NHS Oldham
Local Enhanced Service for Chlamydia Screening in Community Pharmacies
Service Level Agreement

Contents:

  1. Financial Details
  2. Service Aims
  3. Criteria
  4. Accreditation
  5. Ongoing Measurement & Evaluation

Financial Details

This agreement is to commence from 1 April 2009

Fee Structure: On agreeing a service plan with the PCT commencing 1 April 2009 participating pharmacies will receive:

  • A consultation fee of £5.50 for each client seen where a Chlamydia test is dispensed and condoms offered as part of the extended condom distribution scheme
  • £2 for each test received by the RU Clear laboratory. An additional bonus payment will be made of £5 per test if a pharmacy registers a minimum of 30 screens received by the laboratory over the year.
  • £10 for provision of antibiotic via PGD
  • Reimbursement for the cost of the antibiotic will be at Drug Tariff price plus VAT

Remuneration and Monitoring: The re-imbursement for the above costs is via NHS Oldham. Chlamydia Screening Pharmacy Claim Forms (Appendix 1) should be forwarded monthly to LisaHooper, Enhanced Service Co-ordinator, NHS Oldham, Ellen House, Waddington Street, Oldham OL6 9EE.

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

Claim forms should be received within two months of providing the screening intervention – claim forms received after this time will not be eligible for payment.

Payments are made to the pharmacy contractor who employs a pharmacist accredited to provide the service. This will be paid monthly in arrears.

Claim forms will be monitored by the PCT against the number of testing forms received by the Chlamydia Screening Office.

PAYMENT WILL ONLY BE MADE UPON RECEIPT OF PRACTICE SIGNATURE SHEET (Appendix 2)

Service Aims

All Pharmacies are expected to provide essential and those additional services they are contracted to provide to all their patients. This enhanced service specification outlines the more specialised services to be provided. The specification of this service is designed to cover the enhanced services of the Community Pharmacy Contract, all of which are beyond the scope of essential services. No part of the specification by commission, omission or implication defines or redefines essential or additional services.

The aims of this service are to:

(i)To reduce the prevalence of Chlamydia in young people by providing access to Chlamydia screening as part of the Greater Manchester R U Clear Programme in community pharmacies across Oldham and offering condoms as part of the extended condom distribution scheme.

(ii)To increase the number of 15 – 24 year olds being tested for Chlamydia.

(iii)To dispense appropriate treatment for clients diagnosed with Chlamydia.

(iv)To increase the knowledge of risks associated with Sexually Transmitted Infections (STIs) and promote the use of condoms.

(v)To contribute to improving the sexual health of 15-24 year olds by providing information on other sexual health services available and suggesting a full sexual health screen at a specialist sexual health service.

Criteria

The Enhanced Service Specification details the following criteria.

The following pages contain some further guidance from the PCT on expected processes, outcomes and deliverables based on this process. On aspiring to this service practices are required to submit the completed application form (Appendix 3).

  1. Direct Service Delivery
  1. Data Collection
  1. Facilities
  1. Staffing
  1. Liaison/Shared Care
  1. Review/Audit

Criteria One: Direct Service Delivery
Details:
  • To offer a Chlamydia screening test to 15 – 24 year olds as part of the Greater Manchester R U Clear programme from community pharmacies who have agreed to deliver this Local Enhanced Service and have attended training provided by the R U Clear programme.
  • To complete the white sections of the laboratory form and advise the client on how to complete the rest of the form.
  • To supply clients diagnosed with Chlamydia with the appropriate treatment under Patient Group Direction (PGD)
  • To offer clients condoms as part of the extended condom distribution scheme.
  • Pharmacies will offer a user-friendly, non-judgmental, client-centred and confidential service.
  • The supply of the Chlamydia test and appropriate treatment will be made free of charge to the client at NHS expense.
  • Pharmacies will link into the RU Clear Chlamydia Screening Programme.
  • Pharmacies will link into existing networks for sexual health services so that clients can be referred on rapidly if necessary.
  • Pharmacies will provide support and advice to clients accessing the service, including advice on where they can access sexual health services.
  • Accredited pharmacies will ensure consistency of service provision: if there is no accredited pharmacist available to provide treatment, pharmacists will find out (by telephone) which is the closest accredited pharmacy to provide the service at that point in time, and sign post the client to this pharmacy.

