Emergency Hormonal Contraception


New Service Spec for EHC 2016 – 2019 released:

Staffordshire EHC Service Spec 2016-2019

Changes to how Sexual Health Services are commissioned from pharmacies in Staffordshire

 Sexual health services are the responsibility of the public health department, part of Staffordshire County Council Local Authority (SCC), which covers all of Staffordshire.

The current commissioning of sexual services works with Staffordshire County Council having a contract with each pharmacy which wishes to offer the sexual health service.  With over 150 community pharmacies in Staffordshire this means the council have to manage a large number of contracts – see diagram below.

Current Structure:

diagram-1

While the local authority wished to maintain the pharmacy EHC service they have suffered massive funding cuts and so were looking at ways to streamline their processes.

This year the LA went through a tendering process for the sexual health services with the intention that one provider would take on the responsibility for all sexual health services across Staffordshire.  The resulting structure would look similar to the one we are familiar with for Substance Misuse Services where the council commissions One Recovery to deliver the service and One Recovery sub-contract the pharmacies to deliver the supervised consumption and needle exchange services.

The pharmacy sexual health EHC service (Lot 1) tender was awarded in August 2016 to Lloyds pharmacy; they will have responsibility for the service from December 1st 2016 but this does NOT mean that only Lloyds are able to deliver EHC services.

The diagram below shows how the new structure will work

New Structure from December 1st 2016:

diagram-2

Staffordshire Public Health have suffered significant funding cuts this financial year and this was reflected in the funding awarded with the Lot 1 tender.  Therefore, the funding of the service may change but this is up to the winners of the tender to determine the best way to deliver large numbers of EHC provisions from our community pharmacies.

Your LPC is working with Lloyds to ensure that the transition occurs smoothly and that the EHC service remains available from as many pharmacies across Staffordshire as possible.

You can expect to receive an invitation to complete an Expression of Interest to deliver the EHC service during October 2016.  We will make this available on PharmOutcomes and will inform contractors when it is ready for completion – you will need to log on to PharmOutcomes to complete it.

Lloyds have assured the LPC that their intention is to contract with all the pharmacies currently providing EHC, they are looking to produce posters, leaflets and stickers to promote the service.  As more information becomes available we will share this with you.

NB: These changes do not affect pharmacies in Stoke City Council area as the EHC in Stoke will continue to be commissioned directly from pharmacies by Stoke City Council Public Health Dept.

NB Chlamydia Testing

The Chlamydia testing service fell within Lot 2 of the tender process.  From December 1st 2016 the way the Be-Clear service is funded by Staffordshire County Council is changing and so the current system of pharmacy Chlamydia test payments will end on November 30th 2016.  Although SCC remain convinced that pharmacy teams are well placed to give out information and encourage young people to have a Chlamydia test, the new tendering/contract process means that it will now be up to Be-Clear to determine how to best use pharmacies as part of the Chlamydia testing programme.  The LPC will be talking to Be-Clear to discuss this and will keep our contractors informed as we find out what is happening.

Information on Service up to 30th November 2016

Safeguarding Issues:

Please see safeguarding information here

PharmOutcomes Module Updated April 1st 2016:

To enter information on an EHC consultation: 

EHC Registration  (requires name, DOB, address etc)  – complete for all clients

EHC Consultation and Supply – complete for all clients, covers inclusion and exclusion criteria etc.  You will then also record information on any medication supplied

Ideally you will record the consultation live while the client is present, otherwise please use the new paper pro forma (see link further down this webpage).  Where a paper record is used you must enter all of the details onto PharmOutcomes ASAP after the consultation. 

Sexual Health Contract:

Please read this whole page as it contains information on the service including service spec and PGDs, how to be accredited, recording and claims process.

PGDs: You need to print out these PGDs and all pharmacists delivering the EHC service in your pharmacy need to sign and date it and keep the copy in your pharmacy.
The service must be delivered in-line with the service spec

How the current Sexual Health Contract Works – please read.

The contract covers all possible sexual health services (both currently available and those in the planning stage).   If you have not signed and returned this contract the PH department will not be allowed to offer you a contract at any other point in this financial year. This is because of local council rules on tendering and is outside their control to change. A signature is not committing you to a level of delivery but enables you to be part of the services; you are paid for activity in this contract, it is not based on targets.

Pharmacy 2014 15 service specification

Pharmacies providing EHC in Staffordshire Aug 2015

EHC: Under this contract you will be able to supply women of all ages with EHC, levonorgestrel up to 72 hours, Ulipristal acetate (UPA) 72 – 120 hours. You will be paid a professional consultation fee + drug cost.

