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Emergency Hormonal Contraception & Sexual Health
An EHC service is commissioned in all areas across West Yorkshire. Although the titles and service specification for these services vary per area, in essence pharmacies are being commissioned to provide an EHC service as part of a sexual health service which may also include condom distribution, pregnancy testing and a chlamydia screening and other treatment services. Pharmacists providing the service must always refer to the service specification for the service that they are commissioned to provide.
The service specifications for each area are listed below (see links). Also listed for each area are links to the relevant safeguarding teams. If you have concern that a child is being harmed as a result of abuse or neglect, you must NOT keep these concerns to yourself. KEEPING CHILDREN SAFE IS EVERYONE'S RESPONSIBILITY.
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Pharmacists providing an EHC service are responsible and accountable for ensuring that they:
- Maintain competency to provide the service so they are able to practice safely and effectively.
- Keep up to date with relevant guidance and procedures.
- Work under the terms of the relevant PGD for the area in which they are working.
Useful Information & Updates
New Emergency Contraception Guidlines Launched in December 2017
The Faculty of Sexual and Reproductive Healthcare launched new guidance, (see here), on emergency contraception. If you are involved in advising or caring for women who may need emergency contraception, please make sure you read this updated guidance to ensure any advice you give is the most up to date. CPPE have also updated their e-Learning package to fit in with these changes to this may be a good opportunity for you to update your learning.
Remember to Advise Women that Oral Emergency Contraception (EC) Methods Do Not Provide Ongoing Contraception
Local Sexual Health services have reported an increased number of patients recently who have had a positive pregnancy test after taking ulipristal and patients have advised that they were unaware that they needed to use additional barrier contraception after taking.
Providers of oral EC should advise women that oral EC methods do not provide contraceptive cover for subsequent UPSI and that they will need to use contraception or abstain from sex to avoid further risk of pregnancy.
Additionall,y for women taking hormonal contraception, the effectiveness of ulipristal can be reduced if a woman takes progestogen in the 5 days after taking ulipristal. Women should therefore be advised to wait 5 days after ulipristal before starting their hormonal contraception and should be advised to use condoms or abstain from sex until their contraceptive method is effective. Refer to pages 29-31 of the Faculty of Sexual and Reproductive Healthcare guidance here.
The following general information/resources may be helpful for pharmacists providing an EHC service:
- Confidentiality Poster
- Video for Healthcare professionals – spotting the signs of Child Sexual Exploitation
- Barnado's Questions
- A national proforma for identifying risk of child exploitation in sexual health services (See section 2, p10-14)
- Fraser Guidelines
- Talking 1 to 1 with a Young Person
- FSRH Clinical Guidance Emergency Contraception
Bradford Sexual Health (EHC) Service
Changes to Administration of the EHC Contract - April 2018
EHC Service Specification - April 2018
EHC Decision Tree - April 2018
EHC Consultation Form - April 2018
Sexual Health Consultation Overview
Signposting Information (Bradford)
The BASH Bradford website provides a one stop shop for contraceptive information, advice and services in the Bradford district. Patients can be directed to the website or can call Bradford Sexual Health and Contraceptive Services on 030 3330 9500.
Locala offer a free and confidential service providing contraception and STI (sexually transmitted infection) care in clinics across Bradford. This includes a city centre hub near Broadway Shopping Centre (Howard House, above the Yorkshire Building Society). See
https://www.locala.org.uk/services/sexual-health/.
Safeguarding Links & Information
See the Childrens' Safeguarding Board website.
See the Vulnerable Adults Safeguarding Board website.
Claims for the service are processed via PharmOutcomes.
Service Commissioner: Locala Community Partnerships CIC
Service Lead: Jo Marshall - jo.marshall@locala.org.uk
Calderdale Sexual Health (EHC) Service
Service Extension & Contract Variation Letter 2021
Service Extension & Contract Variation Letter 2020
Service Extension & Contract Variation Letter 2019
Service Sub Contract Agreement
Emergency Contraception Decision Tree
Sexual Health Consultation Form 2019
Condom Supply as Part of an EHC Service
COVID-19 Update
Please see updates (below) regarding remote consultations. Pharmacists providing this service now have the option of providing a remote consultation (e.g. over the phone or video call) wherever this is deemed necessary. A consultation must still occur, however, which could now be over the phone. The EHC could then be bagged up and left for collection where this is required.
