Plan B update training 2011.

1. Plan B update training 2011. Ann Gunning & Judith Stonebridge

2. Why Bother? • • England has the highest teenage pregnancy • rate in western Europe • • There were 189,574 abortions in England & • Wales in 2010 • The abortion rate was highest amongst 19 & 20 • year olds • • Improving access to contraception can reduce • rates of unintended pregnancies • • Every £1 spent on contraception saves £11 to • the public purse • • Under 25’s have the highest rates of STI’s • many of whom have no symptoms • Young people want to be offered screening by • health professionals • National drivers

3. Locally based services Accessible, extended opening hours Located in areas of greatest need Approximately 12,000 contacts during 2010/11 2,000 of which were under 18 years old Positivity rates are found to be high amongst those screened in pharmacies Why Pharmacies?

4. Provision of Free oral EHC to eligible women aged 13 years and above Support to access ongoing reliable contraception Opportunistic Chlamydia Screening offered to all 15 – 24 year old females accessing Plan B and opportunistically to men aged 15 – 24 years What?

5. 149 pharmacies are accredited to deliver the scheme Year on year increase in women accessing Plan B via community pharmacies Introduction of PGD for Ella One Refresh of materials and positive media coverage during last 12 months Under 18 conception rate is falling across all 3 areas North of Tyne 367 Chlamydia screens generated by community pharmacies during 2010/11 (Boots Hotspur Way & Nbld St, Co-Op Newbiggin & Morrisons Preston Grange) 13 Pharmacies signed up to LES to undertake Chlamydia treatment Progress

6. Increase rate of referrals to services for ongoing contraception with a particular focus on LARCs Ensure all women are advised of IUD as the most effective method of EC and facilitate access where appropriate Increase uptake of Chlamydia screening in community pharmacies Priorities

7. National programme providing opportunistic Chlamydia screening to 15 – 24 year olds Prevent and control Chlamydia through early detection and treatment of asymptomatic infection Reduce onward transmission to sexual partners Prevent the consequences of untreated infection Chlamydia Screening

8. Free testing urine or swabs (females) Results service (positive and negative) via text, phone etc Free treatment Partner notification and contact tracing Annual screen or after every change of partner National Programme.

9. “Just Ask!” – normalise screening- Information leaflet 15 – 24 year olds male & female Complete lab form (name, date of birth, postcode and contact details) CONFIDENTIAL! Place sticky label on clear urine pot Provide urine specimen (Best not to have passed urine 2 hours previously) Swabs available for females if they prefer. Return in envelope with the completed form. Generating screens

10. Just Ask – normalise Free & confidential Most people don’t know they have it Treatment is free and easy Prompts and materials Whole staff approach Increasing uptake

11. CRB updating Sign posting sheet updated New SLA (Chlamydia screening, pregnancy testing) Missed pills guidance New PGD What’s Changed?

12. Sexual Health Level 1 Incorporates Plan B & Chlamydia screening £1 per screen returned to lab (after first 7 per month) Reimbursement for pregnancy tests from pharmacy stock New SLA

13. Clinical Effectiveness Unit statement – May 2011 Start COC any day of the month but if after day 5 need additional method for 7 days Miss 1 active pill – no additional method Miss 2 or more active pills – additional method for 7 days http://www.fsrh.org/pages/clinical_guidance.asp Missed pill guidance

14. Effectiveness of levonorgesterel reduced by enzyme inducers Effect can last for up to four weeks after stopping First line Cu IUD Second line levonorgesterel 3mg (including up to 120 hours) New PGD

15. 20 year old Upsi 4 days ago LMP 14 days ago How should this woman be managed? Scenario