SOP– Procedure for Supply of Emergency Hormonal Contraception (EHC) under Patient Group Direction (PGD) EXAMPLE

Procedure for supply of EHC working under PGD
ACTION / SUPPLEMENTARY ACTION
Client presents to pharmacy staff requesting EHC or ‘Morning after Pill’ / ·  Ensure staff are trained – sensitive handling of request; non-judgemental; re-assuring.
·  Escort client to consultation area
·  Ask Pharmacist to attend – tell client expected waiting time
·  NB: staff to signpost to alternative EHC provider if trained pharmacist not available & free service is required – via sexhelpglos website/ local info
Begin consultation process as directed by EHC training under PGD – using proforma to record information / ·  Ensure confidentiality mentioned
·  If friends attend, check whether appropriate to stay in consultation, or ask them to step out
·  Consider chaperone requirement/door ajar
·  Warm & friendly attitude
·  Assess UPSI event
·  Record information on proforma
If under 16 yrs ensure Fraser Guidelines have been assessed and any child protection issues / ·  Assess client competence
·  Adult/parental involvement
·  Boyfriend’s age & relationship
·  Phone for help if client falls outside PGD as per training or Safeguarding concerns
If pregnancy suspected following discussion, carry out pregnancy test / ·  Follow SOP for pregnancy testing
·  Patient to produce sample on site or asked to return with sample
·  Sign post onto appropriate services if a positive result obtained (GP, PAS, and Teenage Pregnancy Midwives).
Supply EHC –Levonelle 1500 where indicated, following PGD – client to take pill/s during consultation with water provided / ·  Complete proforma
·  Pharmacist signature
·  Discuss side-effects; failure; after care; contraception
·  If antiemetic indicated follow PGD for Domperidone – dispense dose into a pill pot/cup to take stat – record supply on proforma
·  If client refuses to take – suspect 3rd party request
·  Phone for help if client falls outside PGD and at risk, as per training – note outcome on proforma
Always discuss IUD as alternative EC – and consider risk factors for client / ·  Assess risk – mid-cycle; time since UPSI; does not want to risk pregnancy
·  Sign post to appropriate service – make telephone call if needed to facilitate referral (ellaOne/ IUD) – note on proforma
Give appropriate leaflets & condoms where needed, and any follow up advice / ·  STIs discussed
·  Chlamydia test kit given & for partner/s
·  Signpost to further contraceptive services
·  Discuss follow up as per PGD
Store proforma for 8 years or upto age 25 if under 16 / ·  Follow valid PGD – check date of expiry
·  Make monthly returns to PCO
·  Keep CPD updated on EHC (FSRH) & related topics

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