Annex A1
Department for Children,
Adults and Health
Health & Wellbeing Division
Azithromycin (Chlamydia) Treatment
Service Specification 2015-18
Introduction
A Service Specification describes the minimum requirements for a particular service. It sets out all the important elements of that service.
All types of service that might be commissioned for someone by the Council will be described in Specifications, and the Specification will form a part of any Contracts or Agreements that are drawn up with those who are to provide the service or part of the service.
This Specification will apply until further notice. The views of Service Users, Carers and Providers will be taken into account in any review of the Specification during that time, and their views will be welcomed at any time.
Further information can be obtained from the Partnerships & Commissioning Team, Directorate for Children, Adults & Health, PO Box 298, South Gloucestershire Council, Civic Centre, High Street, Kingswood, South Gloucestershire, BS15 0DQ.
Provision of Azithromycin by PGD
Service Specification 2015-18
Programme Lead: Lindsey Thomas, Specialist Public Health Manager
Tel: 01454 864664
1 Service Background
1.1 The provision of sexual health services in community pharmacies contributes to the following key local and national health priorities:
· Reducing the rate of under 18 conceptions
· Reducing STI rates amongst young people
· Increasing the number of Chlamydia diagnoses
· Outcomes indicated in ‘A Framework for Sexual Health Improvement in England’ (Department of Health 2013)
· Meeting the local Chlamydia screening target for 15-24 year olds.
1.2 All community pharmacies are required to provide some sexual health services as part of their essential services, e.g. promotion of healthy lifestyles, providing opportunistic sexual health advice in Public Health campaigns, signposting people to other services (including Contraception and Sexual Health Services [CaSH], Genito-Urinary Medicine [GUM] and maternity access), and support for self-care.
1.3 This service specification for Chlamydia treatment outlined in this document builds on these essential services, to provide a full and co-ordinated range of sexual health services to young people.
1.4 This Service will operate from 1st April 2015 until 31st March 2018. It will be annually reviewed in the light of any changes to pharmacy provision and healthcare needs of the local population.
2 Service Aims
2.1 To treat clients (and their partners where authorised) who have been identified as having a Chlamydia infection.
2.2 To increase awareness of Chlamydia infection and transmission, its often asymptomatic nature, and potential for harm.
2.3 To increase the uptake of the local Chlamydia Screening Programme, thus increasing the number of identified cases and increase the number of infected patients being treated.
2.4 To raise awareness of sexually transmitted infections (STIs) and provide support and advice to young people on safer sex, condom use & contraceptive methods when required.
3 Service Description
3.1 Community pharmacies participating in this service undertake:
· To provide free Chlamydia treatment (Azithromycin) via patient group direction (PGD) to those referred or authorized by the Chlamydia Screening Team
· To provide free Chlamydia screening kits to 15 – 24 year olds
· To provide a Safer Sex pack (6 free condoms, lubrication and a local services leaflet) to young people being tested or treated, and to those taking screening kits
· To give advice on condom use, contraception, sexual health and sexually transmitted infections
· To signpost to services that provide reliable regular contraception, management of sexually transmitted infections and specialist support (where appropriate)
· To ensure their service meets the Baseline Standards specified by ‘You’re Welcome’, known locally as ‘Young People Friendly’
4 Service Criteria
4.1 Pharmacies will offer free-of-charge Azithromycin in line with the requirements set out in the South Gloucestershire Council PGD for Azithromycin for clients with a positive screen result, confirmed by the Avon Chlamydia Screening Office.
4.2 Pharmacies will offer free-of-charge Azithromycin for contact partners of clients with a positive screen result, in line with the requirements set out in the South Gloucestershire Council PGD for Azithromycin, confirmed by the Avon Chlamydia Screening Office.
4.3 Clients or contact partners requiring treatment who are excluded from treatment under the PGD, will be signposted to an appropriate service. Information on local sexual health services will be supplied to participating pharmacies by South Gloucestershire Council via the LPC South Gloucestershire Sexual Health webpage. The information supplied will include opening hours and services provided.
