Competencies for Chlamydia Screening and Treatment Enhanced by WillyWoodcock

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									          Competencies for Chlamydia Screening and Treatment Enhanced Service using the General Level Framework & Service Specification

This is a comprehensive mapping of the GLF against the enhanced service specification (where this exists) and the use of PGDs where applicable. The
mapping interprets the key GLF behaviours for the enhanced service. The HAG competencies are also listed against the relevant behavioural statements
of the GLF. Pharmacists should use this mapping to support and identify portfolio entries for CPD.

A quick reference guide showing where the HAG competencies specifically map to the GLF behaviours is also available at www.codeg.org and
http://www.pcc.nhs.uk/200 . This excludes the interpretation of the behaviours against the service specification.

The following documents were used to produce this mapping (please see endnotes for more information)

1. EN14. NHS Community Pharmacy Contractual Framework Enhanced Service – Chlamydia screening and treatment July 2008
2. EN13. NHS Community Pharmacy Contractual Framework Enhanced Service – Patient Group Directions (PGD) (Supply and/or Administration of Medicines under a PGD)
December 2007
3. Harmonisation of Accreditation Group (HAG) “Competencies and Training Framework: Provision of Chlamydia Screening and Treatment Service Level 1 (Screening) and
Level 2 (Screening and Treatment) ” Version 1 April 2008
4. Harmonisation and Accreditation Group (HAG) “Competencies and Training Framework Template” Version 1d March 2009


   Delivery of Patient Care      Interpretation for Level 1 Chlamydia           Interpretation for supply of     Link to HAG                 Examples of Evidence for
                                                                     1                                     1,2                  3,4
           Cluster               Service (using national service spec )         medicines under a PGD            Competencies for            a Portfolio
                                                                                (i.e. for a level 2 service)*    Chlamydia Screening and
                                                                                                                 Treatment Services*
                                                                                    1
Patient Assessment                                                              3.16 Where the pharmacy          1e) Able to carry out the   Witness Statement
Uses appropriate questioning     3.1 People less than 16 years of age will be   is commissioned to provide       taking of sexual history
to obtain relevant information   provided with the service if deemed Fraser     a treatment service… the                                     Record from
from the patient                 competent.                                     pharmacy shall assess the                                    informal/formal training
                                                                                suitability of the person to     2j) Able to carry out       role play/OSCE e.g. HAG
                                                                                receive the locally agreed       assessment and treatment    workshop
                                 Essential to establish client eligibility      antibiotic treatment, in line    of asymptomatic Chlamydia
                                 (clinical) and inclusion criteria for the      with the inclusion and           infection                   Completion of CPPE open


                                                                                  -1-
                             service, in particular assessment of people    exclusion criteria detailed in                                  learning programme
                             less than 16 years of age is required in       the PGD.                         Tf) Able to demonstrate        ‘Dealing with difficult
                             accordance with Fraser guidance                                                 knowledge of the clinical      discussions’
                                                                               2
                                                                            1.3 The pharmacist will          content of the relevant PGD.
                                                                            assess each patient on the                                      Completion of CPPE open
                                                                            basis of the PGD                                                learning programme
                                                                            requirements.                                                   ‘Sexual Health: Testing and
                                                                                                                                            Treating’
                                                                            Essential to establish client
                                                                            eligibility (clinical) and
                                                                            inclusion criteria for the                                      Case Example
                                                                            service (3.9). Elicit a clear                                   demonstrating patient
                                                                            and concise clinical picture                                    assessment
                                                                            of the client’s presenting
                                                                            problems. Completion of                                         Critical Incident e.g. where
                                                                            service proforma as                                             information was later
                                                                            required.                                                       identified that could have
                                                                                                                                            been elicited earlier
                                                                                   1
Consultation or referral     1.4 and 3.15 Pharmacies will link in to        3.16 … Where a supply of a       1g) Understands how and        Case example where
Pharmaceutical or health     existing local networks of sexual health and   specific antibiotic is not       when to refer clients and      referral to local services
problems are appropriately   community contraceptive services so that       appropriate, the person          when to ask for support or     took place
referred                     there is a robust and rapid referral pathway   should be referred to the        advice
                             for people who need onward signposting         local specialist service.                                       List of local services
                             …….
                                                                                                                                            Application of Level 1
                                                                               2
                             3.1 A locally agreed referral pathway will     1.3 The pharmacist will                                         information pack (thus
                             provide for the referral of people less than   refer to other health and                                       demonstrating knowledge
                             16 years of age who are not deemed to be       social care providers where                                     of content
                             Fraser competent.                              appropriate
                                                                                                                                            Successful completion of
                             The pharmacist should follow the referral      The pharmacist should                                           HAG workshop or similar
                             pathways for the service, agreed locally       follow the referral pathways                                    assessments
                             with the PCT (3.1), and use information        for the service, agreed
                                                                                                     2
                             provided by the PCT about other services       locally with the PCT (3.9 ),
                             (3.10).                                        and use information
                                                                            provided by the PCT about
                                                                                                2
                             3.15 Verbal and written advice on the          other services (3.8 ).
                             avoidance of STIs….. should be
                             supplemented by a referral to a service        Need for referral may be
                             that can provide further advice and care       identified at various points


