Agenda item

In accordance with Minute No. 224 of 17^th July, 2013, John Radford, Director of Public Health, submitted a further report on the progress to-date on the development of care pathways and safeguarding reporting mechanisms for all young people accessing Sexual Health Services in Rotherham.

Care pathways would be developed to allow for the extension of the Emergency Hormonal Contraception (EHC) service in Pharmacies to young women aged 14 to 16 which would include an automatic referral for all under 16 year olds to a named team within Integrated Youth Support Service (IYSS).  Public Health would work with both IYSS and Pharmacy representatives to agree the necessary protocols and pathways prior to the extension being agreed.

An electronic recording system, similar to that already in use for supervised consumption of drugs at Pharmacies, was to be introduced which would immediately alert any Pharmacist to the pathway that would allow for accurate monitoring.

Protocols in relation to under 16 year olds attending the Genito-Urinary Medicine (GUM) and Contraceptive and Sexual Health (CaSH) already included screening for sexual exploitation but they would be developed to raise the profile of CSE to enhance the capture of concerns in relation to possible sexual exploitation and contain appropriate referral mechanisms.  GUM and CaSH were moving to an integrated service where the protocols and referral criteria would be harmonised and work was taking place on protocols and an algorithm for referral to the newly appointed Sexual Exploitation Nurse.

Discussion ensued with the following issues raised:-

-          Historical evidence showed that it was a very low number of females seeking emergency contraception but there was a need for an easily accessible route

-          The young female would be automatically referred to the IYSS - what happened if they chose not to attend?

-          Would an “automatic” referral deter a young person from seeking emergency contraception for fear of it being brought to their parents’ attention and result in a rise of teenage pregnancies?

-          GPs would be far more challenging than a pharmacist - pharmacists would need support and training and a clear audit trail

-          GPs had a duty of care – fear that the protocol gave duty of care to the organisation and not the individual

-          Investigation of a number of Serious Case Reviews had revealed numerous referrals to GPs/health sector that had not raised alerts

-          If there was no automatic referrals, strong reassurance was required of the process to be followed

-          Proposed drop-in service offered at many pharmacies

-          The pharmacist would inform the young person that they would be referred to the IYSS and that there may be some form of follow up

-          The sub-group that had been set up to consider a protocol had included a pharmacist.  The young person would be encouraged to see their GP as part of safeguarding advice advised that emergency contraception was only a temporary solution

-          It had to be a referral even on the first occasion – how could you be certain that the young person had not attended a pharmacy somewhere else in the County before

Resolved:-  That further work take place on the protocol and submitted to a future meeting.