website
  • GU Clinic of local NHSHospital

Keeping Viable

  • A free exchange of information occurs between the partners of the agencies involved.

5. Access, Referral and Discharge Plans

A client may access the service from a pharmacy by the following methods:

  • Self-referral
  • GP practice
  • Other healthcare professional
  • GU Clinic

The supply and advice is a clinical decision by the accredited pharmacist. The client must present at the pharmacy for a consultation. Supplies to a third party are not allowed except in very exceptional circumstances. No supply for future use is allowed under the patient group direction.

The consultation with the client is carried out at the point of access. The client is supplied with information concerning:

  • contraception
  • STIs
  • information about the antibiotic supply
  • free supply of condoms
  • Further screenings or test of cure (if appropriate)

A patient is discharged after the consultation but may re-refer into the scheme if a further screen, treatment or further advice is required.

The accredited pharmacist must refer all clients who fall into the exclusion criteria to:

  • GP practice
  • RUClear Office
  • GU clinic at Trafford Healthcare Trust
  • Other healthcare professionals

The accredited pharmacist can seek advice from the RUClear office or the NHS GU Services via a helpline if unsure of a course of action.

The pharmacist may refuse a supply to a client who becomes abusive or disruptive or whose behaviour falls outside the agreed standards laid down in local pharmacy protocols. The pharmacist should refer such clients to other accredited pharmacists or other service providers.

The service should be accessible to all clients presenting at the pharmacy during the times that the pharmacy is open, providing the appropriately accredited staff are available.

6. Record Keeping

Trafford PCT medicines management team together with the PCT sexual health service commissioner manage the service. All the necessary paperwork is supplied by the team and the RUClear office to the accredited pharmacist.

The pharmacist is required to complete the designated forms at the time of the consultation with the client. These must be completed for every consultation regardless of whether or not a supply antibiotic has occurred. Appropriate counselling regarding safe sex, condom use and education of sexual risk factors is offered at every consultation.

The information supplied by the client is confidential and stored by the pharmacist for an agreed period of 8 years.

The form recording the consultation for the supply of antibiotics must remain on the pharmacy premises and not be removed under any circumstances unless by a direction from the project manager.

All patient identifiable information must be stored securely and when no longer required should be disposed of as confidential waste. All aspects of confidentiality must conform to the principles set down by the data Protection Act.

7. Information Collection

The pharmacist must complete an audit form of activity and return to the PCT prescribing team by the 5th day of the 3 month payment cycle. Dates for payment claims can be confirmed with the Medicines Management Team at the PCT

The audit form requires completion of the following details:

  • Date and day of the week of request for antibiotic treatment
  • Age of the client
  • Reason for request
  • A record of supply of which antibiotic and the reason for choice if applicable
  • Or a record of refusal to supply with and the reason for such refusal
  • Postcode- first three characters only
  • Ethnicity

The pharmacist should complete an invoice of activity that should arrive at the PCT office no later than the 12th day of the month to ensure prompt payment. A pharmacy with a lower level of activity may complete an invoice every three months. However the audit form should still be completed and returned every month. The method of returning the information to the PCT is via a fax or the access database disc.

An activity report is generated every quarter by the project manager.

8. Training and Accreditation

All community pharmacists providing the service are required to attend the initial training session provided by the RUClear Nurse in conjunction with Trafford PCT. The pharmacists must also complete the open learning packs from the Centre for Pharmacy Postgraduate Education (CPPE), relevant to Sexual Health promotion, and Safeguarding Children, in addition to other material as required by the project management team. Each accredited pharmacist is required to attend a mandatory re-accreditation session every year. In addition the accredited pharmacist must attend training organised by the project manager necessitated by a change to the PGD or as required.

Failure to attend these sessions will result in the pharmacist being removed from the list of accredited pharmacists.

The Treatment element of this service is a pharmacist specific scheme which cannot be devolved to another member of staff unless they are an accredited pharmacist.

Support staff wishing to participate in the screening element of the service must also access the appropriate training from the RUClear Nurse in conjunction with Trafford PCT. staff must be fully aware of the need to adhere to strict patient confidentiality and must understand their responsibilities under the Data Protection Act and Caldicott Guidelines.

9. Adverse Incidents

The accredited pharmacist should record all adverse incidents via the Yellow Card procedure or the PCT incident reporting scheme as appropriate. The project manager and the RUClear office must be informed of all incidents.

10. Clinical Governance

The contracted pharmacist should ensure that:

  • Only appropriately qualified staff, including locums should provide the service to the required professional and ethical standards of care and treatment as to the dispensing of medicines and giving advice to patients.
  • A standard operating procedure should be in place.
  • adequate staffing levels are in place to provide the service
  • appropriate CDP and a personal development plan are maintained by the accredited pharmacist
  • All pharmacy staff including locum or relief pharmacists are aware of their responsibilities under the Data Protection Act and Caldicott Guidelines for maintaining patient confidentiality
  • All pharmacy staff including locum or relief pharmacists are aware of their responsibilities for safeguarding children and making the appropriate referral to the named child protection lead for the PCT.
  • Thecompletion of the annual declaration to the PCT of the names and designation of the staff qualified to provide this service.

11. Quality Indicators

The contracted pharmacist should ensure the following:

  • the appropriate health promotion literature is available for supply at the consultation;
  • reviews the standard operating procedures on an annual basis;
  • the pharmacist has undertaken CPD relevant to this service;
  • the pharmacy has a complaints procedure for monitoring the procedures provided;
  • co-operates with any review of the client experience.

The quality standards for the pharmacist are:

  • Completion of the required CPPE packages;
  • Accreditation by the RUClear Office and Trafford PCT project manager. This also includes feedback and de-briefing from the training team;
  • Mandatory re-accreditation every year or sooner if required;
  • Participation in the ‘mystery shopper’ scheme if applicable. Pharmacists will be provided with further information if the PCT initiate this scheme

12. Financial Details

Payments are made to the pharmacy contractor who employs a pharmacist accredited to provide the service and are as follows:

  • A service fee of £10.00 for the provision of an on-site screening test
  • A consultation fee of £10.00 per client for the supply of antibiotic under PGD
  • Reimbursement of the antibiotic supplied based on current DT prices
  • A service fee of £4 for the issue of each screening postal kit
  • An additional ‘top-up’ fee of £2 for each postal kit that is tested by the lab and identifiable to the issuing pharmacy

Claims will be forwarded to the Medicines Management team of Trafford PCT on a 3 monthly basis

The payments detailed above may be subject to a revision dependent on any changes in the fees following negotiations with the PCT and the LPC

13. Signature Sheet

Signature on behalf of the PCT:

Signature / Name and Designation / Date

Signature on behalf of the Contractor:

Signature / Name and Designation / Date
14. Review

The Service Level Agreement will be reviewed annually or sooner dependent on any changes to the clinical and/or financial arrangements.

Next annual review Sept 2010

LESS Chd – Chlamydia screening & treatment PGD Trafford PCTPage 1 16/09/2018