                                                                              -2-
                                 where appropriate                             during the client encounter.
                                                                               The pharmacist should be
                                                                               able to demonstrate they
                                 Need for referral may be identified at        can identify the need to
                                 various points during the client encounter.   refer from initial
                                 The pharmacist should be able to              questioning or criteria
                                 demonstrate they can identify the need to     within the PGD, service
                                 refer from initial questioning, service       specification and service
                                 specification and service proforma.           proforma.
                                                                                  2
Recording Consultations          3.3 The pharmacy staff shall complete the     3.6 The pharmacist must         2l) Understands and is able    Copy of an example of a
Documents consultation           appropriate consent and demographic           maintain appropriate            to apply the medico-legal      record (anonymised)
where appropriate in the         documentation with people who consent         records.                        aspects of Sexually
patient’s records                to screening                                                                  Transmitted Infection
                                                                               Records should be made          Screening and treatment
                                 3.7 The pharmacy must maintain                using the framework for         and where appropriate, in
                                 appropriate records to ensure effective       recording provided by the       accordance with the PGD.
                                                                                         2
                                 ongoing service delivery and audit.           PCT (3.11 ) and in the
                                                                               client’s pharmacy record.
                                 3.9 The PCT will provide a framework for
                                 the recording of relevant service
                                 information….
                                                                                  2
Patient consent                  3.3 The pharmacy staff shall complete the     3.7 Need for permission of      1h) Understands                Service documentation
Satisfactorily obtains patient   appropriate consent and demographic           the person to share relevant    confidentiality issues and     showing consent
consent if appropriate           documentation with people who consent         information with other          has an awareness of their
                                 to screening                                  healthcare professionals        role in the process of child   Case example
                                                                               and agencies.                   protection                     demonstrating where
                                 3.8 Pharmacists may need to share relevant                                                                   consent was problematic
                                 information with other health care            Signature of client on
                                 professionals and agencies, in line with      proforma. Assess barriers to                                   Completion of CPPE online
                                 local and national confidentiality and data   the client making an                                           assessment ‘Safeguarding
                                 protection arrangements, including the        informed choice (e.g.                                          and Child Protection’
                                 need for the permission of the person to      language). Should consider
                                 share the information.                        Fraser Guidelines in                                           Successful completion of
                                                                               assessment for the capacity                                    HAG workshop or similar
                                                                               of a young person to give                                      assessments
                                 Signature of client on proforma; verbal       valid consent. Document
                                 consent of Chlamydia test supply on initial   any factors taken into
                                 assessment as appropriate. Assess barriers    account in the client record.
                                 to the client making an informed choice
                                 (e.g. language). Should consider Fraser


                                                                                 -3-
                                Guidelines in assessment for the capacity of
                                a young person to give valid consent.
                                Document any factors taken into account in
                                the client record.
Relevant Patient Background     As for client assessment above, but            1.32 The pharmacist will       2j) Able to carry out           Case example
Retrieval of ALL relevant and   including written information as well (i.e.    assess each patient on the     assessment and treatment
available information           PMR info).                                     basis of the PGD               of asymptomatic Chlamydia
                                                                               requirements                   infection

                                                                               As for client assessment       6b) Able to carry out partner
                                                                               above, but including written   management, in conjunction
                                                                               information as well (i.e.      with appropriate colleagues
                                                                               PMR info).
                                                                                    1
Drug History                                                                   3.16 Where the pharmacy        2j) Able to carry out           Case Example
Documents an accurate and                                                      is commissioned to provide     assessment and treatment
comprehensive drug history                                                     a treatment service ….. the    of asymptomatic Chlamydia
when required                                                                  pharmacy shall assess the      infection
                                                                               suitability of the person to   2l) Understands and is able
                                                                               receive the locally agreed     to apply the medico-legal
                                                                               antibiotic treatment ……        aspects of Sexually
                                                                                                              Transmitted Infection
                                                                                                              Screening and treatment
                                                                                  2
                                                                               1.3 The pharmacist will        and where appropriate, in
                                                                               assess each patient on the     accordance with the PGD.
                                                                               basis of the PGD
                                                                               requirements                   Tf) Able to demonstrate
                                                                                                              knowledge of the clinical
                                                                               This is produced from the      content of the relevant PGD.
                                                                               client assessment and
                                                                               retrieval of relevant client
                                                                               background. Allows for
                                                                               medicines exclusions to be
                                                                               identified.
                                                                                   2
Drug – drug interactions                                                       1.3 The pharmacist will        2i) Able to counsel and         For all of these behaviours
Identified, Prioritised and                                                    assess each patient on the     advise on the treatment of      case examples using
Acted upon                                                                     basis of the PGD               Chlamydia infection.            straight forward supplies
Drug – patient interactions                                                    requirements                   Td) Understands the             and/or examples where an
Identified, Prioritised and                                                                                   pharmacotherapy for the         exclusion criterion was
Acted upon                                                                     Drug Interactions are stated   full range of available         identified and the supply



