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You are here: Home / Resources / SystmOne Resource Centre / SystmOne Specialties / Women’s Health Overview / Gynaecology Resource Overview / Contraception

Contraception

Accessing CDRC resources on SystmOne

To access the below resources you will need to be a member of the DCS group on SystmOne. To do this, please follow the instructions on the CDRC SystmOne Access webpage.

Implants

Reports

There are a series of reports to facilitate payment claims and patient safety. The reports are in the CDRC Quality > Gynaecology folder.

Report NameReturns
Sexual Health – * Implant Claim Check – Inserted after 31.11.17 but not claimable # Patients who have had an implant that would be eligible for payment under the County Durham sexual health contract if done at the surgery – they would need the Subdermal etonogestrel implant insertion ESA code added with the same date as the insertion code. 
Sexual Health – * Implant Safety – Implant Present Code but no implant inserted code Patients with Read codes suggesting they have an implant but no insertion code 
Sexual Health – * Implant Safety – Inserted >3y ago and NOT removed # Patients with a record of implant insertion but not removed after 3 years 
Sexual Health – *£ Implant Claim – Inserted after 31.11.17 (with ESA code) # Claimable implant insertion for County Durham Sexual Health contract 

Contraceptive Implant Template

How to Access:

With the Patient record retrieved, in the lower left hand corner there is a search bar, type in ‘Contraceptive Implant – CDRC’ and select the following template:

Alternatively, press F12 and type in ‘Contraceptive Implant’ in the search bar, this will return the aforementioned template.

Contraceptive Implant Template

The Contraceptive Implant template has 4 pages

  • Old – Default page until all practices are happy with the new page 
  • Durham – Comprehensive implant management page 
  • Done Elsewhere – To record implant procedures done at hospital etc. 
  • All codes – Showing all Read codes relating to implants. 

The default opening page is the old template. 

Machine generated alternative text:
urham Done 
INSERTION TEMPLATE 
nseflion of subcutaneous contraceptive in arm 
nseflion of subcutaneous contraceptive 
nformed consent for procedure 
Please acMse patient on risks of anaesthesia, infection, altered menstruation, scars and need 
for removal at 3 years 
inor surgery information leaflet given 
heck postion of implant 
perations and procedures 
REMOVAL TEMPLATE 
Informed consent for procedure 
r 
Ste of insertion (XgOI e) 
r Right (7Na31) 
r Left (7N832) 
New Acute 
Please acMse patient on risks of anaesthesia, infection, scars and immediate risk of 
conception after removal 
Removal of subcutaneous contraceptive 
perations and procedures

Practices that have requested the new template – including all practices in County Durham will go to the new template. 

The elements of the template are 

  • A link to a PIL 
  • A link to the UK Medical Eligibility Criteria and a summary of the commoner criteria on the template 
  • A link to the FFPRHC guidance 
  • A Nexplanon counselling checklist 
  • A Nexplanon fitting checklist 
  • A Nexplanon removal checklist 
  • A New Scheduled Task button for recall purposes (depending on your practice’s procedures) 
  • A link to a page to record implant procedures carried out elsewhere 

The right-hand panel shows previous relevant Read codes and the most recently completed checklists. 

Durham 
Implant 
PIL Nexplanon 
UKMEC Commoner criteria 3 and 4 shown below 
nexplained vaginal bleeding 
'O stroke 
'o ischaemic heart disease 
reast cancer (current) 
reast cancer ago 
irrhosis (decompensated) 
epatocellular adenoma or malignant liver 
umours 
F F pRHc Guidance 
Nexplanon Counselling 
Nexplanon InseNionFepIacement 
Implant Removal 
Implant Insened/Removed Elsewhere 
13 Dec 2017 
Insertion of subcutaneous contraceptive in arm (Xa850 
2 Initiation 
3 Continuation 
2 Initiation 
3 Continuation 
Nexplanon Counselling 
13 Feb 2018 111m 
Entered by 
FORBES: Gareth (Dr) (General Medical Practitioner) 
Nexplanon Counselling 
Does the patient have a Yes 
Pre-fitting checklist 
Issues discussed 
No unexplained vaginal bleeding 
Not currently pregnant 
Not on regular enzyme inducing drugs 
Failure rate 1/3000tyear 
Scar

