Cheltenham Pharmacy
STANDARD OPERATING PROCEDURE
Enhanced Services – Emergency Hormonal Contraceptive supply under the
PGD
Patient requests EHC (must be patient herself not representative, or in exceptional circumstances
a telephone consultation)
Patient must be referred to the pharmacist in sensitive manner without judgement
The pharmacist must be accredited to give EHC by Sexual Health Services as per PGD
(any personnel changes need to be notified to NHSE – contracts team)
Yes
No
Patient must be referred to another
source of EHC- check Sexhelpglos
website or Gloucestershire LPC
website. Call to see if service is
available there. Check who is
nearest provider.
ALWAYS discuss IUD as an alternative or additional method of contraception for increased
efficiency.
Signpost the patient accordingly. Use the referral form. Phone Hope House if patient consents and
book an appointment. Patient should have EHC anyway before IUD (incase IUD not fitted).
Proforma must be completed to assess patient’s suitability for EHC in private consultation area
Obtain patient consent and state confidentiality statement
Refer patient to GP, Hope
House, out- of- hours: Can
have ellaOne or IUD for up to
5 days after UPSI (or 5 days
after expected ovulation).
Contact person we are going
to refer to on patient behalf to
arrange appointment.
Unprotected sex > 72 hours
No
Date: 01-03-2013
Yes
EHC under PGD
Date of review: March 2014
Cheltenham Pharmacy
STANDARD OPERATING PROCEDURE
Enhanced Services – Emergency Hormonal Contraceptive supply under the
PGD

Previous use?
 More than twice in one month i.e two given in previously in this cycle
Allergies? Side-effects- can give domperidone under PGD for nausea and vomiting
No
Yes
Can treat the presented UPSI if further
advice is not available provided patient
is not pregnant – can perform
pregnancy test.
How old is the patient?
>25
Can give if:
Unable to access a
free EHC service
within critical time
scale,
Cannot afford to
purchase OTC
product
Failure to treat
could result in
unwanted
pregnancy
13-15
16-24
Assess patient's Fraser
competence and
record on pro-forma.
Any concerns
regarding child
protection- Follow child
protection SOP &
GSCB procedures
< 13
Refer patient to doctor, any
worries about child protection
issues should be referred. – see
guidance in child protection
SOP and GSCB procedures.
Complete the EHC Pro-forma
Pregnancy test can be performed if suspected pregnancy – will only show 21 days after UPSI
Check patient’s current medication such as enzyme inducers i.e carbamazepine or St Johns Wort.
Adjust Levonelle dose accordingly or contact Hope house for further advice. Dose in certain
circumstances (enzyme inducers) can be increased to two tablets STAT.
Date: 01-03-2013
EHC under PGD
Date of review: March 2014
Cheltenham Pharmacy
STANDARD OPERATING PROCEDURE
Enhanced Services – Emergency Hormonal Contraceptive supply under the
PGD
Does the patient suffer from diseases which can affect absorption such as Crohns disease?
No
Patient must take Levonelle on-site,
i.e. witness administration.
Yes
Seek specialist advice
from Hope House.
Counsel patient on
Mode of action
Common side-effects
Vomiting/diarrhoea within 2 hours – can give domperidone if patient likely to vomit
Contraception – future use counsel on long term contraception such as implant and IUD etc.
Efficacy
Effects on foetus
Effect on next period
Follow-up – abdominal pains, pregnancy test if period > 7 days late.
Give patient PIL
Subsequent UPSI is not protected.
Advise and give patient leaflets on full STI screen, fpa EC, fpa contraception (fpa COC/ POP)
Advise on appropriate time to visit GP/Clinic (if period hasn’t started).
Offer chlamydia screen in an opt-out rather than opt-in manner. One for partner/s as well.
Re-test after 2- 3 weeks. Offer Toilet facilities available on site.
Offer supply patients with condoms if required. Take from counter and will reimbursed.
Date: 01-03-2013
EHC under PGD
Date of review: March 2014
Cheltenham Pharmacy
STANDARD OPERATING PROCEDURE
Enhanced Services – Emergency Hormonal Contraceptive supply under the
PGD
PREPARED BY:
SIGNATURE:
DATE OF PREPARATION:
DATE EFFECTIVE FROM:
VERSION NUMBER:
1st March 2013
1st March 2013
1
I have signed to say that I have read the procedure and understand its implications.
NAME
Date: 01-03-2013
SIGNATURE
EHC under PGD
DATE
Date of review: March 2014