Effectively Managing a Nurse-Led Chlamydia Screening Programme in England

1. Effectively Managing a Nurse-Led Chlamydia Screening Programme in England Sara Lavelle Chlamydia Screening Programme Lead Liverpool, South Sefton and Knowsley Chlamydia Screening Programme, UK

2. Objectives • To demonstrate the model used for the management of a chlamydia screening programme • To illustrate the results achieved within the first 18 months of screening

3. Background • National Chlamydia Screening Programme • Screening commenced in Liverpool in June 2004 • Currently 77 sites offering screening • Screening sites include Contraceptive Services, GPs, Walk-in Centres, Prisons, Pharmacies and Abortion Services

4. Screening • Opportunistic screening of men and women aged under 25 years • Choice to accept concomitant screening for Gonorrhoea • Use of Transcription Mediated Amplification (TMA) • Choice of urine, endocervical and vulvovaginal swabs

5. Screening Test Results • Results received into central Chlamydia Screening Office (CSO) • Nurse-led with steering group and senior clinician support as required • Clients contacted with results by letter, telephone or text message

6. Treatment • Treatment available at a range of sites across screening area • Clients and partners seen by appointment • Treatment issued by nurses trained to use Patient Group Directions (PGDs) and to instigate partner notification as per national guidelines

7. Non-responders • Clients who do not respond to recalls for treatment are managed by Screening Programme Lead • Home visits to untreated clients are undertaken as necessary • Clear lines of communication with screening sites

8. Results • Between June 2004 and December 2005 16052 (14474 women and 1578 men) clients were screened opportunistically • 15050 (94%) also accepted concomitant screening for gonorrhoea • Overall prevalence was 12% for chlamydia and 1% for gonorrhoea

9. Treatment • 1727 women and 205 men were found to be positive for chlamydia • 152 women and 21 men were found to be positive for gonorrhoea • Treatment completion rates were 98% for chlamydia and 93% for gonorrhoea

10. Partner Notification • Partners notified via client or provider referral • 54% of partners who were identified as being contactable were contacted • 60% of those partners who were contacted were treated • National standards set by Society of Sexual Health Advisors (SSHA) are 50%

11. Conclusions (1) • Opportunistic screening for chlamydia and gonorrhoea is acceptable to clients • Opportunistic screening in community setting is an effective way of screening for chlamydia and gonorrhoea

12. Conclusions (2) • Flexibility in treatment provision promotes good treatment completion rates • Nurses can be trained to issue prescription only medication via PGD • Nurses are effective in instigating partner notification in community settings as per national guidelines