PCA(P)(2024)30 - Updated Documentation for Emergency and Bridging Contraception
Published: 14/10/24
This Circular advises Health Boards and community pharmacy contractors of an updated Patient Group Direction (PGD) that is to be implemented for the provision of desogestrel as bridging contraception. It also encloses updated service specifications for both the emergency hormonal contraception (EHC) and bridging contraception (BC) services as well as supporting guidance.
Background
Directions for the Public Health Service enable community pharmacies to provide emergency and bridging contraception. The current version, the Health Board Additional Pharmaceutical Services (Public Health Service) (Scotland) Directions 2023 (“2023 Directions”) was issued when naloxone emergency supply was also added to the Public Health Service. The Directions are available in NHS Circular PCA(P)(2023)34, issued on 12 September 2023.
NHS Circular PCA(P)(2015)20, issued on 14 September 2015, enclosed a revised service specification for emergency hormonal contraception.
NHS Circular PCA(P)(2021)12, issued on 23 September 2021, announced the introduction of bridging contraception and enclosed a service specification.
A Patient Group Direction for the supply of desogestrel as bridging contraception was rolled out in 2021. It has now been reviewed and updated. Health Boards are responsible for local governance processes to approve, sign and publish the PGD.
Detail
A short life working group was set up earlier this year to review the existing services, to make suggested improvements to the service specifications, and provide input to the PGD review process.
Documents attached to this circular are as follows:
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The updated draft PGD for bridging contraception has been approved by NHS 24 and is attached at Annex C to allow pharmacists as much time as possible to familiarise themselves with the relevant details. In the meantime, as local governance procedures must be followed even when a PGD is agreed nationally, Health Boards will each approve, sign and publish this PGD through the appropriate channels. Boards are asked to have the updated PGD in place by 1 November 2024. Pharmacy contractors are asked to ensure all pharmacy teams are familiar with the new arrangements by 30 November 2024.
Individual authorisation forms should be completed by pharmacists delivering the Public Health Service and submitted to each Health Board area that they work in according to the usual process.
The changes that have been made are listed in a summary table at the start of the PGD.
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A summary of the key changes to the service specifications is as follows:
Emergency Hormonal Contraception (EHC)
Change of remuneration arrangements so that from 1 November 2024 a fee of £30 is payable when an EHC consultation is undertaken instead of linked to supply. This means that where a consultation outcome is that the pharmacy provides Advice only or Referral to another healthcare provider, they may claim the consultation fee. Reimbursement will also be paid where a supply has been made.
Update to the training that pharmacists must complete.
Update to the resources section.
Change to the Universal Claim Framework (UCF) options, further explanation in paragraph 17 below.
Note: no changes have been made to eligibility for the EHC service.
Bridging Contraception (BC)
Change to eligibility from 1 November 2024 so that those who are not currently registered with a GP practice can access the service as long as they live in Scotland i.e. this is equivalent to the eligibility for NHS Pharmacy First Scotland.
Update to the training that pharmacists must complete.
Update to the resources section.
Change to the Universal Claim Framework (UCF) options, further explanation in paragraph 17 below.
Note: there are no changes to the remuneration arrangements for Bridging Contraception.
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Following user feedback, changes have been made to the assessment forms for both EHC and BC.
The intention is for the EHC form to replace current local versions to ensure consistency across Health Boards. Health Boards are strongly encouraged to adopt this new version when next reviewing their local EHC PGDs.
The updated assessment form for BC should be used in conjunction with the revised national PGD released at this time.
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Community pharmacy contractors should ensure that pharmacists have completed the e-learning modules referenced in the service specifications. These are now available on the NES TURAS Learn website at:
Sexual Health for Community Pharmacy: Emergency Contraception (EC)
Sexual Health for Community Pharmacy: Bridging Contraception (BC)
Public Protection Modules
i. Adult support and protection (practice level 1 informed and level 2 skilled)
ii. Child protection (practice level 1 informed and level 2 skilled)
https://learn.nes.nhs.scot/64316/public-protection
A webinar on bridging contraception is planned for mid November 2024 – the date and details will be confirmed as soon as possible.
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Since 2021 there have been 3 UCF claim options available: EHC only, BC only and EHC+BC where there is dual supply.
From 1 November 2024 the dual supply option will be removed. Pharmacy teams should claim either EHC only or BC only depending on the type of consultation that has been undertaken. Where both consultations have been undertaken with one person, the pharmacy team should make two claims: one for EHC and one for BC. PMR systems will restrict the choice of medicines to those that are approved for each of the services. It is vital that pharmacy teams claim for each service under the correct UCF module to support accurate payments.
Pharmacy teams may notice changes to their PMR system being made prior to 1 November 2024 but until that date they should continue to claim in the usual way.
Claims should only be made where a consultation has been undertaken as part of the NHS Community Pharmacy Public Health Service and not where a person is purchasing EHC or BC as part of a private or online pharmacy service.
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NHS Circular PCA (P)(2023)26 issued on 4 August 2023, set out the 2023/24 remuneration arrangements for EHC and BC. An updated Circular on remuneration for financial year 2024/25 will be issued in due course.