                                                                                 -4-
Drug – disease interactions                                                in the PGD and should be       medication and appropriate       not made.
Identified, Prioritised and                                                identified to establish        clinical guidance (e.g. NICE).
Acted upon                                                                 service exclusions.                                             CPD entry demonstrating
                                                                                                          Tf) Able to demonstrate          that clinical knowledge is
                                                                                                          knowledge of the clinical        updated (e.g. review
                                                                              2
Ensures appropriate dose                                                   1.3 The pharmacist will        content of the relevant          articles, completion of
Appropriate dose is ensured                                                assess each patient on the     Patient Group Direction(s).      formal CE programmes)
Selection of dosing regimen                                                basis of the PGD
Appropriate route and timing                                               requirements                                                    Completion of CPPE open
of dose is ensured                                                                                                                         learning programme
Selection of formulation and                                               Dose of medicines is                                            ‘Sexual Health: Testing and
concentration                                                              appropriate for indication                                      Treating’
Appropriate formulation is                                                 and supplied as per the
ensured                                                                    PGD. The regimen is
                                                                           provided in the PGD. Advice
                                                                           on dose timing is provided
                                                                           to the client. The
                                                                           formulation supplied is
                                                                           defined in the PGD

The prescription is legal                                                  The supply of the POM          2l) Understands and is able
Legality of prescription is                                                against the PGD complies       to apply the medico-legal
ensured                                                                    with legal requirements i.e.   aspects of Sexually
                                                                           the PGD is signed by all       Transmitted Infection
                                                                           pharmacists delivering the     Screening and treatment
                                                                           service in the pharmacy.       and where appropriate, in
                                                                                                          accordance with the PGD
Labelling of the medicine                                                  Prior to supplying the         2l) Understands and is able      A copy of an anonymised
The label on the dispensed                                                 medicine, the product          to apply the medico-legal        label could be used with a
medicine includes required                                                 should be labeled as per       aspects of Sexually              case example
information                                                                POM requirements.              Transmitted Infection
 The dispensed medicine is                                                 Accommodates special           Screening and treatment          Case example where
labeled appropriately for the                                              requirements (large labels,    and where appropriate, in        special requirement was
patient                                                                    literacy /language issues).    accordance with the PGD          identified and provided for
                                                                              2
Public Health                   1.5 Pharmacies will provide support and    2.1 The service aims to        1a) Able to raise and            Copies of leaflets available
Provides lifestyle advice       advice to people accessing the service,    support self-care and          respond to the issue of          or given to clients
appropriately                   including advice on safe sex, condom use   improve health.                sexual health and/or make
                                and advice on the use of regular                                          the offer of Chlamydia           Witness statement
                                                                              2
                                contraceptive methods, when required.      2.3 The pharmacist should      screening to men and             demonstrating this
                                                                           provide advice and support     women.                           competence

                                                                             -5-
                         2.4 To increase clients’ knowledge of the     alongside treatment or          1c) Able to counsel and
                         risks associated with STIs                    prophylaxis for the             advise on screening             Case example
                                                                       condition being managed.        1d) Understands and is          demonstrating public
                         3.15 Verbal and written advice on the                                         aware of common sexually        health activities
                         avoidance of STIs and the use of regular      This may be provided by the     transmitted infections
                                                                                 2
                         contraceptive methods, including advice on    PCT (3.12 ) or sourced          including signs and             CPD entry demonstrating
                         the use of condoms, shall be provided to      nationally.                     symptoms.                       update on knowledge in
                         the person.                                                                   1f) Able to give advice on      this area
                                                                                                       safer sex.
                                                                                                       2k) Able to carry out partner   Copy of any quality
                                                                                                       notification in conjunction     indicator information
                                                                                                       with appropriate colleagues     supplied to the PCT
                                                                                                       where this service is
                                                                                                       required.

                                                                                                       6b) Able to carry out partner
                                                                                                       management, in conjunction
                                                                                                       with appropriate colleagues

                                                                                                       6c) Able to counsel and
                                                                                                       advise on the tracing of
                                                                                                       clients

                                                                          2
Health Needs             1.3 Pharmacies will offer a user-friendly,    1.3 The pharmacist will         1a) Able to raise and
Takes into account the   non-judgmental,       client-centred  and     provide support and advice      respond to the issue of         Case Example
patient’s individual     confidential service.                         to the patient for the          sexual health and/or make       demonstrating patient
circumstances                                                          condition being treated         the offer of Chlamydia          information gathering
                                                                                                       screening to men and
                                                                       (Cultural/social background     women.                          CPD information on
                         Cultural/social background may influence      may influence client choice).   1c) Able to counsel and         psychosocial aspects of
                         client choice. Repeated access to the                                         advise on screening.            sexual healthcare
                         service should be referred to GP or sexual                                    1d) Understands and is
                         health clinic. Need to assess and account                                     aware of common sexually        Completion of CPPE open
                         for the psychosocial aspects in relation to                                   transmitted infections          learning programme
                         sexual and reproductive healthcare and                                        including signs and             ‘Dealing with difficult
                         management (e.g. stigma, shame)                                               symptoms.                       discussions’
                                                                                                       1f) Able to give advice on
                                                                                                       safer sex.
                                                                                                       2k) Able to carry out partner
                                                                                                       notification in conjunction


                                                                         -6-
                                                                                                              with appropriate colleagues
                                                                                                              where this service is
                                                                                                              required.