The PGD letter confirms that the PGD requirement for the woman to attend in person has been suspended until 31 December 20. A copy of this letter should be kept with the PGDs for reference.
EHC Update Letter - 8th July 2020
EHC PGD Letter - 8th July 2020
Signposting Information (Calderdale)
Integrated Sexual Health Service - telephone: 01422 261370
The Calderdale Sexual Health services website provides a one stop shop for contraceptive information, advice and services in the Calderdale area. See https://sexualhealth.cht.nhs.uk/services/.
Services are located across Calderdale with the main hub (Broad Street) located centrally in Halifax. Address: 51 Northgate Plaza, Broad Street, Halifax HX1 1UB.
Safeguarding Links & Information (Calderdale)
See the Calderdale Safeguarding website.
If you are worried about a vulnerable child or adult see http://calderdale-safeguarding.co.uk/report-concerns/ for information on how to report your concerns.
Claims for the service are processed via PharmOutcomes.
Service Commissioner: Calderdale & Huddersfield NHS Foundation Trust
Service Lead: Gill Harries - gill.harries@cht.nhs.uk
Kirklees Sexual Health (EHC) Service
Locala Service Specification Updated Service (includes ulipristal)
Consultation Form Updated Service
Locala Service Specification (old service - supply of levonorgestrel only)
Chlamydia screening is included as part of the commissioned EHC/Sexual Health service in Kirklees, however, postal chlamydia test kits are not currently available so pharmacists providing the service will need to refer patients to SH24 which provides online testing for Kirklees residents aged over 16. See https://sh24.org.uk/.
Patients aged under 16 will need to be referred to Locala - https://www.locala.org.uk/services/sexual-health/
Signposting Information (Kirklees)
Locala offer a free and confidential service providing contraception and STI (sexually transmitted infection) care in clinics across Huddersfield and Dewsbury. See https://www.locala.org.uk/services/sexual-health/.
The main sexual health clinics are located at Princess Royal Health Centre, Huddersfield, HD1 4EW and Dewsbury Health Centre, Wellington Road, WF13 1HN.
Patients can make an appointment in Kirklees (or get advice about a drop-in session) by calling 030 3330 9981.
Safeguarding Links & Information (Kirklees)
See the Kirklees Childrens Safeguarding Board website for information. If you are worried about a child in Kirklees, see here for a list of contacts.
For vulnerable adults in Kirklees see http://www.kirklees.gov.uk/beta/adult-social-care-providers/safeguarding-adults-information-professionals.aspx.
Claims for the service are processed via PharmOutcomes.
Service Commissioner: Locala Community Partnerships CIC
Service Lead: Jo Marshall - jo.marshall@locala.org.uk
Leeds Sexual Health (EHC) Service
Note - The Leeds EHC service only pays a £10 consultation fee. Community Pharmacy West Yorkshire have previously made representations to the commissioner on pharmacy contractors' behalf for an increase in the £10 EHC supply fee due to the level of clinical input required to deliver this service. Supply of EHC is under a Patient Group Direction which carries significant clinical responsibility and pharmacy contractors should be adequately remunerated for the clinical decision making associated with the supply of EHC. Before applying to provide the service contractors should consider the burden of delivering the service for the remuneration available.
Leeds Sexual Health Pharmacy Service Specification - 1st July 2020 to 31st March 2023
Levonorgestrel PGD - July 2020
Chlamydia/Gonorrhoea screening is commissioned as part of this service. Dual screen test kits are provided by Preventx. To order additional kits, email Jane at jane@preventx.com or call 0333 344 4462 and ask for Jane.
Condoms and pregnancy tests are provided FOC by Leeds Community Healthcare for pharmacies commissioned to provide the Leeds Sexual Health service. Refer to the service specification for information on how to order.
