Chlamydia pharmacy ES



V1.3 19th January 09

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| |Southgate House |

| |Pans Lane |

| |Devizes |

| |Wiltshire |

| |SN10 5EQ |

| |Tel: 01380 733757 |

| |Fax: 01380 733854 |

| |Email: chris.phillips@wiltshire.nhs.uk |

|NHS Wiltshire |

| |

|Local Enhanced Pharmacy Service for Chlamydia Treatment |

| |

|Service Level Agreement 08/09 |

1. Introduction

2. Signatures

3. Aims and Objectives

4. Service Specification

5. Quality Indicators

6. Financial Detail

7. Termination of Contract

Appendix A – Chlamydia Screening and Treatment Pathway

Appendix B – Signposting

Appendix C – Chlamydia Treatment Form

Appendix D – Points of Contact Sheet

Appendix E – Payment Claim Form

|1. Introduction |

Genital Chlamydia trachomatis infection is the sexually transmitted infection most frequently diagnosed in genitourinary medicine (GUM) clinics in England. Prevalence of infection is highest in sexually active young men and women, especially those aged less than 25 years. Untreated infection can have serious long-term consequences, particularly for women, in whom it can lead to pelvic inflammatory disease (PID), ectopic pregnancy and tubal factor infertility. Since many infections are asymptomatic, a large proportion of cases remain undiagnosed, although infection can be diagnosed easily and treated effectively.

Chlamydia screening is currently carried out across England as part of the National Chlamydia Screening Programme (NCSP). The objective of the programme is to control chlamydia through the early detection and treatment of asymptomatic infection, preventing the development of sequelea and reducing onward transmission of the disease. The aim is a multi-faceted, evidence based and cost effective national prevention programme in which all sexually active young men and women under 25 years of age and those under 16 years of age deemed Fraser competent are aware of chlamydia, its effects, and have access to services providing screening, prevention and treatment to reduce their risk of infection, the development of untoward sequelae and onward transmission. An opportunistic approach is used bringing on board a diverse combination of healthcare and non-healthcare screening venues to deliver the programme. The voluntary and business sectors also play a key role in delivering the NCSP.

The NCSP covers the whole country and is managed by the Health Protection Agency. National standards apply to the programme and funding has been provided to Primary Care Trusts (PCTs) to commission the service.

In November 2005 a two year partnership between the Department of Health (DH) and Boots the Chemists to pilot free chlamydia screening and treatment for 16-24 year olds within the greater London area commenced. The pathfinder was independently evaluated by TNS Healthcare. The evaluation shows considerable promise with over 87% of young people reporting they would recommend the service. The evaluation is available on the DH website at: .uk/chlamydia.

The Wiltshire Chlamydia Screening Programme (WCSP) coordinates the service locally for NHS Wiltshire (PCT). Screening, using first-void urine samples or self-taken vulva-vaginal swabs, is initiated in a range of settings, both clinical and non-clinical. Samples are sent to a laboratory for analysis using the nucleic acid amplification test (NAAT) and the results are returned to the WCSP; patients are then informed of their result and contact tracing is conducted with people with positive results and treatment is offered to people who screen positive and their partners. Treatment for those with positive screening results will be carried out from a variety of settings.

|2. Signatures and contact details |

This document constitutes the agreement between the pharmacy and NHS Wiltshire with regard to the above Service Level Agreement for the dates specified in the body of the agreement.

Name and address of Pharmacy:

|Signature of behalf of the Pharmacy |Name (please print) |Date |

| | | |

NHS Wiltshire

|Signature of behalf of NHS Wiltshire |Name |Date |

| | | |

| | | |

| |C.J. PHILLIPS | |

|3. Aims and objectives of service |

| |

|3.1 To increase access to the NCSP by providing additional locations where people can access treatment. |

|3.2 To increase access to treatment of Chlamydia infection. |

|3.3 To increase access for young people, to sexual health advice and referral on to specialist services where required. |

|3.4 To increase clients’ knowledge of the risks associated with STIs. |

|3.5 To strengthen the network of contraceptive and sexual health services to help provide easy and swift access to advice. |

