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Sexual Health (including EHC)

A sexual health service which incorporates EHC supply is commissioned by every area within West Yorkshire.  The titles and service specifications for these services vary but in essence pharmacies are being commissioned to provide a holistic sexual health service in which supply of EHC forms only a part of the service.

Other sexual health services which may be commissioned include chlamydia screening and pregnancy testing.  In some areas these services are commissioned as one service which incorporates EHC, while in other areas they are commissioned separately.

Pregnancy, or suspected pregnancy, is an exclusion to the supply of EHC; If there is the possibility that a client may be pregnant from a previous instance of unprotected intercourse then supply of EHC cannot be made until pregnancy is ruled out.

If available, a chlamydia screen should be offered to all clients under 25 who access the sexual health (EHC) service.  It should be noted that it takes 2 weeks post-infection before chlamydia will show positive in a urine test.  Therefore a chlamydia screen should be offered immediately with the advice that the client should be screened for all sexually transmitted infections two weeks after the episode of unprotected sex.

Links to the relevant safeguarding teams are provided for each area. 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.

If you are interested in providing this service in your pharmacy please click here for information on what you need to do.

 

Jump to general information to support the delivery of this service

Jump to providing commissioned Sexual Health (EHC) Services in West Yorkshire

Jump to Bradford service details

Jump to Calderdale service details

Jump to Kirklees service details

Jump to Leeds service details

Jump to Wakefield service details

 

Sexual Health (EHC) Service - General Information

General information to assist with providing the service:

Confidentiality Poster

Aide Memoire 

Barnado's Questions

Fraser Guidelines

Talking 1 to 1 with a Young Person

Faculty of Sexual & Reproductive Healthcare Clinical Guidance - see Emergency Contraception Guidance - http://www.fsrh.org/pages/Clinical_Guidance_2.asp 

How to use a condom - http://www.kypf.org.uk/contraception/condom/how-to-use-a-condom/
 

FPA Briefing - talking to patients about emergency contraception (including top tips for pharmacists) http://www.fpa.org.uk/sites/default/files/professional-sexual-health-week-2014-professional-briefing-WEB.pdf

Poster- embarrassing moments (http://www.fpa.org.uk/sites/default/files/FPA-sexual-health-week-2014-poster-tights.pdf)

Poster- no need to hide - http://www.fpa.org.uk/sites/default/files/FPA-sexual-health-week-2014-poster-bag.pdf 

 

Health Education England have published a short film on how healthcare professionals, including pharmacy teams, can spot the signs of Child Sexual Exploitation. Watching and reviewing this film could be used as CPD and support you in demonstrating development around the child safety aspect of the community pharmacy contract.

 

https://www.youtube.com/watch?v=sC4Nn_mYKu0


 

Sexual health (EHC) services are underpinned by Patient Group Directions (PGDs).  Pharmacists are responsible and accountable for ensuring that they work under the relevant PGD and correct Service Specification applicable to the area, and commissioner, where they are working.

PGD Information Sheet

 

What are the responsibilities for pharmacists?

Pharmacists providing a sexual health (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
  • work under the terms of the relevant PGD for the area in which they are working
  • work under the correct service specification for the area in which they are working
  • only provide the service from pharmacies that are commissioned to provide the Sexual Health (EHC) Service

These responsibilities have always been in place through professional registration, PGD legislation and service agreements.

 

What is the difference between an EHC service and a Sexual Health (EHC) service?

The name of the service has been updated to reflect that pharmacies are providing a holistic sexual health service in which EHC supply is only part of the consultation.  All sexual health (EHC) services are commissioned on the basis that the consultation includes a discussion of all the options for emergency contraception and their relative efficacy, advice on the avoidance of pregnancy and sexually transmitted infections through safer sex and condom use, information about on-going contraception (including the place of Long Acting Reversible Contraception), a safeguarding assessment (where necessary), and signposting onto other services.

An aide memoire for a Sexual Health Service Consultation is available to download here

 

New Emergency Contraceptive Guidelines Launched

The Faculty of Sexual and Reproductive Healthcare have recently launched new guidance, (see here), on emergency contraception following a survey which found that only 15% of women, aged 18-45, who had been offered or accessed emergency contraception said that they had been offered the copper intrauterine device (Cu-IUD).  This new guidance aims to bridge the gap in awareness and knowledge and provides clear evidence-based information for healthcare professionals and all those involved in advising and caring for women who access emergency contraception. 

