PN guidelines update SSHA 2012 Justine Mellor, Heather Wilson, Jonathan Roberts, Gill Bell

Background Why update the SSHA PN guidelines? –SSHA Manual 2004 –BASHH PN Statement 2012 –Increasing fragmentation of sexual health services- need for guidance for commissioners and practitioners across a range of providers –Electronic PN resources being piloted –Overview of revised sections

PN consultations Motivational interviewing approach –‘Dancing rather than wrestling’ –Spirit of MI: collaborative, evocative, respectful –Person – centred counselling skills: open questions, reflections, affirmations and summarising –Managing resistance –Eliciting ‘change talk’ or commitment statements –Building confidence and self efficacy –Planning Evocative

MI Traps which may create resistance* Question / answer trap Expert trap Premature focus trap Confrontation / denial trap –If you don’t get your partner in you are just going to keep getting re-infected! –I know, but I’ve told him and now its up to him!

MI approaches to avoid / reduce resistance Simple reflection –You’ve already told him, and don’t see what else you can do. Double sided reflection –You are concerned about getting re-infected, but find it difficult to get your partner to attend Rolling with resistance –You’d prefer not to give any details of your partner. That’s fine. Maybe we can talk again when you have had chance to speak to him / her?

MI approaches to avoid / reduce resistance Re-framing –Whoever gave you my name is just causing trouble! –The person who asked me to contact you thought you had the right to know. Shifting focus –I’m not asking for anyone’s name right now, just wondering if any else could be involved.

Provider referral Aim of all communication methods is to secure a conversation with the contact where possible Telephone PN –Overcoming barrier of suspicion –Private numbers / cold calling –Examples of dialogue Text messaging –Use of IT systems –Sample texts

Provider referral –Trust Information Governance policies vary –Illegal to read others’ s –Good practice guidelines Social networking –NHS restrictions (IG approval essential) –Site restrictions – facebook Dating sites and apps –GMFA

HIV PN NAT seminar: HIV partner notification: a missed opportunity? BASHH Statement on PN

PN audit BASHH 2012 auditable outcomes illustrated 4 PN auditable outcome measures: –PN discussion documented (97%) –Agreed contact action documented (97%) –Attendance reported by index case or by HCW Chlamydia 0.6 Gonorrhoea 0.4 London; 0.6 outside London –Attendance verified by HCW Chlamydia 0.4 Data collection tools –Action and outcome codes

PN audit example Reported attendance by index (40) + attendances verified by HCW (40) Divided by number of index cases (100) Reported: ( ) / 100 = 0.8 Verified: 40 / 100 = 0.4

The future Draft on website by end November 2012 Consultation period until end January 2013