Signposting Information (Leeds)
See https://leedssexualhealth.com/for contraceptive information, advice and available sexual health services in Leeds.
There are a number of sexual health clinics across Leeds with a city centre hub based at the Merrion Centre, LS2 8NG. See https://leedssexualhealth.com/professional-area/clinic-timetable-1 for an overview of clinics and opening times.
Safeguarding Links & Information (Leeds)
The Safeguarding Children's Team can be contacted to discuss any concerns relating to child protection. Safeguarding contacts are available at the following link: http://www.leedslscb.org.uk/Concerned-about-a-child.
To raise safeguarding concerns for adults see: https://leedssafeguardingadults.org.uk/.
Leeds 3 in 1 Scheme
The 3 in 1 scheme allows trained members of the pharmacy team to offer free condoms, pregnancy testing and chlamydia/gonorrhoea testing to 13-24 year olds. There is no payment for providing this scheme, which runs separately to the Leeds EHC commissioned service, but pharmacies with a high footfall of young people may want to be able to offer this additional sexual health support (e.g. free condoms) to their patients.
Leeds 3 in 1 Scheme Information & Frequently Asked Questions
Once trained, all equipment to run the scheme e.g. all condom products/testing kits are provided by Leeds City Council.
Training for staff is delivered either over a full day or 2 mornings and will cover the 3 aspects of the 3 in 1 scheme – C-card (condom distribution), pregnancy testing and chlamydia/gonorrhoea screening kits, as well as providing additional information around supporting young people to stay sexually healthy. Please see here for more info on the training and here for info on the C-Card element of the scheme.
If your pharmacy would be interested in providing the 3 in 1 scheme, please contact Kerry Swift on 0113 3786066 or by email: Kerry.swift@leeds.gov.uk.
Claims for the service are processed via PharmOutcomes. Queries about payments for the Leeds EHC service should be directed to Janet Wilson, 0113 220 8559.
Service Commissioner: Leeds Community Healthcare
Service Lead: Emma Tiernan, emma.tiernan@nhs.net
Wakefield Sexual Health (EHC) Service
Wakefield EHC Contract from 1st June 2021
Wakefield EHC Service Extension Letter - to March 2022
Levonorgestrel PGD – July 2020
Wakefield Pharmacy Level 1 Sexual Health Scheme
Wakefield Sexual Health Scheme Overview - Presentation Slides
Wakefield EHC Launch Event Video
FSRH Guideline - Emergency Contraception
Signposting Information (Wakefield)
Patients can be signposting to https://spectrumhealth.org.uk/services/sexual-health/ for details of sexual health clinics and services in Wakefield.
Patients can also be directed to this website to order screening kits for chlamydia/gonorrhoea. The website includes an interactive map for patients to find their nearest clinic.
There is a central hub based at Trinity Walk Shopping Centre. Details below:
Spectrum Sexual Health
Trinity Walk Clinic
Unit LG1A, Trinity Walk Shopping Centre
Wakefield,
WF1 1QS
Tel: 0800 1214860
COVID Update - the walk-in-clinics are currently suspended however the service is still open. Please see the poster below for how to contact the service.
Wakefield Sexual Health Poster
Safeguarding Links & Information (Wakefield)
The Safeguarding Children's Team can be contacted to discuss any concerns relating to child protection. See https://www.wakefieldlscb.org.uk/.
To raise safeguarding concerns for adults see: http://www.wakefield.gov.uk/health-care-and-advice/adults-and-older-people-services/safeguarding/safeguarding.
If you have concerns about an adult or child who may be at risk, please contact Social Care Direct on 0345 8503503 or 01924 303450.
Claims for the service are via submission of a paper claim form (see below). Claims must be submitted on a monthly basis. See the form for details of where to return the form to.
Service Commissioner: Spectrum Community Health CIC
Service Lead: Belinda Loftus - belinda.loftus@spectrum-cic.nhs.uk - 01924 311400.
If you are interested in providing this service in your pharmacy please click here for information on what you need to do.
Last Updated: 6th October 2020