The checklists guide the user through the relevant procedure and ensure the correct Read codes are entered 

Nexplanon Insertion 
3 
10 
11 
Is this 
Initial insertion 
Replacement 
Does the patient ha ea 
v PIL 
Yes 
Pre-fitting checklist 
r 
No unexplained vaginal bleeding 
Not currently pregnant 
r 
Not on regular enzyme inducing drugs 
Issues discussed 
r 
Failure rate 1/3000tyear 
r Scar 
Must be removed after 3 years 
r Method of action - inhibits ovulation, thickens cervical mucus and inhibits implantation 
Risk of acne: fluid retention and breast tenderness 
Weight gain 
Risk of itching or bruising at site of insertion 
r Possible changes to menses (amenorrhoea: oligomenorrhoea: frequent/prolonged bleeding) 
Insertion error 
Procedure notes 
Confirm Nexplanon insertion 
Yes 
Implant palpable 
Yes 
Due date for removal/replacement 
Counselling given - patient should return if 
Cannot feel the implant or it has changed shape 
They become pregnant

ENSURE THE SAVE FINAL VERSION OPTION IS CHOSEN WHEN CLOSING THE QUESTIONNAIRE 

The Read codes added by the questionnaire are designed specifically for the County Durham sexual health service but could be customised for other areas 

 Implant insertion Implant replacement Implant removal 
Codes added Insertion of etonorgestrel implant Subdermal etonogestrel implant insertion ESA Insertion of etonorgestrel implant Removal of etonorgestrel implant Subdermal etonogestrel implant insertion ESA Removal of etonorgestrel implant Subdermal etonogestrel implant insertion ESA 

IUCD

Reports

There are a series of reports to facilitate payment claims and patient safety. These reports are in CDRC Quality>Gynaecology 

Report NameReturns
Sexual Health – * IUCD Safety – IUCD Present Code but no IUCD inserted code Patients who have evidence of an IUCD but no code for IUCD inserted 
Sexual Health – * IUD Claim Check -Inserted after 30.11.17 but not claimable # For Durham Sexual Contract to identify patients who might have had an IUD at the surgery. Add the XaK9z code with the same date as the procedure to make a claim. 
Sexual Health – * Mirena Claim Check  – Coil Check after 31.12.17 but not claimable # For North Durham Gynae contract. Patients who have had a mirena coil check but which is not currently claimable.  Claimable if Done at the surgery The coil is principally for menorrhagia Add the codes XaK9z and K5920 with the same date as the coil check to make a claim 
Sexual Health – * Mirena Claim Check  – Inserted after 30.11.17 but not claimable # For North Durham Gynae or Durham Sexual Health contracts. Patients who have had a mirena coil inserted but which is not currently claimable.  Claimable if Done at the surgery The coil is principally for menorrhagia or contraception Add the codes  XaK9z AND K5920 (menorrhagia) OR XaDbF (intrauterine contraception)  with the same date as the coil insertion to make a claim 
Sexual Health – * Mirena Claim Check  – Removed after 31.12.17 but not claimable # For North Durham Gynae contract. Patients who have had a mirena coil removal but which is not currently claimable.  Claimable if Done at the surgery The coil was principally for menorrhagia Add the codes XaK9z and K5920 with the same date as the coil removal to make a claim 
Sexual Health – * Mirena Safety – Inserted and NOT removed within 5-7y # Patients with a Mirena insertion but no removal within 5-7 years (depending on age) 
Sexual Health – *£ Implant Claim – Inserted after 31.11.17 (with ESA code) # Durham Sexual Health Contract – claim for implant insertion 
Sexual Health – *£ IUD Claim – Inserted after 30.11.17 (with ESA code) # Durham Sexual Health Contract – claim for IUD insertion 
Sexual Health – *£ Mirena Claim NDCCG – Inserted after 31.12.17 with ESA for Menorrhagia # North Durham Gynae contract – claim for Mirena insertion 
Sexual Health – *£ Mirena Claim NDCCG – Mirena Check/Removal after 31.12.17 with ESA for Menorrhagia # North Durham Gynae contract – claim for Mirena check/removal 
Sexual Health – *£ Mirena Claim PH – Inserted after 31.11.17 with ESA for Menorrhagia # Durham Sexual Health Contract – claim for IUS insertion 
IUCD Template

How To Access

With the Patient record retrieved, in the lower left hand corner there is a search bar, type in ‘IUCD’ and select the following template:

Alternatively, press F12 and type in ‘IUCD – CDRC’ in the search bar, this will return the aforementioned template.