|4. Service Specification |

| |

|4.1 Participating Pharmacies will provide Chlamydia treatment (Clamelle), condoms and test kits to males and females aged 16 to 24 years of age |

|who have been notified of a positive diagnosis of Chlamydia by the Wiltshire Chlamydia Screening Programme and in accordance with the Community |

|Pharmacy treatment pathway (Appendix A). |

|Partners |

|Partners who attend pharmacies accompanied by a client for which WCSP have notified the FIT Id number may be treated. |

|Partners with an NHS Wiltshire chlamydia notification slip with a FIT Id number who attend participating pharmacies may be treated and offered |

|condoms and a test kit and claimed for even if over 24 years of age. |

|Partners with NHS Wiltshire chlamydia notification slip containing a FIT Id number who attend participating pharmacies may be treated and offered |

|condoms and a test kit and claimed for even if over 24 years of age. |

|Partners without NHS Wiltshire chlamydia notification slip should not be treated in this scheme but may be offered a test kit if aged 16 to 24 or |

|referred to a CASH clinic or GP for treatment. |

| |

|4.2 Pharmacies will offer a user-friendly, non-judgmental, client-centred and confidential service. |

|4.3 Pharmacies will link into existing local networks (Appendix B) of sexual health and community contraceptive services so that there is a robust |

|and rapid referral pathway for people who need onward signposting to services that provide on-going contraception, for example long acting |

|reversible contraception (LARC) and diagnosis and management of sexually transmitted infections (STIs). |

|4.4 Pharmacies will provide support and advice to people accessing the service, including advice on safe sex, condom use and advice on the use of |

|regular contraceptive methods, when required. |

|4.5 The part of the pharmacy used for the provision of the service must provide a sufficient level of safety and privacy (including visual privacy |

|where appropriate), which in most circumstances will be at the level required for the provision of the Medicines Use Review service. |

|4.6 The pharmacy contractor must ensure that pharmacists and staff involved in the provision of the service have relevant knowledge and are |

|appropriately trained in the operation of the service, including sensitive, client-centred communication skills. Pharmacists and staff providing |

|this service should also be aware of local and national guidance on safeguarding children. Development of the knowledge base of staff may be |

|facilitated by the provision or procurement of training by NHS Wiltshire. |

|4.7 The pharmacy contractor must have a standard operating procedure (SOP) in place for this service. The pharmacy contractor must ensure that |

|pharmacists and staff involved in the provision of the service are aware of and operate within national and locally agreed protocols. |

|4.8 The pharmacy must maintain appropriate records to ensure effective ongoing service delivery and audit. Records are confidential and should be |

|stored securely and for a period of ten years. |

|4.9 Pharmacists may need to share relevant information with other health care professionals and agencies, in line with local and national |

|confidentiality and data protection arrangements, including the need for the permission of the person to share the information. |

|4.10 NHS Wiltshire will provide a framework for the recording of relevant service information (including the national core dataset) for the purposes|

|of audit and the claiming of payment (Appendices C & E). |

|4.11 NHS Wiltshire may arrange a contractor meeting where appropriate to promote service development and update pharmacy staff with new |

|developments, knowledge and evidence. |

|4.12NHS Wiltshire is responsible for the provision of health promotion and other promotional material, including leaflets on EHC, long-term |

|contraception and STIs to pharmacies. |

|4.13NHS Wiltshire will facilitate the promotion of the service locally, including the development of publicity materials and the use of nationally |

|produced materials, in order to ensure young people and other local health care providers are aware that the service is available from local |

|pharmacies. Pharmacies should use these materials to promote the service to the public and should ensure they coordinate their promotional |

|activities with those of NHS Wiltshire. |

|5. Quality Indicators |

| |

|5.1 The pharmacy has appropriate NHS Wiltshire provided health promotion and other promotional material available for the client group, actively |

|promotes its uptake and is able to discuss the contents of the material with the client, where appropriate. |

|5.2 The pharmacy is making full use of promotional material provided by the NHS Wiltshire. |

|5.3 The pharmacy reviews its standard operating procedures and the referral pathways for the service on an annual basis. |

|5.4 The pharmacy participates in an annual NHS Wiltshire organised audit of service provision. |

