Cheltenham Pharmacy

STANDARD OPERATING PROCEDURE

Enhanced Services – Emergency Hormonal Contraceptive supply under the PGD

Patient requests EHC (must be patient herself not representative, or in exceptional circumstances a telephone consultation)

Patient must be referred to the pharmacist in sensitive manner without judgement

The pharmacist must be accredited to give EHC by Sexual HealthServices as per PGD

(any personnel changes need to be notified to NHSE – contracts team)

ALWAYS discuss IUD as an alternative or additional method of contraception for increased efficiency.

Signpost the patient accordingly. Use the referral form. Phone Hope House if patient consents and book an appointment. Patient should have EHC anyway before IUD (incase IUD not fitted).

Proformamust be completed to assess patient’s suitability for EHC in private consultation area

Obtain patient consent and state confidentiality statement

Unprotected sex > 72 hours

STANDARD OPERATING PROCEDURE

Enhanced Services – Emergency Hormonal Contraceptive supply under the PGD

Previous use?

More than twice in one month i.e two given in previously in this cycle

Allergies? Side-effects- can give domperidone under PGD for nausea and vomiting

How old is the patient?

Complete the EHC Pro-forma

Pregnancy test can be performed if suspected pregnancy – will only show 21 days after UPSI

Check patient’s current medication such as enzyme inducers i.e carbamazepine or St Johns Wort. Adjust Levonelle dose accordingly or contact Hope house for further advice. Dose in certain circumstances (enzyme inducers) can be increased to two tablets STAT.

STANDARD OPERATING PROCEDURE

Enhanced Services – Emergency Hormonal Contraceptive supply under the PGD

Does the patient suffer from diseases which can affect absorption such as Crohns disease?

Counsel patient on

Mode of action

Common side-effects

Vomiting/diarrhoea within 2 hours – can give domperidone if patient likely to vomit

Contraception – future use counsel on long term contraception such as implant and IUD etc.

Efficacy

Effects on foetus

Effect on next period

Follow-up – abdominal pains, pregnancy test if period > 7 days late.

Give patient PIL

Subsequent UPSI is not protected.

Advise and give patient leaflets on full STI screen, fpa EC, fpa contraception (fpa COC/ POP)

Advise on appropriate time to visit GP/Clinic (if period hasn’t started).

Offer chlamydia screen in an opt-out rather than opt-in manner. One for partner/s as well.

Re-test after 2- 3 weeks. Offer Toilet facilities available on site.

Offer supply patients with condoms if required. Take from counter and will reimbursed.

STANDARD OPERATING PROCEDURE

Enhanced Services – Emergency Hormonal Contraceptive supply under the PGD

PREPARED BY:
SIGNATURE:
DATE OF PREPARATION: / 1st March 2013
DATE EFFECTIVE FROM: / 1st March 2013
VERSION NUMBER: / 1

I have signed to say that I have read the procedure and understand its implications.

NAME / SIGNATURE / DATE

Date: 01-03-2013 EHC under PGDDate of review: March 2014