Partner Notification and Primary Care

1. Partner Notification and Primary Care Chris Harbut & Sam King Community Sexual Health Advisers Sandyford Glasgow

3. STI Shared Care Initiative Launched November 2002

4. Aim… For the Community Sexual Health Adviser to provide on-going: • Support • Advice • Education regarding the management of chlamydia and other STIs for GP Practices in Greater Glasgow

5. Background • Written proposal • Health Board approval and funding • Local Medical Council approval • GP Sexual Health subcommittee approval

6. Preparation • Involvement of local labs • Dedicated helpline • Launch event 1st November 2002 • Meetings with LHCC managers • Database of GP Practices • Launch pack • Mail shot to all GP Practices

7. Community Health Care and Partnerships • West • North • East • South West • South East • West Dunbartonshire • East Dunbartonshire • East Renfrewshire • South Lanarkshire • Renfrewshire • Inverclyde Approx. 328 Practices

8. Positive Results Chlamydia & other STIs. Recall & Management. Public Health/Partner Notification. Blood Borne Viruses Other topics as identified by Practice Support Helpline TOP Services The Detail...... Community Sexual Health Adviser Training Admin / Audit

9. Uncomplicated Partner Notification • Follows a protocol • Concentrates on current partner(s) • Purpose designed PN Sheet • Training, support and audit by SHAs

10. Feedback from GP Practices • Time consuming, adding to workload • Moving to paperless systems, extra paperwork unwelcome • Infrequency of use leading to lack of familiarity with their use • Not used by everyone within the practice(e.g.when someone leaves it is discontinued)

11. What we did next • In September 2007 an informal pilot of a system to capture P/N outcome data was introduced • Database altered allowing us to document sexual contacts and outcomes • Same coding system as used by the Sexual Health Advisers at Sandyford • Audit period September 2007-August 2008

12. Centralised Documentation of PN • Information from 2 sources • From GP Practice Staff at results discussion • Patient attendance at Sandyford • Entered onto Shared Care Database

13. Results • 1903 positive results • PN documented in 401 cases (21%)

14. Shared Care PN Outcomes Sept 07 – Aug 08 Sandyford PN Outcomes April – June 08 Quality Improvement Scotland Standard for Chlamydia P/N: 64% of all index patients should have at least 1 contact verified as tested/treated

15. Problems • CSHA not always aware of partners attendance at Sandyford • We aren't checking up on GPs • Some practices requested no calls(self managed – 20/328) • Not always being told what we need to know • Not documented well in notes • Other priorities for staff

16. The Way Forward • Encourage better documentation in notes re contacts • Encourage Practice Nurses and GPs to ask for contact details • Name • Dob • Age • Relationship • Last sexual intercourse • Suggest follow up 2-4 weeks in compliance with Sign Guideline 109(Scottish Inter Collegiate Guidelines Network)

17. Thank you