Pharmacist Accreditations
For pharmacists who are new to the EHC PGD, to become accredited to deliver the EHC service you must have successfully passed the CPPE e-assessments on EHC and also Safeguarding Children and Vulnerable Adults.  Public Health would like you to renew your e-assessment every 3 years.

You should complete a CPPE Declaration of Competence (DoC) for EHC in Staffordshire.  You will need to put details of your DBS in box 2 of the DoC before you sign it.

Sign the DoC and keep the signed copy in your PGD folder in the pharmacy.

Ensure that you have allowed PharmOutcomes to access your CPPE records so it can confirm that you have completed the DoC.

 

DBS Check Requirements

In order to provide EHC to under 18yr olds you are required a DBS check, this will be at the pharmacy’s expense and can be arranged through the LPC if your company does not already have a mechanism in place to do this.  Pharmacists who were providing EHC under the previous contract will also need to get a DBS check if you do not already have one but there is no deadline for this.  Public Health Staffordshire do not want you to suddenly stop providing the service and so require you to start the process as soon as possible if you do not have a DBS check in place (The old CRB checks were only valid for 2 years). Information on DBS checks can be found on this website

Pharmacy Accreditations
To deliver the PGD not only has the pharmacist to be accredited, the pharmacy must also have a contract with Staffordshire Public Health.  If you wish to deliver EHC in a pharmacy please do not do so until you have confirmed that the pharmacy does have a contract in place.

The consultation process:

either live recording on PharmOutcomes or paper form and details added to PharmOutcomes afterwards – details of process and client signature requirement is given below:

You are required to record the patient’s postcode – this information does not go to the commissioner so is confidential but allows the PharmOutcomes system to anonymously sort the data into CCG areas or Coucil Ward areas and so allows more sophisticated data analysis.

Consultation with live connection to PharmOutcomes: Consultations can be conducted and information added straight on to PharmOutcomes if you have a live connection in your consultation room.

If you are completing the module live on PharmOutcomes in the consultation room with the patient in front of you, there is a question requiring you to confirm that you have checked that the patient has received and understood the advice and the commissioners will accept this in lieu of a signature on a paper form.

EHC consultation proforma 2016

Consultation without live connection to PharmOutcomes: Please use the ProForma during the consultation .  The ProForma is also available on the PharmOutcomes EHC module.  The ProForma reflects the questions in the PharmOutcomes module and has been written to reflect the details in the PGDs.  When no live link is available in the consultation room please print out a copy of the ProForma for use during the consultation process.

The PGD requires the client to sign to say they have given consent and have been counselled and understand the advice, there is space at the bottom of the ProForma for the pharmacist and the client to sign. If you are completing a paper form this must be signed by the client. The information MUST be transferred to PharmOutcomes as soon as possible after completing the consultation to record and claim for the provision.

SCC Levonelle PGD Apr 2016

SCC EllaOne PGD Apr 2016

 

PharmOutcomes Module:

The EHC PharmOutcomes module requires you to register the client PLUS complete stages 1 and 2;

EHC Registration  – complete for all clients

EHC Stage 1  Consultation – complete for all clients to receive the consultation fee

EHC Stage 2 LNG or Stage 2 UPA supply –  – complete only if client is to be given LNG or UPA and this will generate payment for the medication.

You will only be paid correctly if you record the consultation.

Where a pharmacy records a supply but does not complete a record of the consultation payment will not be made

The claims process

PharmOutcomes for Payment: From January 2015 only claims via PharmOutcomes will be paid. When you record and save consultations on PharmOutcomes your claims are generated automatically and you will be paid monthly.

Supporting Documentation:

To help with service provision the Public Health Department have put these documents together for you to use.

EHC safeguarding flowchart July 2014

Emergency contraception risk assessment July 14

Full-list-of-sexual-health-providers Aug 2015 (please note the Stafford clinics are now held at 2nd Floor, Civic Centre, Riverside, Stafford ST16 3AQ)

CEUStatementQuickStartingAfterUPA

Chlamydia: You will be expected to encourage all females who present for EHC who are aged 16 – 24 to send in a Chlamydia test so make sure you have plenty in stock. As well as those attending for EHC please also encourage as many 16 – 24 year old males and females to take a Chlamydia test.

Chlamydia Treatment: The Chlamydia treatment service will continue under the new PH contract and you will be paid £6 per consult + drug cost. Details of the service, accreditation process and the updated PGD will be available on the LPC website once it is all signed off.  At this time the final details are being sorted out.