In line with NICE guidance, the recommendations mark a new emphasis on advising women that the Cu-IUD, is the most effective method of emergency contraception.  All healthcare professionals who provide emergency contraception should offer women the Cu-IUD, and if they cannot provide it, refer them on to services that can. 

Other key changes include:

  • Ulipristal acetate (EllaOne®) now classed as first-line oral emergency contraceptive
  • Guidance relating to emergency contraception and earliest date of ovulation
  • Updated figures from the Office of National Statistics. 

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 it with these changes so 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. 

Additionally, 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 The Faculty of Sexual and Reproductive Healthcare Guidance 

 

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Providing Commissioned Sexual Health (EHC) Services in West Yorkshire

The West Yorkshire* Local Authority Sexual Health commissioners have agreed that pharmacists in West Yorkshire can use the Declaration of Competence model to demonstrate that they are able to provide commissioned Sexual Health (EHC) Services.

The Declaration of Competence model moves away from ‘accreditation’ towards a model whereby pharmacy professionals take responsibility for their own personal competence to deliver a service. This is in-line with the GPhC / professional obligation to ensure pharmacists and pharmacy technicians keep up- to- date and reflects the processes used by GPs and some other healthcare professionals commissioned to provide local services.

Under the agreed pathway, pharmacists will be able to provide sexual health (EHC) services from any pharmacy commissioned to provide the service within West Yorkshire (Bradford & Airedale, Calderdale, Kirklees, Leeds and Wakefield) without the need to be authorised by individual Commissioners for each area.  This approach:

  • provides a clear and consistent approach within our area
  • enables pharmacists to seamlessly work across West Yorkshire commissioning boundaries
  • removes the need for duplicate training / authoristation
  • improves delivery of and access to sexual health services in West Yorkshire  

It should be noted that pharmacist ability to provide the Sexual Health (EHC) services is independent of pharmacies being commissioned to provide the Sexual Health (EHC) service.  Any pharmacy who wishes to be commissioned to provide the funded Sexual Health (EHC) service should contact the commissioner as detailed for the relevant areas below.

Further details on the Declaration of Competence Model can be accessed here

* West Yorkshire relates to the areas covered by the following local authorities: Bradford, Calderdale, Kirklees, Leeds and Wakefield.  Pharmacists working outside of West Yorkshire should contact the commissioner of the EHC service to confirm the requirements to deliver EHC.

 

What are my responsibilities?

Pharmacist

Under the Declaration of Competence model a pharmacy professional has responsibility to ensure that they have the up-to-date knowledge and skills relevant to the role they are undertaking, to understand the limits of their professional competence and to identify areas for further development.  You are accountable for ensuring that you have met the skills and knowledge and could demonstrate their competence if requested to do so.

Pharmacy Contractor

In the Local Authority contracts in West Yorkshire outline that it is the duty of the pharmacy commissioned to provide the sexual health (EHC) service to ensure that all individual pharmacists delivering this service from their premises are: 

  • Fit to Practise
  • Suitable to deliver the service
  • Can demonstrate they are competent to deliver the service

Asking for copies of the DoC from all pharmacists who provide the service from within your pharmacy can be a mechanism of ensuring that as a pharmacy contractor you can demonstrate that the pharmacists providing the service are competent to deliver the EHC service.

 

My EHC accreditation certificate has expired.  Do I need to redo the recommended programmes and workshop?

Under the DoC model each individual pharmacist needs to be able to demonstrate that they are able to meet the competencies for the service and be confident that they have the up-to-date knowledge and skills to be able to deliver the commissioned service.

For example, if you completed the HAG training 2 years ago, have been regularly providing the EHC commissioned service (e.g. once a month), have kept up to date with the changes in evidence for different emergency contraception (e.g. by reading the Faculty of Sexual and Reproductive Healthcare guidance) you may decide that you meet some of the competencies without repeating the CPPE programmes and workshops listed as recommended learning for emergency contraception.  It is up to you as a registered pharmacist to reflect on your learning needs and complete the relevant training to declare yourself competent to deliver a service.

 

I work outside West Yorkshire. 