                                                                                                              6a) Able to carry out
                                                                                                              extended management of
                                                                                                              asymptomatic Chlamydia
                                                                                                              infection
                                                                                 2
Need for information is        1.1 Pharmacies will provide Chlamydia          1.3 The pharmacist will                                       Case Example
identified                     screening kits to sexually active males and    provide support and advice
Patient need for information   females under the age of 25, for example       to the patient for the
is accurately identified       when purchasing condoms, dispensing oral       condition being treated
                               contraceptive pills and supplying EHC, in
                               agreement with the local Chlamydia             Obtain and interpret client’s
                               Screening Office. Advice on how to utilise     knowledge and
                               the kit, how to return it for testing and      understanding in order to
                               what will happen following completion of       meet their information
                               the test will be provided in line with the     needs.
                               approach adopted by the local Chlamydia
                               Screening Office.                                                              1b) Able to communicate
                                                                                 2
Medicines Information          Any written or verbal information given        1.3 The pharmacist will         with clients appropriately    Case Example
Accurate and appropriate       about medicines should be communicated         provide support and advice      and sensitively.
medicines information is       in a manner that is suitable for the client.   to the patient for the
communicated                                                                  condition being treated

                                                                              (Any written or verbal
                                                                              information given about
                                                                              medicines should be
                                                                              communicated in a manner
                                                                              that is suitable for the
                                                                              client.)


Provision of written           3.12 The PCT will be responsible for the       1.3 The pharmacist will                                       Copies of leaflets available
information                    provision of health promotion and other        provide support and advice                                    or given to clients
Appropriate information is     promotional material, including leaflets on    to the patient for the          1b) Able to communicate
provided                       EHC, long-term contraception and STIs to       condition being treated         with clients appropriately    List of useful internet sites
                               pharmacies.                                                                    and sensitively               passed on to clients
                                                                              Written information to

                                                                                -7-
                                  3.15 Verbal and written advice on the          support verbal advice                                             List of local related
                                  avoidance of STIs and the use of regular       should be available and                                           services
                                  contraceptive methods, including advice on     provided in a manner
                                  the use of condoms, shall be provided to       suitable for the client. Use
                                  the person.                                    relevant information
                                                                                 sources (leaflets, internet
                                                                                 etc). Information should
                                  4.1 The pharmacy has appropriate PCT-
                                                                                 enable the client to make
                                  provided health promotion and other
                                                                                 informed choices about
                                  promotional material available for the
                                                                                 their care and condition.
                                  client group, actively promotes its uptake
                                                                                 The PCT may provide
                                  and is able to discuss the contents of the                                2
                                                                                 appropriate leaflets (3.13 )).
                                  material    with     the   client,  where
                                  appropriate.




                                  Written information to support verbal
                                  advice should be available and provided in
                                  a manner suitable for the client. Use
                                  relevant information sources (leaflets,
                                  internet etc). Information should enable
                                  the client to make informed choices about
                                  their care and condition.
                                                                                        1
Use of Guidelines                 1.1 Advice on how to utilize the kit, how to   3.16 Where the pharmacy          1c) Able to counsel and          Copy of Guideline (or
Current clinical guidelines are   return it for testing and what will happen     is commissioned to provide       advise on screening              executive summary)
applied as appropriate            following completion of the test will be       a treatment service, locally     2i) Able to counsel and
                                  provided in line with the approach adopted     agreed guidance should be        advise on the treatment of       Case example
                                  by the local Chlamydia screening office.       followed that complies with      Chlamydia infection              demonstrating where
                                                                                 the core requirements of         2j) Able to carry out            guidance applied
                                  3.1, 3.2 The service can only be provided to   the NCSP                         assessment and treatment
                                  people 16 years and under, if Fraser                                            of asymptomatic Chlamydia        Critical evaluation of local
                                                                                    2
                                  guidance and DoH guidance on confidential      3.3 The pharmacist must be       infection                        guidance compared to
                                  sexual health advice and treatment for         aware of and operate within                                       national or other guidance
                                  young people, has been followed                local protocols                  Td) Understands the
                                                                                                                  pharmacotherapy for the
                                                                                        2
                                  3.5 Pharmacists and staff providing this       3.10 Where national              full range of available
                                  service should be aware of local and           guidelines exist for a           medication and appropriate
                                  national guidance on safeguarding children.    therapeutic area, these          clinical guidance (e.g. NICE).


                                                                                   -8-
                                                                               should be taken account of.
                                3.14 Where the pharmacy is responsible for
                                notifying people of the results of screening
                                and/or contact tracing, a locally agreed
                                protocol will be followed


                                Pharmacists should follow the Clinical
                                Guidelines. Use of local guidelines when
                                neglect, physical or sexual abuse, sexual
                                assault is suspected in any client
Record of contributions         3.9 The PCT will provide a framework for       3.91 The PCT will provide a    2l) Understands and is able   A completed service
Appropriate documentation of    the recording of relevant service              framework for the recording    to apply the medico-legal     proforma or record sheet
the intervention is             information for the purpose of audit and       of relevant service            aspects of Sexually
completed                       claiming of payment                            information for the purpose    Transmitted Infection
                                                                               of audit and claiming of       Screening and treatment
                                Service Proforma is completed and              payment                        and where appropriate, in
                                retained.                                                                     accordance with the PGD
                                                                                  2
                                                                               3.6 The pharmacy must
                                                                               maintain appropriate
                                                                               records to ensure effective
                                                                               ongoing service delivery and
                                                                               audit.