Criteria Two: Data Collection
Details:
Data will be recorded as follows:
  • Number of clients given a Chlamydia testing kit
  • Number of clients who return a sample for testing to R U Clear
  • Number of clients receiving treatment for Chlamydia and/or Gonorrhoea
  • Number of clients who receive condoms as part of the extended condom distribution scheme

Criteria Three: Facilities
Details:
The service can only be provided in an approved pharmacy, which MUST have a suitable area for consultation with clients. This may be a quiet area within the shop or a separate room.
The pharmacy will be required to clearly display promotional materials provided by the PCT and R U Clear and provide leaflets opportunistically as appropriate.
The pharmacy has appropriate health promotion material (provided by the PCT) available to the client group, actively promotes its uptake and is able to discuss the contents of the material with the client, where appropriate.
Criteria Four: Staffing
Details:
  • Appropriately trained pharmacy staff can offer a test after attending a short training session delivered by the R U Clear Programme
  • Pharmacists can provide both screening and treatment after completion of PGD training and the Centre for Pharmacy Postgraduate Education distance learning (covering Child Protection: a guide for the pharmacy team and Sexual Health: testing and treating) to gain HAG accreditation
  • All training documentation must be retained
  • Further training is mandatory every two years
  • All requests should be handled in a sensitive and non-judgemental manner

Criteria Five: Review/Audit
Details:
  • Pharmacies must keep a record of the consultation and outcome on the client pro-formas provided for 3 years
  • The pharmacy should maintain appropriate records to ensure effective ongoing service delivery and audit
  • The pharmacy reviews its standard operating procedures and the referral pathways for the service on an annual basis.
  • Computerised records are recommended to be kept
  • The pharmacist will complete an audit form provided and return it to the R U Clear programme. (Appendix 4)

Accreditation

Member of the Royal Pharmaceutical Society of Great Britain has undergone specific training for providing treatment service.

Premises be up to required standard.

Ongoing Measurement & Evaluation

The ongoing measurement is outlined in the various criteria in the previous section.

In addition the pharmacy is required to agree with the PCT this service specification/plan at the start of the year and to submit the completed document at the end of the year for evaluation purposes.

True Partnerships, Professionals, Patients and the Public

The accredited community pharmacy should work closely with Family Planning, the Brook Advisory Service and GP practices.

The scheme is managed by Oldham PCT who will maintain a list of names, addresses, contact details, opening hours, sex of the pharmacist and languages spoken.

The list is circulated to:

  • All community pharmacists
  • Brook Advisory Service
  • Family Planning
  • NHS Direct
  • GP Practices
  • Accident and Emergency Department at Royal Oldham Hospital
  • NHS Walk-in Centre
  • Go-to-Doc

Keeping Viable

A free exchange of information should occur between the partners of the agencies involved.

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

The client must present at the pharmacy for a test. Supplies to a third party are not allowed except in very exceptional circumstances. No supply of medication 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 a pack with information concerning:

  • Contraception
  • Sexually Transmitted Infections (STIs)

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 participating pharmacists or other service providers.

Record Keeping

The pharmacy staff are required to complete the relevant sections of the laboratory form at the time of the consultation with the client.

The following clients details are to be recorded on the monthly claim form: name, date of birth and postcode along with the unique Chlamydia reference number from the tear off label on the laboratory form.

A checklist (Appendix 5) is to be completed and kept as a record in relation to issuing treatment in accordance with PGD and protocol for the supply of treatment of uncomplicated genital Chlamydia.

The following details are to be recorded for those clients who receive condoms: age, gender, ethnicity, post code and number of condoms issued

Adverse Incidents

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

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.

The community pharmacist is responsible for maintaining adequate staffing levels to provide the service and for maintaining a personal development plan.

