Tudor Centre Services Partner Notification Health Advisor Service

Tudor Centre Services Partner Notification Health Advisor Service Dawn Hall Senior Health Advisor October 2010

Tudor Centre Services • Tudor Centre is located at Hillingdon Hospital behind the Maternity Building. Telephone No 01895 279537. • Walk-in clinics every day. • Asymptomatic patients wanting a check-up can have an appointment with a nurse.

Tudor Centre Opening Times Monday (walk-in) 8. 30 am-11. 00 am Monday (Young@Tudor YAT for Under 18’s) 3. 00 pm– 5. 30 pm Monday contraceptive clinic for under 25’s 3. 30 pm– 5. 30 pm Tuesday (walk-in) 8. 30 am-11. 00 am 1. 45 pm-4. 00 pm Wednesday (walk-in) 8. 30 am-10. 30 am 1. 45 pm-4. 00 pm Thursday (walk-in) 1. 45 pm-6. 00 pm Friday (walk-in) 8. 30 am-10. 30 pm Closed at Weekends

Available Services ü Screening and treatment for sexually transmitted infections ü HIV testing and counselling (same day results by appointment) ü Referral for termination ü Emergency contraception

Available Services ü Contraceptive clinic (CASH) – free contraception, implants, injections and patches ü Hepatitis C screening ü Hepatitis B testing and vaccination ü Information and advice on sexual health ü Cervical smears, if indicated

Available Services ü Support and referral following sexual assault (male and female) ü Female doctor – by prior arrangement if possible. ü Sexual dysfunction services – under review ü Treatment and care for people with HIV infection ü Psychology services ü Specialist Dietician

Definition of partner notification “A public health activity that aims to control infection by identifying key individuals and sexual networks, warn the unsuspecting and attempt to break the chain of infection” John Potterat 1997

Rationale for PN • Break the chain of transmission • Prevent re-infection of the index patient • Prevent complications of untreated infection • Duty to inform

Partner notification methods • Patient referral (contact slips) • Provider referral

Securing co-operation with PN • • • Non-judgemental and supportive approach Emphasise patient choice / control Confidentiality Patient risk of re-infection Partner at risk from untreated infection Risk of transmission to others

Identifying partners at risk • • • Look-back periods Thorough and explicit sexual history Condom use may not protect Memory prompts may help recall Document details to track progress

Contact slips • Provide anonymity and confidentiality for the index patient • Enable sexual contacts to seek medical advice or treatment • Inform the contacts clinic of index patients diagnosis, reference number and date of diagnosis • Enable cross-referencing and evaluation of partner notification action

Provider referral methods • Tracing partners from incomplete data • Contact methods – telephone, letter, text message etc • Encouraging attendance

PN resolution • Follow-up for each partner identified • Re-interview patient if partners not attended • Audit outcomes against national standard (0. 5 – 0. 6 contacts verified screened per case)

PN in primary care • Advise patients with an STI that partner(s) will need testing / treating • Consider local care and referral pathways for management of patient with STI to include PN arrangements

Management options for STIs dia • Refer patient to GUM for all management • Treat and refer to GUM for TOC / PN • Treat and refer to GUM / Community Health Advisor for PN only (HA to telephone patient, no trip to GUM needed) • Treat, interview patient re partners, pass details to HA if provider referral requested • Manage all aspects of PN in-house, including provider referral and follow-up

HIV testing and management • We provide same day HIV TESTING. This involves pre-test HIV discussion and risk assessment. Methods of giving HIV results, including face-to-face counselling for the HIV positive patient and significant others

Working with specific patient groups • • African people Young people under 16 years Gay men Lesbians Interpreters Sexual assault Worried well Pregnancy options

Reasons to contact Health Advisor A patient has been diagnosed with a positive infection, A HIV test is needed ie chlamydia, adherence to treatment and partner notification is required Four reasons to contact A Health Advisor A young person under 16 is Sexually active and needs advice Diagnosed + whilst in hospital with an STI

Contact Please contact Dawn Hall Senior Health Advisor Tudor Centre Extension 3236