                                                                               The PCT should provide a
                                                                               framework for recording
                                                                                                         2
                                                                               relevant information (3.11 )
                                                                                   1
Assessing outcomes of           3.9 The PCT will provide a framework for       3.9 The PCT will provide a     2l) Understands and is able   Copy of information on
contributions                   the recording of relevant service              framework for the recording    to apply the medico-legal     service provision e.g.
Outcomes of contributions are   information for the purpose of audit and       of relevant service            aspects of Sexually           audits, patient satisfaction
appropriately assessed          claiming of payment                            information for the purpose    Transmitted Infection         survey
                                                                               of audit and claiming of       Screening and treatment
                                4.4 The pharmacy participates in an annual     payment                        and where appropriate, in
                                PCT organized audit of service provision                                      accordance with the PGD
                                                                                  1
                                                                               4.4 The pharmacy
                                4.5 The pharmacy co-operates with any          participates in an annual
                                national or PCT-led assessment of service      PCT organized audit of
                                user experience                                service provision

                                Data is submitted as requested to PCT for      4.51 The pharmacy co-


                                                                                 -9-
                              evaluation.                                     operates with any national
                                                                              or PCT-led assessment of
                                                                              service user experience


                                                                              Data is submitted as
                                                                              requested by the PCT for
                                                                              evaluation in line with
                                                                              suggested service quality
                                                                                                 2
                                                                              indicators (4.1-4.6 )

                                                                              Audits of treatment
                                                                              provided and client follow
                                                                              up will be required if service
                                                                              is provided as described in
                                                                                        1
                                                                              points 1.2 c, d or e.

Personal Competency Cluster   Interpretation for Chlamydia Service            Interpretation for supply of     Link to HAG Competencies        Examples of Evidence for
                              (using national service spec)                   medicines under a PGD (i.e.      for Chlamydia Screening         a Portfolio
                                                                              for a level 2 service)           and Treatment Services
Prioritisation                For service provided with contact tracing       For service provided with        6a) Able to carry out           Case example
Prioritises work well         (as described in 1.2c, d, and e) essential to   contact tracing (as              extended management of          demonstrating
                                                                                               1
                              prioritise the action required in response to   described in 1.2 c, d, and e)    asymptomatic       Chlamydia    prioritisation
                              the test results.                               essential to prioritise the      infection.
                                                                              action required in response      6b) Able to carry out partner   Service audit
                                                                              to the test results.             management, in conjunction
                                                                                                               with appropriate colleagues.
                                                                                                               6c) Able to counsel and
                                                                                                               advise on the tracing of
                                                                                                               clients.

Efficiency                    Able to meet the service waiting time;          Able to meet the service         6b) Able to carry out partner   Service audit
Uses time efficiently         provides the service in a timely way.           waiting time; provides the       management, in conjunction
                              Essential if service provides contact tracing   service in a timely way.         with appropriate colleagues.
                              (1.2c,d,e).                                     Essential if service provides    6c) Able to counsel and
                                                                                                   1
                                                                              contact tracing (1.2 c,d,e).     advise on the tracing of
                                                                                                               clients.




                                                                               - 10 -
Communication with              1.3 Pharmacies will offer a user-friendly,         3.22 The pharmacist must         1a) Able to raise or respond    Witness statements
(client/carer and health        non-judgemental, client-centred and                have sensitive, client-          to the issue of sexual health   demonstrating
professionals and PCO)          confidential service.                              centred communication            and/or make the offer of        communication skills
Communication is clear,         3.5 The pharmacy contractor must ensure            skills.                          Chlamydia screening to men
precise and appropriate         that pharmacists and staff involved in the                                          and women                       Case example
                                                                                      2
                                provision of the service have relevant             3.7 The pharmacist may           1b) Able to communicate         demonstrating where
                                knowledge and are appropriately trained in         need to share relevant           with clients appropriately      communication was
                                the operation of the service, including            information with other           and sensitively                 difficult
                                sensitive, client-centred communication            healthcare professionals         1c) Able to counsel and
                                skills.                                            and agencies.                    advise on screening             Successful completion of
                                                                                                                    2i) able to counsel and         HAG workshop or similar
                                Communication skills are an essential                                               advise on the treatment of      assessments
                                component of delivering the service due to                                          Chlamydia Infection
                                its sensitive nature, particularly if delivering
                                a service as described in 1.2c,d and e.
                                                                                      2
Multi-disciplinary Team         1.4 Pharmacies will link into existing local       3.7 The pharmacist may           1g) Understands how and         Local Referral
Recognises the value of other   networks of sexual health and community            need to share relevant           when to refer clients           Pathways/services
health professionals and uses   contraceptive services so that there is a          information with other           (signposting) and when to
appropriate channels for        robust and rapid referral pathway for              healthcare professionals         ask for support from others.    Case example where
referral                        people who need onward signposting to              and agencies.                    2k) Able to carry out partner   referral was made
                                services……                                                                          notification in conjunction
                                                                                      2
                                                                                   1.3 The pharmacist will          with appropriate colleagues     Completion of Level 1
                                3.8 Pharmacists may need to share relevant         refer to other health and        where this service is           information pack
                                information with other health care                 social care providers where      required.
                                professionals and agencies…..                      appropriate                                                      Successful completion of
                                                                                                                    6b) Able to carry out partner   HAG workshop or similar
                                3.10 The PCT will provide up to date details       Pharmacists need to know         management, in conjunction      assessments
                                of other services which pharmacy staff can         the roles of other health        with appropriate colleagues
                                use to refer on service users who require          professionals and service
                                further assistance.                                providers to ensure referral
                                                                                   is correctly applied.