4.4 Avon Chlamydia Screening Office (ACSO) will inform pharmacies directly of clients intending to attend for treatment following a positive test. The ACSO will check the pharmacist’s availability, and provide details of the client’s name, date of birth, and ACSO number. These details should then be verified by the pharmacist with the client, upon attending at the pharmacy for treatment. Advice will be supplied by pharmacists on the need for contact partner notification of any positively-tested and treated clients. Partner notification will be undertaken by trained staff at the local Chlamydia screening office.
4.5 Pharmacies will also provide a Safer Sex pack (6 free condoms, lubrication and a local services leaflet) to all young people requesting testing or treatment. Packs (for this purpose only) can be ordered free from KRIS at The Greenway Centre, 0117 922 2290 Email: . Order forms are available on the LPC webpage.
4.6 Pharmacists will need to satisfy themselves that treatment of, or provision to, any individuals under the age of 16 years is only after they have been judged to have met the Fraser Guidelines for treatment. Where a young person is judged not to be competent, they should be referred to, or advised to attend a Sexual Health Clinic or GP. Any Safeguarding concerns must be recorded and discussed with your nominated Child Protection lead. There is also an additional requirement to notify FirstPoint (Children & Families Service) on 01454 866000 of any clients aged 12 and under.
5 Pharmacy requirements
5.1 The pharmacy contractor must ensure that all relevant commissioning contracts have been signed by both the pharmacy lead and the South Gloucestershire Council lead.
5.2 Pharmacies must have an appropriate consultation room which provides a sufficient level of privacy (at the level required for the provision of the Medicines Use Review service).
5.3 A Chaperone Policy must be produced by the pharmacy and be in place in the pharmacy consultation room.
5.4 The pharmacy will clearly display any logos that are developed to brand any part or all of the service.
5.5 The pharmacy must review its standard operating procedures and the referral pathways for the service on an annual basis.
6 Pharmacist requirements
6.1 Pharmacists must have read and signed the South Gloucestershire Council Patient Group Directions for Azithromycin. Up to date copies of the PGD should be held in each pharmacy offering this service, and be available for reference. The pharmacist must ensure that their professional indemnity cover includes the supply of medicines through Patient Group Directions.
6.2 The pharmacy contractor has a duty to ensure that all pharmacists and staff involved in the provision of the service are aware of and operate within appropriate Standard Operating Procedures (SOPs) which must be in place.
6.3 Pharmacists may need to share relevant information with other health care professionals and agencies, in line with locally determined confidentiality arrangements, including, where appropriate, the need for the permission of the client to share the information.
Pharmacist Training
6.4 The pharmacy contractor has a duty to ensure that all pharmacists and staff involved in the provision of the service are qualified, have relevant knowledge and are appropriately trained in the operation of the service, including confidentiality, sensitive patient centred communication skills, and data protection.
6.5 All pharmacists involved in the provision of the service must attend a sexual health training session organised by South Gloucestershire Council, Bristol City Council, or North Somerset Council before delivering this service. In addition pharmacists need to attend an annual update provided by South Gloucestershire Council.
6.6 Pharmacists providing this service must have evidence of completing Level 1 training in Safeguarding Children & Vulnerable Adults delivered by South Gloucestershire Council, Bristol City Council, North Somerset Council or CPPE. Pharmacists will also be required to undertake level 2 equivalent Safeguarding training (through the same providers) within 12 months of commencing service delivery or by October 2015 if already delivering. Local Safeguarding procedures are available at www.swcpp.org.uk . If you have any concerns about a child or young person, call FirstPoint on 01454 866000. If you are concerned about an adult being at risk, you must report it by calling Adult Care on 01454 868007. If a child, young person or vulnerable adult is in immediate danger, dial 999 and ask for police assistance.
6.7 South Gloucestershire Council also recommends the completion of the following self-learning packages as additional resources:
Centre for Pharmacy Postgraduate Education (CPPE) ‘Sexual health’
CPPE: ‘Contraception’
CPPE: ‘Dealing with Difficult Discussions’.
7 Quality Measurement and Monitoring Requirements
7.1 An assessment of need and suitability for a client to receive Azithromycin must be recorded on PharmOutcomes.
7.2 A summary of the outcome of the consultation for Azithromycin must be recorded on PharmOutcomes.
7.3 The PGD relating to the service may be downloaded from the LPC website.
7.4 The Provider will maintain an effective system for Quality Assurance based on the outcomes for Service Users, in which standards and indicators to be achieved are clearly defined and regularly monitored.
