1. 1 Pathfinder Chlamydia Screening Pilot Presented by Rebecca Adeojo on behalf of : Danielle Mercey (1) Tina Sharp (2) Jill Martin (3) Julie Hamner (4) 1) UCL 2) Camden PCT 3) DoH 4) Boots Boots is providing chlamydia screening and treatment on behalf of the NHS

2. 2 Methods – Testing and treatment – Training programme – Marketing – Contract monitoring Results to date Summary Overview

3. 3 Background DH tender to provide chlamydia screening to young people in rural and urban community pharmacies. Boots the Chemist awarded contract for London. Complementary to National Chlamydia Screening Project.

4. 4 To test and evaluate the effectiveness of high street community pharmacies as an access point for screening and treatment for genital chlamydia infection Objective

5. 5 Available in 215 Boots stores within 31 London PCTs, from 14 th November 2005 Two year pathfinder project Methods

6. 6 Chlamydia Screening Service Boots are providing free Chlamydia screening to 16 - 24 year olds in all stores in the London area. Client collects test kit & information booklet from Pharmacy counter Client returns with a urine sample Sample tested at laboratory using PCR (Roche) Client receives test result within 3 business days

7. 7 Test Kit Test kit contains:  Urine sample pot  Instructions  ‘Self-complete’ request form (same data as National Chlamydia Screening Programme)

8. 8 Boots notify all negative clients, and those that require a retest Clients can be notified of results via text, letter or phone Pathfinder CSO (Camden Chlamydia Screening Office) notify all positive clients Result Notification

9. 9 Treatment Treatment can be given by Boots stores Azithromycin first line Doxycycline second line Patient Group Directions (to be hosted by Camden PCT).

10. 10 Chlamydia Positive Results Positive results received from Boots daily CSO contacts client by requested method: phone, text or letter Explain result, initiate PN, triage for treatment If within PGD criteria, offered option of free treatment at any Boots in London or GU Clinics If does not meet PGD criteria, Explore options: GU clinics, general practice …. Arrange appt & referral letter with outcome form.

11. 11 Partner Notification Partners aged 16+ years can go to Boots for free treatment if within PGD criteria (no upper age limit) Partners not meeting PGD criteria will be assisted to access NHS GU Services As partner not screened, CSO will contact partner before and/or after treatment to ask about other sexual contacts in previous six months. Their partners will be encouraged to screen.

12. 12 CSO Monitors if client and partners have received: Treatment (& where) Initiate PN discussion Follow-up compliance PN resolution Option of further STI screen Sexual health education Ongoing Management in CSO

13. 13 Training

14. 14 Training PHARMACIST TRAINING Coordinated training programme Medical Director, Pharmacy Superintendent, Legal Advisor Distance learning pack and workshop attendance Competency assessment (Q & As and case study) Senior area pharmacist sign off STAFF TRAINING Pharmacy staff Store staff Non participating stores

15. 15 Marketing

16. 16 Increase awareness of service – Posters, flyers, hanging cards, window displays Remove barriers to testing – Vouchers Information – Information leaflet Marketing Materials

17. 17 Hanging Card

18. 18 Contract Monitoring

19. 19 Key features include Weekly activity data Key performance indicators Incident reporting Independent evaluation Financial penalties Contract Monitoring

20. 20 Contract Advisory Board – Quarterly: Key stakeholders and evaluation team Joint Service Reviews – Monthly: Boots, DH and Lead PCT Contract Management Structure

21. 21 DH Leads (Sexual Health Policy and Commercial Directorate) Provider Lead Boots Project Manager Pathfinder CSO London wide SHA Sexual Health Lead Clinical Advisors - GUM, Microbiology, Family planning, Pharmacy Camden Clinical Governance Lead Evaluation Lead Contract Advisory Board

22. 22 Contract Advisory Board Role Representing the views of clinical groups in services the PCSPf contract affects Identifying issues arising from service design and implementation, which may impact on associated services Review activity and KPI information and advising on ways of maximising service impact Undertake risk assessment on clinical governance and advising on maximising safe clinical governance and minimising clinical risk Advise on membership of panels for Joint Service Investigations Consider interim results of the independent evaluation

23. 23 Joint Service Review Performance monitoring Activity Key Performance Indicators Incidents and complaints Investigations Rectification plans Sanctions Changes

24. 24 Clinical Governance PGD to be hosted by Camden PCT Governance of treatment services to be undertaken by Camden PCT

25. 25 Results

26. 26 Tests performed November 2005 to May 2006 17,763 kits issued 7,362 samples returned (41%) 646 positive samples (9%)

27. 27 Client Treatment Sites

28. 28 Number of Clients seen in GUM clinics 31% of positive clients treated in GUM clinics

29. 29 Partner outcomes For 413 clients, 239 partners have been confirmed as treated (0.58 contacts per case)

30. 30 Seems acceptable Good follow up and PN rates Await independent evaluation Summary