IUCD Template

The IUCD Template has 4 pages:

  • Old – Default page until all practices are happy with the new page 
  • Durham – A comprehensive IUCD management page 
  • Done Elsewhere – To record IUCD procedures done at hospital etc. 
  • All codes – Showing all Read codes relating to IUCDs. 

The default opening page is the old template. 

IUCD 
Other Details 
r•---T7F 
16G0 q 
x 
Changing the consultation date will affect all other data enterel To avoid this: 
Intra-uterine contraceptive device ftting - enh serv admin 
Please tick each time a coil is fitted in the practice and for a 12 month annual check. 
Reason for Mirena 
Endocervlcal chlamydia swab 
Irena 
her Coil 
Intrauterine contraception (XaDbF) 
r 
Menorrhagia (KSg20) 
Introduction of Mirena coil (XaSSw) 
r Removal of Mirena coil (XaJIK) 
Introduction of intrauterine contraceptive device (78 
r Removal of intrauterine contrace ive device XaC3 
please state where MIRENA coil was fitted 
place of procedure 
Intrauterine contraceptive device 6 week check 
12 month coil checkn(tick both) 
IUD checked - problems 
Advice about treatment given 
IUD change due 
Please tick if coil was fitted in surgery or hospital 
New acute of: Levonorgestrel 20microgramsQ4hours 
New acute of: Nova-T 380 intrauterine contraceptive cc 
New ILICD Annual Review

Practices that have requested the new template – including all practices in County Durham – will go to the new template. 

The elements of the template are 

  • A link to a PIL 
  • A link to the UK Medical Eligibility Criteria and a summary of the commoner criteria on the template 
  • A link to the FFPRHC guidance 
  • An IUS/IUD counselling checklist 
  • An IUS/IUD fitting checklist 
  • An IUS/IUD check appointment checklist 
  • An IUS/IUD removal checklist 
  • A New Scheduled Task button for recall purposes (depending on your practice’s procedures) 
  • A link to a page to record IUCD procedures carried out elsewhere 

The right hand panel shows previous relevant Read codes and the most recently completed checklists. 

Durham 
ne Elswehe 
IUCD 
CD 
PIC IUD 
Cod 
UKMEC 
Some ofthe commoner eligibility criteria shown below 
nexplained vaginal bleeding 
4 weeks post-partum 
urrent 
10 IHD 
'O stroke 
ong QT syndrome 
urrent cervical cancer 
reast cancer within 5 years 
reast cancer ago 
ndometrial cancer 
istoned uterine cavity 
elvic infections (see link 
bove for details) 
irrhosis (decompensated) 
enign and malignant liver 
umours 
F F pRHc Guidance 
ILIS/IJD Counselling 
ILIS/IJD Fitting or Replacement 
IUsnUD Check 
IUsnUD Removal 
New Scheduled Task 
Cu-IUO 
4 Initiation 
2 Continuation 
3 Initiation 
1 Continuation 
4 Initation 
2 Continuation 
4 Initiation 
2 Continuation 
3-4 Initiation 
2 Continuation 
LNG-IUD 
4 Initiation 
2 Continuation 
2 Initiation 
3 Continuation 
2 Initiation 
3 Continuation 
3 Initiation 
Continuation 
4 Initation 
2 Continuation 
4 Initiation 
2 Continuation 
3-4 Initiation 
2 Continuation 
Mirena 01 Dec 2010 
- 24 1 
ntroduction of Mirena coil CXaBSw) 
IIJS/IUD Fitting or Replacement 
13 Feb 2018 
Entered by 
FORBES: Gareth (Dr) (General Medical Practitioner) 
IUSAUD Fitting or Replacement 
Pre-fitting checklist 
Which device is being 
fitted? 
What is the prinicple 
indication for the IIJCD? 
Is this a replacement 
IUD? 
Which device is being 
removed? 
Issues discussed (US) 
No delivery within 4w 
No symptoms of STI 
Risk of recent STI discussed 
No unexplained bleeding 
Contraception 
Yes 
Mode of action - then endometrium and 
prevents implantation 
Failure rate %tyear 
Duration of use- 5 years 
Small risk of pelvic infection in first 20d 
after insertion 
Ectopic pregnancy- overall risk 
reduced 
Rapid return to fertility when removed 
Risk of expulsion 1/20: mainly first 3 
months 
Expulsion of intrauterine contraceptive device

