NEW GENERAL MEDICAL SERVICES CONTRACT SPECIFICATION FOR THE PROVISION OF AN ENHANCED SERVICE SERVICE SPECIFICATION CHLAMYDIA SCREENING

Transcription

1 NEW GENERAL MEDICAL SERVICES CONTRACT SPECIFICATION FOR THE PROVISION OF AN ENHANCED SERVICE SERVICE SPECIFICATION CHLAMYDIA SCREENING April 1, 2013 March 31, 2014 SERVICE CHLAMYDIA SCREENING REFERENCE SERVICE SPECIFICATION Updated: Introduction 1. This Service Level Agreement outlines the more specialised care being offered above that is normally provided through essential and additional services that General Medical Services are contracted to provide. No part of this specification by commission, omission, or implication defines or redefines essential or additional services. Deputy Director of Public Health Public Health Lead: Chlamydia Programme Contact Velena Gilfillian Owen Brigstock-Barron Daniel Ajegbo Background 2. Chlamydia is the most common sexually transmitted disease 1 in young people under the age of 25, and affects over 8% of screened General Practice populations in Chlamydia screening pilots Chlamydia infection is often asymptomatic, with up to 70% of women and 50% of men being symptom free. 4. Chlamydia infection can lead to complications, such as pelvic inflammatory disease, chronic pelvic pain, infertility and ectopic pregnancy 3. 1 Health Protection Agency, SCIEH, ISD, National Public Health Service for Wales, CDSC Northern Ireland, and UASSG. Renewing the focus. HIV and other sexually transmitted infections in the UK in London: Health Protection Agency Modelling the healthcare costs of an opportunistic chlamydia screening programme. E J Adams, D S LaMontagne, A R Johnston, J M Pimenta, K A Fenton, W J Edmunds. Sex Transmitted Infections 2004; 80: Department of Health Effective Commissioning of Sexual Health & HIV Services (Jan 2003). 1

2 5. Chlamydia infection can be easily treated with a single dose of antibiotics. Screening in community pharmacies will enable Chlamydia testing to reach young people who currently attend these pharmacies. Aims 6. By promoting opportunistic screening in Community Pharmacies this LES aims to contribute to: Reducing the prevalence of Chlamydia in year olds living or visiting Wandsworth. Reducing the incidence of complications, such as pelvic inflammatory disease, ectopic pregnancy and infertility. Developing Chlamydia screening in core primary care & community settings. Raising awareness of Chlamydia infection in sexually active young people. Contributing to the Wandsworth target of identifying 2,800 positives per 100,000 population Service Outline 7. All asymptomatic patients aged between 15 and 24 who are sexually active should be offered opportunistic screening for Chlamydia infection. All samples will also be tested for Gonorrhoea. 8. Patients who screen positive for either Chlamydia or Gonorrhoea will be contacted by the Chlamydia Screening Office. Screening sites will not be expected to inform patients of their results, initiate treatment or contact tracing, or follow up patients as part of this SLA 9. Inclusion criteria for screening: 2

3 Any males/females aged between 15 and 24 who are sexually active Any males/females under 16 who are sexually active and assessed competent according to the Fraser Guidelines, with consideration of possible child protection issues (see Appendix 1) Previously screened patients should be offered annual repeat, unless risk assessment identifies change of partner and unprotected sexual intercourse, whereby there should be a minimum of 5 weeks between repeat tests (see also Manual for Screening Sites). 10. Exclusion criteria Any male/female 25 years or older Any male/female under 15 Those without a valid postcode of residence 11. Individuals identified as being eligible for screening should be given information (verbally and/or in the form of the information leaflet included in the screening kit) to assist them to make an informed choice. Written consent for screening is not required as completing the test form implies consent. Provider Requirements 12. Provider staff must attend/undertake training sessions arranged by The Chlamydia Screening Programme (CSO) 13. Providers must receive a screening site accreditation code (NB issued by the Public Health England via the CSO). 14. There should be appropriate patient information advertising the screening programme, with posters and leaflets available in waiting areas 15. Providers are responsible for ensuring that they carry out all aspects of screening according to the procedures laid out in the Manual for Screening Sites. 3