Pharmacists who wish to provide Sexual Health (EHC) Services outside the West Yorkshire region will need to contact their commissioner directly.  Some commissioners are already aware of the Declaration of Competence model and have integrated it into their processes. Others may be not yet be familiar with the model. Pharmacists wishing to use this model should liaise with the commissioners in their own area to ensure it has been adopted. The employers and commissioners area of the CPPE website (under my services) explains the model for commissioners: https://www.cppe.ac.uk/services/declaration-of-competence

Maintenance of Competency

Pharmacists are responsible for reassessing their competence to deliver this service at least once every three years. This should involve revisiting the self-assessment of core competences, reflecting on each competency and identifying personal learning needs to assure self-declaration again at this point. Where changes are introduced to the commissioned service, pharmacists and their staff will need to update themselves as part of their usual continuing professional development.

 

Must I go to the workshop for the Emergency Contraception (EHC) DoC?

Although attendance at the workshop is not a mandatory requirement, without attendance at the workshop how could you demonstrate that you have met the competencies? Several competencies including effective consultation skills, legal implications of PGD supply and demonstrating knowledge of clinical content (a, b, e, f, h, i) have been mapped as being met by attendance at the workshop.

You need to be able to demonstrate what you have undertaken to meet the competencies and be confident that you have the up-to-date knowledge and skills to be able to deliver the commissioned service.


Can I demonstrate that I am competent without completing the recommended minimum training for the Emergency Contraception (EHC) DoC?

You need to be able to demonstrate what you have undertaken to meet the competencies and be confident that you have the up-to-date knowledge and skills to be able to deliver the commissioned service. It is expected that most pharmacy professionals will need to complete the minimum training that is in place to be able to meet the competencies.

For example, it is likely that if you work a day a week in a sexual health service, such as a CASH clinic, you may be able to demonstrate that you meet some of the competencies without completing the CPPE programmes and workshops.

Another example is that if you completed the HAG training 2 years ago, have been regularly providing the EHC commissioned service (e.g. once a month), have kept up to date with the changes in evidence for different emergency contraception (e.g. by reading the Faculty of Sexual and Reproductive Healthcare guidance) you may meet some of the competencies without completing the minimum recommended training.  It is up to you as a registered pharmacist to reflect on your learning needs and complete the relevant training to declare yourself competent to deliver a service.

However, it is expected that most pharmacy professionals will need to complete the minimum training be able to meet the competencies.  All professionals using the DoC model need to be confident that they can demonstrate what they have undertaken to become competent as they are personally responsible and accountable, and may be called to justify and demonstrate how you met each competency.

 

I notice that there are DoCs available for other services on the CPPE website.  Can I use them?

Only where a commissioner has agreed to their use can the DoCs be used for a service.  You need to confirm this in the service specification.  At the time of writing (April 14) the use of DoC model has only been agreed for EHC services in West Yorkshire and the Bradford supervision service.

 

Link to DoC framework on CPPE website: https://www.cppe.ac.uk/services/declaration-of-competence

 

Preparing for the Workshop

The following resources may be useful when preparing for the workshop.

Sexual Health (EHC) Service - General Information

Overview from a GP talking about EHC services in pharmacy:

http://www.youtube.com/watch?v=oudvg5wQDL4

 

Role Play assessment Framework

This outlines what is assessed during the role play.  The role plays are carried out in groups of 3.

Role Play Assessment Record 

Aide Memoire

   

Common questions and feedback from the CPPE EHC workshop

This information is provided to support pharmacists in service delivery and in preparing for the workshop.

Common Workshop Feedback

 

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Bradford Sexual Health (EHC) Service

From the 1st April 2014 Bradford Council are commissioning two EHC services.  

Before applying to provide the service contractors should consider the burden of delivering the service for the remuneration available. 

Community Pharmacy West Yorkshire have previously made representations to commissioners on pharmacy contractors’ behalf for an increase in the £10.50 EHC supply fee due to the level of clinical input required to deliver the high quality consultation local pharmacies provide. The supply is under a patient group directive (PGD) which carries significant clinical responsibility and we believe that pharmacy contractors should be adequately remunerated for the clinical decision making associated with these supplies.

NB The EHC Plus service pays £15 per consultation.


Bradford EHC Service

EHC Service Specification

EHC Consultation Form

PGD Ulipristal Acetate

PGD Levonorgestrel

Bradford Emergency Contraception Decision Tree

 

Bradford EHC Plus Service

The EHC PLUS service has been introduced for pharmacies who can guarantee that the service and therefore emergency contraception is available for all the pharmacy opening hours (core and supplementary).  The service also includes the provision of Chlamydia screens.