                                Pharmacists need to know the roles of
                                other health professionals and sexual
                                health service providers to ensure referral
                                is correctly applied
                                                                                      2
Confidentiality                 1.3 Pharmacies will offer a user-friendly,         3.7 Data may need to be          1h) Understands                 Premises accreditation
Maintains confidentiality       non-judgmental,       client-centred     and       shared, in line with local and   confidentiality issues and      record
                                confidential service.                              national confidentiality and     has an awareness of their
                                                                                   data protection                  role in the process of child    Critical incident


                                                                                    - 11 -
                            3.4 The part of the pharmacy used for the     arrangements.                  protection                     demonstrating
                            provision of the service must provide a                                                                     confidentiality issues
                            sufficient level of safety and privacy
                            (including    visual    privacy    where                                                                    Completion of CPPE open
                            appropriate), which in most circumstances                                                                   learning programme
                            will be at the level required for the                                                                       ‘Dealing with difficult
                            provision of the Medicines Use Review                                                                       discussions’
                            service.


                            3.8 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.
                                                                             2
Recognition of Limitation   As for referral                               3.5 Pharmacists must act       1g) Understands how and        Example of when advice
Recognises limitations                                                    within their competence.       when to refer clients          was sought from a
                                                                                                         (signposting) and when to      colleague
                                                                                                         ask for support from others.
                                                                                                                                        Example of CPD where
                                                                                                                                        performance gap
                                                                                                                                        identified

                                                                                                                                        Successful completion of
                                                                                                                                        HAG workshop or similar
                                                                                                                                        assessments
                                                                             2
Quality and Accuracy of     Completion of service documentation and       3.6 The pharmacist must        2l) Understands and is able    Copy of a sample
documentation               recording of information on PMR               maintain appropriate           to apply the medico-legal      proforma
Legally required info is                                                  records to ensure effective    aspects of Sexually
documented                                                                ongoing service delivery and   Transmitted Infection
                                                                          audit.                         screening and treatment
                                                                                                         and where appropriate, in
                                                                          Records should be made         accordance with Patient
                                                                          using the framework for        Group Directions
                                                                          recording provided by the
                                                                                   2
                                                                          PCT (3.11 )


                                                                           - 12 -
Legislation                    Laws relating to younger clients (e.g. as       3.52 The pharmacist must        1h) Understands                Critical Incident
                               detailed in Children’s NSF); Data               sign and retain a copy of the   confidentiality issues and
                               protection;                                     PGD.                            has an awareness of their      Completion of CPPE online
                                                                                                               role in the process of child   assessment ‘Safeguarding
                                                                               There may be laws relating      protection                     and Child Protection’
                                                                               to the specific client group    2l) Understands and is able
                                                                               e.g children; Data              to apply the medico-legal
                                                                               protection.                     aspects of Sexually
                                                                                                               Transmitted Infection
                                                                                                               screening and treatment
                                                                                                               and where appropriate, in
                                                                                                               accordance with Patient
                                                                                                               Group Directions
Confidence                     The results of the annual patient survey will                                                                  Results of annual patient
Inspires confidence            provide an indication of patient confidence.                                                                   survey
Responsibility for patient     Duty of care to counsel/refer clients.          Duty of care to                                                Critical Incident
care                           Responsibility to undertake contact tracing     counsel/refer clients.
Takes responsibility for       and follow up if providing service as           Responsibility to undertake                                    Case Example
patient care                   described in 1.2c,d or e.                       contact tracing and follow
                                                                               up if providing service as
                                                                                                1
                                                                               described in 1.2 c,d or e.
                                                                                  2
CPD                            4.6 The pharmacy can demonstrate that           3.4 The pharmacist must                                        CPD record (i.e. plan and
                               pharmacists and staff involved in the           undertake any local training                                   record entry relating to
                               provision of the service have undertaken        that the PCT may require                                       Chlamydia)
                               CPD relevant to this service.                   them to.
                               4.7 Pharmacists and appropriate support
                               staff attend a PCT organised update
                               meeting each year.

Problem Solving Cluster        Interpretation for Chlamydia Service            Interpretation for supply of    Link to HAG Competencies       Examples of Evidence for
                               (using national service spec)                   medicines under a PGD (i.e.     for Chlamydia Screening        a Portfolio
                                                                               for a level 2 service)          and Treatment Services
Accesses Information                                                                These may be clinical      Tf) Able to demonstrate
Able to access information      These may be clinical information about            information about the       knowledge of the clinical
from appropriate information      the patient or information about the             patient or information      content of the relevant PGD.
                                                                                                                                              Case Example
sources                          services. The information provides the          about other services. The
                                                                                                                                              Critical incident (e.g. out of
                               basis for completing the client assessment        information provides the
                                                                                                                                              date
                                        and supply of testing kits.               basis for completing the
                                                                                   client assessment and
                                                                                   supply of the medicine