|5.5 The pharmacy co-operates with any national or NHS Wiltshire led assessment of service user experience. |

|5.6 The pharmacy can demonstrate that pharmacists and staff involved in the provision of the service have undertaken CPD relevant to this service. |

|5.7 Pharmacists and appropriate support staff attend a NHS Wiltshire organised update meeting each year when held. |

|6. Finance Details |

| |

|6.1 For the consultation and the provision of Clamelle® (pharmacy medicine) from stock procured by NHS Wiltshire and condoms also from stock |

|procured by NHS Wiltshire, the Pharmacy will be entitled to claim £15.00 |

|6.2 The provision of test kits on an ‘as required’ basis - for partners of clients who are treated with Clamelle or for test kits offered to other |

|people - is not specifically funded in this service but is anticipated to create further presentations for treatment . The subsequent treatment of |

|partners referred by the WCSP is funded. |

|6.3 Pharmacists are required to complete and submit a monthly Payment Claim Form (Appendix E) to NHS Wiltshire by the 5th day of the month following|

|consultation(s). |

|7. Termination of contract |

| |

|This contract can be terminated by one month’s written notice on either side. |

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Appendix A

Chlamydia Screening Programme (WCSP) –Screening & Treatment Pathway – Community Pharmacies v1.2

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Signposting Appendix B

|Telephone |Email/Address |Web site |Services |

|Brook Advisory Centres |

|0808 802 1234 |admin@.uk |.uk |Confidential sexual health advice and free contraception for under 25s |

|Sexwise |

|0800 28 29 30 | |ruthinking.co.uk |Information and advice about sexual health matters for young people |

|Sexual Health Direct fpa (Family Planning Association) |

|0845 122 8690 | |.uk |Information and advice on sexual health matters and on family planning |

|National Chlamydia Screening Programme |

|0208 327 7436 | |chlamydiascreening.nhs.uk |Information and advice on the national chlamydia screening programme |

|Wiltshire Chlamydia Screening Programme |

|01380 733844 | |takethetestnow.co.uk |Information and advice on accessing the local Chlamydia screening |

| | | |programme |

|Wilts and Swindon Men's Sexual Health Service (Swindon, Kennet, North and West Wiltshire) |

|01722 421 951 |info@.uk |.uk |Information, advice and services for men in connection with sexual health |

| | | |issues |

| |First Floor | | |

| |1 John Street | | |

| |Swindon, SN1 1RT | | |

|Wilts & Swindon Men's Sexual Health Service (Salisbury) |

|01722 421951 |info@.uk |.uk |Information, advice and services for men in connection with sexual health |

| | | |issues |

| |Greencroft House | | |

| |42-46 Salt Lane | | |

| |Salisbury, Wiltshire, SP1 1EG | | |

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Medical- in-Confidence [pic]

Chlamydia Treatment Form – Pharmacy Treatment v1.3 Appendix C

Pharmacies are requested to keep a copy of this form for six months after forwarding to WCSP

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Appendix D

NHS Wiltshire Chlamydia Screening Programme (WCSP)

Points of Contact

Screening Issues

Jane Vowles

Screening Programmes Manager

Wiltshire Chlamydia Screening Programme

NHS Wiltshire

Southgate House

Pans Lane

DEVIZES

Wiltshire

SN10 5EQ

Email: jane.vowles@wiltshire.nhs.uk

Tel: 01380 733844

Fax: 01380 736031

Contractual Issues

Chris Phillips

Primary Care Contract Manager

NHS Wiltshire

Southgate House

Pans Lane

DEVIZES

Wiltshire

SN10 5EQ

Email: chris.phillips@wiltshire.nhs.uk

Tel: 01380 733757

Fax: 01380 733854

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Appendix E

Payment Claim Form

Local Enhanced Pharmacy Service

Chlamydia Treatment

|Pharmacy Name and Address: |

|(or official stamp) |

| |

a) I declare that the information on this form is correct and that the activity claimed has been carried out and not previously claimed for.

b) Records of this work are maintained

Signed ………………………………………………… Date:………………………….