4 16. Providers must maintain appropriate supplies of kits and order more kits when necessary from the CSO 17. The provider must agree a named screening lead to communicate with the CSO and the Council s Chlamydia Screening Programme Manager. 18. The provider must have confidential consulting rooms. 19. Patients must have access to toilet and hand washing facilities, in order to provide the test sample in a suitable environment, should the patient wish to provide a sample within the community pharmacy. 20. Should the patient wish to complete the test away from the community pharmacy, it is recommended that the provider ensures that all the other functions associated with screening are carried out before advising the patient to complete the screening by providing a urine sample at home, and posting the sample, and completed test request form in the prepaid addressed envelope provided. NB It is important to note that community pharmacies will only be paid if the test is received by the Lab. 21. The provider should ensure that all patient details required are collected, including patient contact details, and that these details are recorded accurately on the Chlamydia Screening Programme test request form (See Appendix 2) as specified in the Manual for Screening Sites. 22. It is particularly important to ensure that the screening site code is correctly entered on the test request form (see Appendix 2), otherwise it will be impossible to allocate the screen to the site where it was carried out and payment cannot be made. 23. Test results will be managed by the CSO, and the community pharmacy will not be automatically notified. 24. This SLA does not include the provision of treatment or partner notification in relation to Chlamydia, and the payment covers screening only. The Chlamydia Screening Office will arrange to refer positive clients to Chlamydia treatment and partner notification hubs such as local GUM Services. 4

5 Payment 25. The SLA is effective from the date received by the Council until 31 March All screens completed before the receipt of this SLA will be paid as below, provided that the SLA is subsequently signed. 26. To ensure payment: Only screens which are received by the Lab are eligible for payment; please ensure that you keep a record of the screening reference number of all kits completed. All test request forms must be complete and legible. Test request forms must contain the screening site accreditation code in the relevant box. NB neither the name of the screening site, nor any other code (e.g. the community pharmacy code) is acceptable in place of the site accreditation code issued by the PHE Screening sites must comply with all relevant procedures as specified in the Manual for Screening Sites 27. Payment will be per Chlamydia screening test carried out on a patient within the age range years. 28. No claim or payment can be made with respect to patients screened in the following circumstances (and such patients cannot be included in the provider s screening numbers): If the patient does not fit the inclusion criteria above If the patient is screened elsewhere, for example at a screening event at a school or college If the community pharmacy has not signed the SLA 29. Providers will be required to participate in any service audit required by Wandsworth Borough Council. Community Pharmacy 30. All providers must be compliant with their essential services as part of assurance around the Community Pharmacy Contractual framework and delivering this framework to a high standard. 5

6 31. All providers must be undertaking the PCT commissioned Community Pharmacy Emergency Contraception Service. Duration of SLA The SLA will run for the period April 1, 2013 to March 31,

7 Signatures of Parties The signatures below will constitute an agreement between the community pharmacy and Council for the provision of this SLA. The agreement will be reviewed annually Pharmacy Name:. Lead Pharmacist: Address:..... Telephone number Address. PRACTICE: Community Pharmacy (Print): Signature: Date: WANDSWORTH BOROUGH COUNCIL (Print): Signature: Date: Important Contacts Support Owen Brigstock-Barron Public Health Sexual Health Lead Tel: obrigstock-barron@wandsworth.gov.uk Daniel Ajegbo Wandsworth Lead South West London Chlamydia Screening Programme Tel: Daniel.ajegbo@tht.org.uk PLEASE FAX A SIGNED COPY OF THIS PAGE TO REF: CHL1314 7

8 APPENDIX 1: Fraser Guidelines Participating agencies must demonstrate a working knowledge of the Fraser guidelines, and of child protection issues as they relate to the Chlamydia screening programme. The Fraser guidelines 1 The young person understands the advice and has sufficient maturity to understand what is involved That the health professional could not persuade the young person to inform their parents, nor allow the doctor/nurse to inform them That the young person would be very likely to begin or continue having sexual intercourse with or without the advice or treatment (NB in this case, chlamydia screening) That without advice or treatment, the young person s physical or mental health would suffer That it would be in the young person s best interest to give such advice or treatment without parental consent Under 16 s have a right to confidentiality whether asking for advice or medical treatment Child Protection Consideration must be given to the age and understanding of the young person seeking chlamydia screening to assess whether they are at risk of child protection issues, even if sexually active with peers. The Sexual Offences Act 2003 states that a child under the age of 13 years is not competent to give consent to sexual activity 2. References: DH Guidance reference 3382 Guidance for Health Professionals on the provision of contraceptive sexual and reproductive health services for under 16s 2 8

9 Appendix 2: SWL Chlamydia Screening Programme Test Request Form (lab form) Remember to add site code to box 9

10 10