Alice Middleditch, counter assistant supervisor at Clare Pharmacy in Suffolk, talks to Saša Janković about running a sexual health service for young people. 

Service type: Sexual health advice for young people, including the Terrence Higgins Trust C-Card scheme and chlamydia testing.  

Name of pharmacy: Clare Pharmacy, Clare, Suffolk. 

Name of counter assistant supervisor: Alice Middleditch. 

Why did you start offering this service? 

I joined the pharmacy five years ago and we started the sexual health service for young people four years ago, once I became counter assistant supervisor. 

We are in quite a rural location with a lot of local schools around us, but there was nothing in our area offering children and young people this kind of service or advice. Our pharmacy is at the heart to the community so we were in the ideal position to do something to help. 

How much did it cost to set up the service? 

Not a great deal really, apart from our time to offer the service. The Terrence Higgins Trust training is free, and we order the condoms through them for free, but we do have to pay to be DBS checked in order to give advice to the under 16s (which costs £26 per person).

What, if any, training did you or other team members have to undergo? 

Everyone in our pharmacy has done the training from the Terrence Higgins Trust to offer the C-Card service. They come in and organise sessions for new members of staff and to keep the rest of us up to date. It’s very informative and helps you understand not only the need but how to discuss topics with young adults.

In a nutshell, what does the service involve? 

The Terrence Higgins Trust C-Card Scheme is a free condom distribution scheme – for anyone aged 13 to 24, no matter if they are having sex, thinking about having sex or are just curious about condoms. We also have a Suffolk County Council service commissioned through pharmacy to supplier chlamydia tests to young adults, and this then can be treated via the pharmacy as well, which dovetails in very nicely.

As we are all trained, anyone in the pharmacy can give them out and talk the young person through things, which involves a discreet and confidential conversation to make sure they are not being pushed into sex, and they are ok and happy with what’s going on. If the young person is under 16 then there are other safeguarding issues we have to bear in mind, and we need to make sure they are not being exploited and or being taken advantage of.  

If it’s a young person using the C-Card service for the first time we also offer them chlamydia testing. This involves them filling in a form and being given a test to take away and do at home, which they send away in the post and get their results back directly. 

The service is very confidential, and anonymous, but everybody who works in our pharmacy is quite young, friendly and chatty so we often find that once we start talking to the young person they open up and ask for other health advice. I also make sure that if I know someone is in a new relationship they repeat the chlamydia test. 

Are there any opportunities to sell OTC or prescription products during or after the consultation? 

Not really contraception wise – although of course if they have symptoms or concerns about other things that come up in conversation then we support and help them with those. 

How have patients responded to the service? 

Sexual health is such an intimate thing that we don’t really get any feedback directly about the service, but we do have a lot of young people coming in who say their friend got their C-Card from us and can they have one too. We have a poster about the service in the window and our other customers often ask us what it’s about, so they may well spread the word for us as well. 

Roughly how often each month do you carry out the service? 

Before Covid we would see about four a five people a week for the C-Card, and in busier times it could be up to 12 or 13 a day. For the chlamydia test it was maybe one or two a week. We do notice that as soon as young people start learning about sexual health at school – from about March time – we get busier, and also through the summer holidays.  

How much do you charge for the service? 

It’s free to the young adult using the service, which helps reduce any barriers to provision.

Roughly how much a month do you make from offering the service? 

Not a great deal, but this kind of service is not about making money, it’s about supporting the young people in our community. The Suffolk County Council Chlamydia service does generate some income to cover the pharmacy staffs’ time.

Would you recommend offering this service to other contractors? 

Yes, definitely. Young children often get lost in the system and it’s such an important thing when you are younger to be looked after and kept an eye on, just in case. Being able to interact like this with young people helps them build trust in your pharmacy and encourages them to talk to us about other concerns they might have. Sometimes we are the only people they open up to about these issues, and especially on mental health too. 

The C-Card scheme operates across Cambridgeshire, Norfolk and Suffolk. Visit the website for more details, or to sign your pharmacy up.

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