The PGDs which underpin the services and the requirements for pharmacists to be able to deliver these services do not differ.

EHC Plus Service Specification

EHC Plus Consultation Form

PGD Ulipristal Acetate

PGD Levonorgestrel

 

 

 

General leaflets relating to sexual health and contraception can be ordered from Lynfield Mount, telephone 01274 223900. 

 Signposting List

Condoms and pregnancy tests for use within the service can be ordered from Liz Ward, liz.ward@bthft.nhs.uk - 01274 365495

Pregnancy testing is included as part of the sexual health (EHC) service specification and funded at £5 per test.

The Safeguarding Children's Team can be contacted to discuss any concerns relating to child protection.   Comprehensive information, including safeguarding contacts, can be accessed at:

http://www.bradford-scb.org.uk/

 

Claims are processed via PharmOutcomes.

 

Service Commissioner:

City of Bradford Metropolitan Council

Service Lead: Jeanette Crabbe - jeanette.crabbe@bradford.gov.uk


Details for the Contraception and Sexual Health Service (CASH) in this area can be found here.  Alternatively patients can also be directed to their GP (NB not all GPs offer a coil fitting service).


 

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Calderdale Sexual Health (EHC) Service

Letter Regarding Sub Contract of Service

Service Sub Contract Agreement

Memorandum of Agreement

Emergency Contraception Decision Tree

PGD Levonorgestrel

PGD Ulipristal

Ulpristal Supporting Information

EHC Consultation Form

Condom Supply as Part of an EHC Service

EHC Poster

 

Pharmacies providing the Emergency Hormonal Contraception Service in Calderdale.

EHC Pharmacies

 

Pregnancy testing is commissioned as part of the EHC service, where indicated. 

Chlamydia screening from pharmacy within Calderdale is commissioned as part of the sexual health (EHC) service.

Pharmacies can request Chlamydia test kits via the following website www.sexualhealth@cht.nhs.uk or by phoning the service on 01422 261370.


The Safeguarding Children's Team can be contacted to discuss any concerns relating to child protection.   Comprehensive information can be accessed at:

http://www.calderdale-scb.org.uk

 

Safeguarding contacts are available at the following link:

http://www.calderdale-scb.org.uk/reporting_concerns.html

 

Vulnerable Persons Pathway

The aim of this pathway is to ensure that vulnerable people can gain easy access to Sexual Health Services in Calderdale by removing obstacles that previously may have discouraged these people from attending the clinics.   If a pharmacy makes a referral to CASH for a vulnerable person (as defined in the Referral Procedure) they should contact the CASH service for an appointment time and provide the vulnerable person with the Registration Form to hand in at the reception desk.

Referral Procedure

Registration Form

Sexual Health Service Opening Times

 

Claims are processed via PharmOutcomes.

 

Service Commissioner EHC:

Calderdale and Huddersfield Foundation Trust 

Service Lead:  Gill Harries - gill.harries@cht.nhs.net

  

Service Lead Chlamydia:

CHLASP - 01484 481030

 

Details for the Contraception and Sexual Health Service (CASH) in this area can be found here.  Alternatively patients can also be directed to their GP (NB not all GPs offer a coil fitting service).
 
 

Newsletters

Consent Poster

Festival Flyer

Quarterly Bulletin - July 17

 

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Kirklees Sexual Health (EHC) Service

Before applying to provide the service contractors should consider the burden of delivering the service for the remuneration available. 

Community Pharmacy West Yorkshire have previously made representations to commissioners on pharmacy contractors’ behalf for an increase in the £10 EHC supply fee due to the level of clinical input required to deliver the high quality consultation local pharmacies provide. The supply is under a patient group directive (PGD) which carries significant clinical responsibility and we believe that pharmacy contractors should be adequately remunerated for the clinical decision making associated with these supplies.

Locala Service Specification

Levonorgestrel PGD

Consultation Form

 

Chlamydia Test kits can be sourced from the Sexual Health Outreach & Prevent Team (SHOPT) based at Princess Royal Community Health Centre. Pharmacies should call the team on 03330 436 219.