The checklists guide the user through the relevant procedure and ensure the correct Read codes are entered 

IIJS/IUD Fitting or Replacement 
4 
Pre-fitting checklist 
r 
No delivery within 4w 
No symptoms of STI 
Risk of recent STI discussed 
r 
No unexplained bleeding 
Describe the patient's menses 
Describe any important gynaecological history fibroids 
Which device is being fitted? 
What is the prinicple indication forthe IIJCD? 
Contraception 
Menorrhagia 
Hormonal component of HRT 
Is this a replacement IUD? 
Yes 
Issues discussed (US) 
r Mode of action - then endometrium and prevents implantation 
r 
Failure rate %tyear 
r 
Duration of use- 5 years 
r 
Small risk of pelvic infection in first 20d after insertion 
Ectopic pregnancy overall risk reduced 
r 
Rapid return to fertility when removed 
Risk of expulsion 1/20, mainly first 3 months 
r 
Perforation <1/1 000 
Menstrual changes common - especially in the first 3-6 months 
r Overall blood loss may be reduced by up to 
r 
Hormonal symptoms - no greater than IUD users on average 
r Confirm Mirena counselling complete 
Procedure notes

ENSURE THE SAVE FINAL VERSION OPTION IS CHOSEN WHEN CLOSING THE QUESTIONNAIRE 

The Read codes added by the questionnaire are designed specifically for the County Durham sexual health service but could be customised for other areas 

 IUCD insertion for contraception IUCD insertion for menorrhagia IUCD removal (contraception) IUCD removal (menorrhagia) 
Mirena insertion /removal Introduction of Mirena coil Intrauterine contraceptive device fitting ESA Intrauterine contraception (Removal of Mirena/IUCD code added if replacement) Introduction of Mirena coil Intrauterine contraceptive device fitting ESA Menorrhagia (Removal of Mirena/IUCD code added if replacement) Removal of Mirena coil Intrauterine contraceptive device fitting ESA Intrauterine contraception Removal of Mirena coil Intrauterine contraceptive device fitting ESA Menorrhagia 
IUD Insertion /removal Introduction of intrauterine contraceptive device Intrauterine contraceptive device fitting ESA Intrauterine contraception (Removal of Mirena/IUCD code added if replacement) Introduction of intrauterine contraceptive device Intrauterine contraceptive device fitting ESA Menorrhagia (Removal of Mirena/IUCD code added if replacement) Removal of intrauterine contraceptive device Intrauterine contraceptive device fitting ESA Intrauterine contraception Removal of intrauterine contraceptive device Intrauterine contraceptive device fitting ESA Menorrhagia 
 6 week check (contraception) 6 week check (menorrhagia) Other check (contraception) Other check (menorrhagia) 
Mirena coil check Mirena coil check Intrauterine contraceptive device 6 week check Intrauterine contraceptive device fitting ESA Intrauterine contraception Mirena coil check Intrauterine contraceptive device 6 week check Intrauterine contraceptive device fitting ESA Menorrhagia Mirena coil check Intrauterine contraceptive device fitting ESA Intrauterine contraception Mirena coil check Intrauterine contraceptive device fitting ESA Menorrhagia  
IUD check Intrauterine contraceptive device 6 week check Intrauterine contraceptive device fitting ESA Intrauterine contraception Intrauterine contraceptive device 6 week check Intrauterine contraceptive device fitting ESA Menorrhagia IUD check Intrauterine contraceptive device fitting ESA Intrauterine contraception IUD check Intrauterine contraceptive device fitting ESA Menorrhagia 

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