Pharmacist Name:……………………………………. Month of claim……………………………….

|Serial|FIT Id Number |Date of Treatment |Remarks |

|1 | | | |

|2 | | | |

|3 | | | |

|4 | | | |

|5 | | | |

|6 | | | |

|7 | | | |

|8 | | | |

|9 | | | |

|10 | | | |

|Entity|Account |Cost |Analysis|Service Provision |Total clients |Fee |Amount |

| |Code |Centre |Code | | | |Payable |

|5QK |8415 |170900 |099 |Consultation, Clamelle® and condoms (both from stock supplied to | |£15.00 |£ |

| | | | |pharmacy by NHS Wiltshire) | | | |

………………………………………………………………………………………………………………………

NHS Wiltshire Use Only

Payment Authorised by

Name:…………..…………….…….Position:………………….………………Date:…………………..

Return completed form and order further Clamelle & condom supplies from:

Primary Care Contracts, NHS Wiltshire, Southgate House, Devizes, Wiltshire, SN10 5EQ

Tel: 01380 733903 Fax: 01380 733854

-----------------------

Client presents for treatment at pharmacy quoting FIT Id number* if known. NHS Wiltshire Partner notification slips/test kits offered for partners.

WCSP contact clients chosen pharmacy to advise of patient details and FIT Id number*.

Positive result – Client informed by WCSP using clients chosen contact method(s) through FIT. Letter or phone call to clients chosen address or text message to clients mobile phone.

Client presents for treatment at different participating pharmacy in place of chosen pharmacy. Pharmacy contacts WCSP to confirm details especially the FIT Id number* then continues as box below. NHS Wiltshire Partner notification slips/test kits offered for partners.

Pregnant, breastfeeding, interactions, contraindications, symptoms, recent treatment

Absence of: pregnancy,

breastfeeding

interactions, contraindications,

symptoms,

recent treatment

Possible

pregnancy

Give Clamelle and Sexual Health advice. Complete Treatment Form and forward to WCSP. Ask client to call back in 7 days for follow up and condoms. Recommend that clients partner(s) contact WCSP for screening.

Do not treat. Refer Client for pregnancy test.

If not pregnant then treat. If pregnant refer Client to WCSP for letter to be raised for midwife if pregnant or into appropriate NHS service.

Do not treat. Refer Client to WCSP for letter to be raised for midwife/health visitor or into appropriate NHS service.

Three WCSP attempts to contact client with no response. No further action.

Client makes contact with WCSP within 7 days. Informed of positive result and given information of participating pharmacies and other providers in their area and asked to present for treatment. Client advises choice of pharmacy to WCSP. FIT Id number* advised to client.

Client asked to inform partners or is requested to pass details to screening office to conduct partner tracing. WCSP traced partners process as for clients above.

*A unique FIT Id number is allocated to a client for each positive Chlamydia test. (Future Information Technology Systems Software)

Clients Initials_______ DOB__________Client FIT Id Number ________________________

Clients Name ____________________________________ Telephone ___________________

Date of Last sexual contact_______________ Contraception ________________________

If female LMP ______________ Normal Cycle/ recent changes_________________________

Risk of pregnancy Yes /No

Pregnant/breast feeding Yes/ No Name of Ante Natal clinic_________________________

Current medication ____________________________________________________________

Allergies _____________________________________________________________________

Relevant Medical History________________________________________________________

Symptoms____________________________________________________________________

Referred to other agency _______________________________________________________

Condoms given Yes/No Sexual health discussed Yes/No

Treatment

Azithromycin (Clamelle) 1gm stat ( Client taken Clamelle on site Yes/No

Advice:

• No sexual contact until partner/contacts have also been treated, even with a condom

• No sexual contact for 7 days after treatment, even with a condom

• If using oral contraception discuss possible effects

• Inform client the screening office will make contact in two weeks to check all is OK

Name of pharmacist: _____________________ Signature:_________________Date_________

Pharmacy Address__________________________________________________________________

Please return completed forms, preferably by fax, to the WCSP: Fax: 01380 736031 or by post: Screening Office, NHS Wiltshire, Southgate House, Pans Lane, Devizes, Wilts, SN10 5EQ Tel: 01380 733844

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For WCSP office use only: Follow-up date__________________________________________

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