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

STI Shared Care Initiative Launched November 2002

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

Background  Written proposal  Health Board approval and funding  Local Medical Council approval  GP Sexual Health subcommittee approval

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

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

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

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

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)

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

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

Results  1903 positive results  PN documented in 401 cases (21%)

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

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

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)

Thank you