                                                                                - 13 -
                                3.10. The information provided by the PCT
                                with details of other services will be                                                                        CPD record (i.e. plan and
                                assigned an expiry date.                                                                                      record entry relating to
Up to date information                                                                                                                        Chlamydia)
Keeps information needed on     Pharmacists should ensure they have
a day to day basis up to date   access to the current version.
                                                                                   2
Pathophysiology                                                                 3.2 The pharmacist must        1d) Understands and is
Knowledge of                                                                    have adequate knowledge        aware of common sexually
pathophysiology                                                                 of the medical condition for   transmitted infections
                                                                                which the medicines are        including signs and
                                                                                being supplied and/or          symptoms
                                                                                                                                              CPD entry relating to the
                                                                                administered.
                                                                                                                                              disease state of Chlamydia
Pharmacology                    The pharmacist will require underpinning        The pharmacist will require    2i) Able to counsel and
                                                                                                                                              or its management
Able to discuss how drugs       knowledge of sexual health and                  underpinning knowledge of      advise on the treatment of
work                            contraception                                   the condition and its          Chlamydia Infection
Side effects                                                                    treatment.                     2j) Able to carry out
                                                                                                                                              Completion of CPPE open
Able to describe the major      Knowledge from Clinical Guidance notes                                         assessment and treatment
                                                                                                                                              learning programme
side effects of drugs           and BNF/SPC                                                                    of asymptomatic Chlamydia
                                                                                                                                              ‘Sexual Health: Testing and
                                                                                                               infection
                                                                                                                                              Treating’
                                                                                                               Td) Understands the
                                                                                                               pharmacotherapy for the
                                                                                                                                              Case Example
                                                                                                               full range of available
                                                                                                                                              demonstrating managing
                                                                                                               medication and the
                                                                                                                                              the side effects of
                                                                                                               appropriate clinical
                                                                                                                                              treatment
                                                                                                               guidelines

                                                                                                               Tf) Able to demonstrate
                                                                                                               knowledge of the clinical
                                                                                                               content of the relevant PGD.
Evaluates information           If providing a service as described in 1.2c,d   If providing a service as      2j) Able to carry out          Successful completion of
                                                                                                 1
Able to evaluate information    or e pharmacist will be required to evaluate    described in 1.2 c,d or e      assessment and treatment       HAG workshop
gathered                        the results in order to take the appropriate    pharmacist will be required    of asymptomatic Chlamydia      assessments (i.e. MCQ and
                                action.                                         to evaluate the results in     infection                      role play)
                                                                                order to take the
                                                                                appropriate action.
Problem identification          This includes drug and non-drug issues.         Any problem the client may                                    Case Example
Able to identify problems       Problems could relate to the testing kit or     have in taking the medicine    2i) Able to counsel and
                                contacting follow ups, for example, in          should be identified via the   advise on the treatment of     Critical Incident
                                addition to any issues the client may have.     assessment and medication      Chlamydia infection

                                                                                 - 14 -
                                                                               history.
                                                                                                               2j) Able to carry out
                                                                                                               assessment and treatment
                                                                                                               of asymptomatic Chlamydia
                                                                                                               infection.
                                                                                                               6a) Able to carry out
                                                                                                               extended management of
                                                                                                               asymptomatic       Chlamydia
                                                                                                               infection.
                                                                                                               6b) Able to carry out partner
                                                                                                               management, in conjunction
                                                                                                               with appropriate colleagues.
                                                                                                               6c) Able to counsel and
                                                                                                               advise on the tracing of
                                                                                                               clients.
Provides accurate                                                                                              1f) Able to give advice on      Case example, critical
information                                                                                                    safer sex                       incident
                                                                                                               2i) Able to counsel and
Provides relevant information                                                                                  advise on the treatment of      Case example, critical
                                                                                                               Chlamydia Infection             incident
                                                                                                               2k) Able to carry out partner
                                                                                                               notification in conjunction
Provides timely information     Acting on results of the test in terms of      Providing timely access to                                      Case example, critical
                                                                                                               with appropriate colleagues
                                following up the clients and contact tracing   treatment is essential for                                      incident
                                                                                                               where this service is
                                is essential for this service.                 this service
                                                                                                               required

                                                                                                               6a) Able to carry out
                                                                                                               extended management of
                                                                                                               asymptomatic       Chlamydia
                                                                                                               infection.
                                                                                                               6b) Able to carry out partner
                                                                                                               management, in conjunction
                                                                                                               with appropriate colleagues.
                                                                                                               6c) Able to counsel and
                                                                                                               advise on the tracing of
                                                                                                               clients.
Ensures resolution of                                                          This includes following up      6c) Able to counsel and         Case example, critical
problem                         This includes following up clients who do      clients who do not attend       advise on the tracing of        incident
                                not attend for test results                    for test results or treatment   clients.                        Audit



                                                                                - 15 -
Management and                  Interpretation for Chlamydia Service           Interpretation for supply of     Link to HAG Competencies      Examples of Evidence for
Organisation Cluster            (using national service spec)                  medicines under a PGD (i.e.      for Chlamydia Screening       a Portfolio
                                                                               for a level 2 service)           and Treatment Services
                                                                                  2
Standard Operating              3.6The pharmacy contractor must have a         3.3 The pharmacist must be       2l) Understands and is able   Examples of SOPs used for
Procedures                      standard operating procedure in place for      aware of and operate within      to apply the medico-legal     the service
Uses relevant and up to date    this service. The pharmacy contractor must     local protocols                  aspects of Sexually
procedures for practice         ensure that pharmacists and staff involved                                      Transmitted Infection         Critical review of the
                                in the provision of the service are aware of   Pharmacists will need to         screening and treatment       service related SOP
                                and operate within national and locally        show they can apply the          and where appropriate, in
                                agreed protocols                               service to the specification     accordance with Patient       Record of training
                                                                               and have SOPs in place for       Group Directions              pharmacy team about the
                                4.3 The pharmacy reviews its standard          the service                                                    SOP and service
                                operating procedures and the referral                                                                         specification.
                                pathways for the service on an annual
                                basis.                                                                                                        Witness statement from a
                                Pharmacists will need to show they can                                                                        person observing
                                apply the service to the specification and                                                                    specimen collection
                                have SOPs in place for the service.                                                                           process

                                                                                    2
Working environment             3.4 The part of the pharmacy used for the      3.1 The part of the
Implements legal and            provision of the service must provide a        pharmacy used for the
professional requirements for   sufficient level of safety and privacy         provision of the service
working environment             (including    visual    privacy    where       provides a sufficient level of                                 Premises accreditation
                                appropriate), which in most circumstances      privacy and safety and                                         record
                                will be at the level required for the          meets other locally agreed
                                provision of the Medicines Use Review          criteria.
                                service.

