SSHA Conference 2014 Elizabeth Kershaw Senior Health Adviser, 56 Dean Street

1. Express Sexual Health: maintaining quality of care for new HIV diagnoses alongside new technology SSHA Conference 2014 Elizabeth Kershaw Senior Health Adviser, 56 Dean Street

2. 56 Dean Street • One of three sexual health clinics run by Chelsea and Westminster NHS Foundation Trust, based in Soho • Full range of staff and sexual health services

3. Dean Street Express • New walk in clinic for asymptomatic sexual health screening • Latest technology to process samples and deliver swift results within 6 hours

5. Patient attendances Feb. – Sept.

6. Attendances Feb – Sept. 2014

7. Patient flow at DSE • Up to 330 patients in a 12 hour day • Up to 220 patients on a Saturday 6 hour day • Infinity test cycle 90 minutes • Infinity machine capacity 620 samples per day

8. Preliminary results

9. Preliminary patient details • 72% of men attending are MSM • 94% of women attending are heterosexuals

10. Role of health adviser at DSE • DSE a largely automated service, incl. results management • Each patient sees staff member for serology • Risk assessment questions as standard • HAs available to provide advice and support to staff and for patient referrals • HAs manage new HIV diagnoses in the clinic and through recall after serology

11. Managing an HIV reactive result at DSE • HIV INSTI POCT reactive at DSE • Determine test set running by nurse/HCA • Health Adviser on call via 56DS • HA attends to confirm results, discuss with patient, take first HIV bloods and provide support and information

12. HIV results

13. Follow up • All patients see health adviser at diagnosis and are offered an HA appointment one week post diagnosis • All patients offered first medical appointment at 56 DS, usually available within 2/52 post result

14. Patient ethnicity in new HIV diagnoses

15. Age range in new HIV diagnoses

16. Gender of new HIV diagnoses

17. Risks and testing history • 9% of newly diagnoses were testing for the first time • 23% reported >10 sexual contacts in last 3/12 • 68% reported UPAI within last 3/12 • 32% reported drug use within last 3/12

18. Partners • Where partners subsequently tested, 33% tested positive • In cases where there had been unprotected sex in the last 72 hours, 75% of partners started on PEP

19. Challenges • Managing the flow of patients • Language diversity • Patient expectations from express screen • Clinic environment

20. Thanks to the 56 Dean St Health Advisers • Daniel Dennehy • Jen Fearnley • Chris McCormack • Gaynor Lawrenson