7.5 Outcomes from the Quality Assurance process will be made available to Service Users, Carers, and all stakeholders including the Department.
7.6 The Provider will have responsibility for monitoring of their service and maintain sufficient records for this purpose. These records should be retained and kept up-to-date and made available on request for inspection by a nominated representative of the Department.
7.7 The Provider will have a system in place to identify and put in place continuous and sustainable improvements in the quality of the service. Details of improvements are to be provided to the Department on request.
7.8 The performance of the Provider will be reviewed by the Department. The Provider will allow access for service review or inspection by Officers designated by the Department if required. Financial information will be supplied as requested by the Department from time to time.
8 Equalities
8.1 South Gloucestershire Council is committed to ensuring that it is operating fairly and equitably through services delivered directly by the Council and through those it commissions.
8.2 Commissioned services are expected to determine the appropriate level of monitoring required in order to ensure that an effective analysis can be undertaken to inform both the ongoing delivery of that service and future commissioning intentions
8.3 All relevant sections of the patient information form must be completed in relation to the required data sets: age, gender, ethnicity, and postcode
8.4 Commissioners will utilise this information collected to undertake an analysis of the data gathered in relation to these specific issues.
9 Review and Audit
9.1 All data inputted into PharmOutcomes will be automatically saved in line with the legal requirements for data storage and protection.
9.2 Information will be supplied from the Avon Chlamydia Screening Programme on pharmacy performance on tests issued.
9.3 The pharmacy will co-operate with any locally agreed assessment of service user experience, this can include ‘mystery shopping’.
9.4 The pharmacy will participate in a periodic South Gloucestershire Council audit of service provision and usage.
10 Contact Details
Lottie Lawson
Department for Children, Adults and Health
PO Box 298, Health & Wellbeing Division
Kingswood Civic Centre,
High Street, Bristol, BS15 0DQ
Email lottie.lawson@southglosgcsx..gov.uk
11. Financial Details
11.1 In 2015-18 each pharmacy contracted to provide this service will receive:
· A payment of £10 per sexual health consultation (whether suitable for supply of medication under PGD or not, providing paperwork and signposting is completed).
· A payment of £10 per individual Azithromycin supply under PGD. One supply is 4 x 250mg Azithromycin capsules.
· A payment of £5 per ‘completed’ Chlamydia test received by the lab for testing. A ‘completed’ test is where the sample yields a positive or negative result. This payment will be made following information received by South Gloucestershire Council from the Chlamydia Screening Office.
11.2 Claims must be submitted monthly to South Gloucestershire Council using PharmOutcomes. Any claims made over 3 months from when activity was undertaken will be voided and not paid. Payments will be made quarterly.
12 Managing Complaints
12.1 The Provider will have a complaints procedure which is simple, well publicised and in a format accessible to all Service Users to enable an individual, or someone acting on their behalf, to make a complaint or suggestion in relation to services they receive.
12.2 Service Users must be informed of the means of registering a complaint and this should allow for Service Users who may choose to raise their complaint or concern verbally.
12.3 The procedure must show how complaints are dealt with, how Service Users views are taken into account, how they will be informed of the outcome and the timescales involved. Service Users should be advised of their right to contact the Local Authority if they remain dissatisfied with the outcome of the Provider’s handling of the complaint.
12.4 Service Users of adult social care services also have a right of recourse to the Local Government Ombudsman (this includes those who self-fund their own care). The complaints procedure must provide information about the Local Government Ombudsman.
12.5 All Providers have a duty to cooperate with the Department in resolving complaints.
12.6 All Providers will maintain a log of complaints, concerns and compliments showing:
· The date the complaint, concern or compliment was received
· The name and address of the Service User
· The name and address of the complainant (where different)
· The nature of the complaint, concern or compliment
· The response to the complaint or concern. If it is a complaint a response, including timescales, should be in writing and the date of the response letter should be included in the log, with brief details of the outcome
· Learning points for the Service User and changes made to policies, procedures and practice as a result of dealing with a complaint