 

The Safeguarding Children's Team can be contacted to discuss any concerns relating to child protection.   Comprehensive information can be accessed at:

http://www.kirkleessafeguardingchildren.co.uk

Safeguarding contacts are available at the following link:

http://www.kirkleessafeguardingchildren.co.uk/contact-us.html 

Kirklees Young People Friendly site offers up to date information on Sexual Health Services available to all young people within Kirklees:
 
http://www.kypf.org.uk/

 

Claims should be sent to:

From the 1st May  2017 Community Pharmacy West Yorkshire will be providing Service Administration for the Community Pharmacy Sexual Health & EHC Service on behalf of Locala Community Partnerships CIC.

From this date claims are to be submitted through PharmOutcomes.

 

Service Commissioner:

Locala Community Partnerships CIC

Commissioner Lead: Clifford Dunbavin - clifford.dunbavin@locala.org.uk

 

From 1 April 2016, contraception, sexual health and genito-urinary medicine (GUM) clinics will be provided in Kirklees by Locala Sexual Health.

The number to call to make an appointment or find a drop-in session is 030 3330 9141.  Full details are availableat: www.locala.org.uk/ksh

Clinics are located within: Princess Royal Health Centre, Huddersfield, HD1 4EW and Dewsbury Health Centre, Wellington Road, WF13 1HN

Alternatively patients can also be directed to their GP (NB not all GPs offer a coil fitting service).

 

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Leeds Sexual Health (EHC) Service

 

Before applying to provide the service contractors should consider the burden of delivering the service for the remuneration available. 

 

Community Pharmacy West Yorkshire have previously made representations to commissioners on pharmacy contractors’ behalf for an increase in the £10 EHC supply fee due to the level of clinical input required to deliver the high quality consultation local pharmacies provide. The supply is under a patient group directive (PGD) which carries significant clinical responsibility and we believe that pharmacy contractors should be adequately remunerated for the clinical decision making associated with these supplies.


Sexual Health Service Specification

Levonorgestrel PGD

Ulipristal PGD

Consultation Form

Consultation Summary Sheet

Monthly Summary Claim Form

Click on the link below for a list of pharmacies commissioned to provide the Leeds EHC Service:

http://www.leedssexualhealth.com/pharmacies 

Pregnancy testing is included as part of the sexual health (EHC) service specification.

Dual Chlamydia and Gonorrhoea screening is included as part of the sexual health (EHC) service specification.

 

The Safeguarding Children's Team can be contacted to discuss any concerns relating to child protection.   Comprehensive information can be accessed at:

http://www.leedslscb.org.uk

 

Safeguarding contacts are available at the following link:

http://www.leedslscb.org.uk/Concerned-about-a-child

 

Claims forms should be returned to:

Pharmacy Claims, The Office of the Direstor of Public Health, Technorth, 9 Harrogate Road, Leeds, LS7 3NB

 

Contact Phil Slavin - phil.slavin@leeds.gov.uk - 0113 3786046 for queries around stationery and payments.

 

Service Commissioner:

Leeds City Council

Service Lead: Hannah Sowerbutts - hannah.sowerbutts@leeds.gov.uk

 

From 1 July 2015, Leeds will have a new sexual health service providing contraception, sexually transmitted infection testing and treatment, and HIV testing.

Click on the links below for further information: 

Integrated Sexual Health Service Briefing

Clinic Timetable

 

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Wakefield Sexual Health (EHC) Service

Sexual health services in Wakefield are now being delivered by Spectrum CIC.

Pharmacies who meet the qualification criteria set out in the Pharmacy EHC Strategic Intent document should complete the application form in the letter below.

Letter and application to provide service

Pharmacy EHC Strategic Intent

 

Pharmacies should contact Spectrum CIC for the service specification.

Belinda Loftus  belinda.loftus@spectrum-cic.nhs.uk

Telephone: 01924 311400

 

Contact details for the sexual health clinics for Wakefield are below:

Spectrum Sexual Health Services Contact Details are as follows:

The Central Clinic

15 Margaret Street

Wakefield

WF1 2DQ

T: 01924 327586

 

Largely CASH Team currently

Margaret Street fax is; 01924 327603

Josephine Butler Centre

King Street Health Centre

47 King Street, Wakefield

WF1 2SN

T: 01924 542921

 

Largely GUM Team currently

King St reception fax is ; 01924 542975

 

Please note the service will be moving to a new central integrated hub location in March 2016

 

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