The contractor pharmacist is responsible for completing the annual declaration to the PCT of names and designation of the staff qualified to provide this service.

APPENDIX 1

CHLAMYDIA SCREENING IN PHARMACY

MONTHLY AUDIT CLAIM FORM

MONTH/YEAR CLAIMED …………………..

Pharmacy Stamp:

DATE / CHLAMYDIA REFERENCE NO. (CRN) / ETHNICITY / AGE / POST CODE / RU CLEAR PACK GIVEN / RECEIVED BY RU CLEAR LAB
(for PCT to complete) / ANTIBIOTIC
DISPENSED / ACCREDITED PHARMACIST

CUMULATIVE TOTAL £ ……………………

AUTHORISING SIGNATURE OF PHARMACY …………………………………………………

Please return this form to:

Lisa Hooper,

Enhanced Service Co-ordinator,

NHS Oldham,

Ellen House,

Waddington Street,

Oldham,

OL9 6EE

APPENDIX 2

Signature Sheet

This document constitutes the agreement between the pharmacy and the PCT in regard to this local enhanced service (Chlamydia screening)

……………………………………………………………………………………………. Pharmacy

Signature on behalf of the Pharmacy:

Signature / Name / Date

Signature on behalf of the PCT:

Signature / Name / Date

Please return this signed sheet to:

Lisa Hooper,

Enhanced Service Co-ordinator,

NHS Oldham,

Ellen House,

Waddington Street,

Oldham

OL96EE

Appendix 3

Application

Please return this form to Lisa Hooper, Enhanced Service Co-ordinator, NHS Oldham, Ellen House, Waddington Street, Oldham OL6 9EE

Pharmacy Provider Application for Local Enhanced Scheme 2009/10
Pharmacy Name:
Using the criteria within this SLA please give a brief overview of how the service will operate in your pharmacy.
Please confirm that you have appropriate facilities to provide this service:

Yes No
Will providing this service adversely affect the practice’s ability to provide essential or additional services?

Yes No
Who will be providing the service?
Do you have evidence of appropriate staff qualifications?
Yes No
How will you ensure staff providing the service remain suitably qualified?
How will you monitor and audit service provision (refer to any requirements within the scheme).

Appendix 4

Chlamydia Screening in Pharmacies LES

Annual Review Audit and Monitoring Form 2009/10

Please return by 12th February 2010 to Lisa Hooper, Enhanced Service Co-ordinator, NHS Oldham, Ellen House, Waddington Street, Oldham OL6 9EE

Pharmacy:
Name of person completing form:
Phone number and email address for contact for this LES:

Two years compared: 2008-2009 and 2009-2010

Comparing 2008-9 with 2009-10, has your pharmacy screening rate improved or deteriorated :

Improved Deteriorated Same

1. If any of the actions taken to improve uptake at your practice have been successful, please describe them below:

2. If your screening rates are low, please describe your plans to address this:

Are you willing for the information supplied for questions 2 and 3 to be shared with other practices?

Yes, with practice name:Yes, if anonymised: No:

Appendix 5

PHARMACY CHLAMYDIA PRESCRIPTION FORM

Check list to be used by accredited pharmacist issuing treatment in accordance with patient group direction and protocol for the supply of the treatment of uncomplicated genital Chlamydia.

Pt details: Name or CRN numberDate of birth

Seen by:Date:

Post Code : Ethnicity:

NO / YES / Notes
Test Kit supplied
Azithromycin supplied / Batch No
Expiry
Check patient details & check correct diagnosis, medication, dose and expiry date
Check for exclusions as per patient group direction.
Discussed treatment, side effects and the importance of compliance
Advised to refrain from sexual contact until infection fully treated and partners treatment completed
Discussed possible reduced efficacy of OCP and possible interactions with other medication
(if appropriate)
Safer sexual health discussed, diagnosis discussed and information leaflets given for both chlamydia & azithromycin
Details of follow up arrangements given if appropriate

Pharmacist signature ………………………………………………………..

1