Risk management                 Recording of critical incidents relating to    Recording of critical
Documents critical incidents    delivery of the service including              incidents relating to supply
                                                                                                                                              Critical incidents
and forwards to appropriate     management of follow ups and contact           of treatment antibiotic.
organisations                   tracing
                                                                                2
Service Quality                 4. Suggested quality indicators                4 . Suggested quality
Looks to improve the quality    (Quality measures met as detailed in the       indicators
of the service offered          service specification. Participation in new    (Quality measures met as
                                developments as advised by the PCT)            detailed in the service                                        Service Audit
                                                                               specification. Participation
                                                                               in new developments as
                                                                               advised by the PCT)


                                                                                - 16 -
Service Reimbursement           Pharmacists will follow the reimbursement        Pharmacists will follow the      Completion of service
Uses relevant reference         process as detailed in the service               reimbursement process as         reimbursement proforma
sources to ensure appropriate   specification                                    detailed in the service
and accurate reimbursement                                                       specification
                                                                                    2
Prescribing budgets                                                              2.2 Provide medicines at
Interprets how prescribing                                                       NHS expense for those
affects prescribing budgets                                                      exempt from prescription
                                                                                 charge.
Linked Organisation             Linked organisations for referral and            Linked organisations for         Local Referral
Can describe the key            support                                          referral and support             Pathways/services
organisations that affect
service delivery                                                                                                  Successful completion of
                                                                                                                  HAG workshop
                                                                                                                  assessments (i.e. MCQ and
                                                                                                                  role play)

                                                                                                                  Completion of Level 1
                                                                                                                  information pack


                                                                                    2
Staff Training                  3.5 The pharmacy contractor must ensure          3.2 The pharmacy                 Example of training
Ensures staff are competent     that pharmacists and staff involved in the       contractor has a duty to         information provided
to undertake the tasks          provision of the service have relevant           ensure pharmacists involved
allocated to them.              knowledge and are appropriately trained in       in the provision of the          Witness statement of staff
                                the operation of the service, including          service have relevant            observation
                                sensitive, client-centred communication          knowledge and are
                                skills. Pharmacists and staff providing this     appropriately trained in the     SOPs defining role of
                                service should also be aware of local and        operation of the service         different staff members in
                                national guidance on safeguarding children,                                       the service
                                as it is possible that people under the age      Training of counter staff on
                                of 16 will request screening. Development        the service and their roles in   Review of own and staff
                                of the knowledge base of staff may be            delivering it                    competencies against the
                                facilitated by the provision of local training                                    roles.
                                by the PCT
Pharmaceutical procurement      Knows how to source testing kits in a timely                                      Copy of SOP
Describes how                   manner                                                                            Critical incident
pharmaceuticals can be
sources and sources them in a

                                                                                  - 17 -
timely manner

Supply problems                                                                  2.22 Make medicines                                       Critical incident with stock
Supply problems are             Pharmacists need to be aware of how to           available via PGDs where
resolved promptly               access alternative sources of the test kits in   there would otherwise be
                                the case of supply difficulties.                 problems in accessing the
                                                                                 medicines easily or
                                                                                 promptly.

                                                                                 (Stock levels of the medicine
                                                                                 need to be maintained to
                                                                                 ensure service continuity)
                                                                                    2
Stock management                Stock levels of the Chlamydia test kit and       2.2 Make medicines                                        Copy of SOP
Ensures stock is managed        antibiotics for treatment, need to be            (antibiotic) available via                                Critical incident
                                maintained to ensure service continuity.         PGDs where there would
                                                                                 otherwise be problems in
                                                                                 accessing the medicines
                                                                                 easily or promptly.

1
  EN14. NHS Community Pharmacy Contractual Framework Enhanced Service – Chlamydia screening and treatment July 2008
2
  EN13. NHS Community Pharmacy Contractual Framework Enhanced Service – Patient Group Directions (PGD) (Supply and/or Administration of Medicines under a PGD)
December 2007
3
  Harmonisation of Accreditation Group (HAG) “Competencies and Training Framework: Provision of Chlamydia Screening and Treatment Service Level 1 (Screening) and
Level 2 (Screening and Treatment) ” Version 1 April 2008
4
  Harmonisation and Accreditation Group (HAG) “Competencies and Training Framework Template” Version 1d March 2009
* The HAG Competencies and Training Framework encompasses two levels of service: Level 1 (screening) and Level 2 (Screening and Treatment). Core competencies are
defined for a Level 1 service (described in this document as 1a – 1h etc). Additional competencies are described for provision of a Level 2 service (described in this
document as 2i – 2l etc). This mapping also includes general competencies for a level 2 service from the HAG Competencies and Training Framework Template. These are
described as Td – Te.




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