Gill Bell, Nurse Consultant Sexual health Adviser, Sheffield A Partner Notification Bureau in action: outcomes for centralised management of positive gonorrhoea and chlamydia results form primary care by a sexual health service Gill Bell, Nurse Consultant Sexual health Adviser, Sheffield

Background: how the PN Bureau came about Recommendation of the National Chlamydia Screening Programme (Beyond the National Chlamydia Screening Programme. Clarke et al 2009) Centralised reporting of gonorrhoea positives to SHS introduced in April 2014 to manage a gonorrhoea outbreak among students Centralised reporting of chlamydia positives introduced September 2015 Negotiated by the Sexual Health Lead for Public Health with the Local Medical Council (LMC)

Potential benefits of centralised management Treatment rates free tx option at SHS monitoring / follow-up to verify tx Partner notification outcomes Expert PN support, including provider referral option Follow-up to verify partner attendance Improved cross-referencing of partners

How the PN Bureau works All positive gonorrhoea and chlamydia results from primary care are copied to the Health Adviser team in Sexual Health Sheffield ( SHS) GPs aware (SHS) responsible for giving the result, arranging treatment and managing PN Patient informed will be contacted by SHS if positive result Health Adviser admin support worker contacts GP surgery for patient phone number / address (unless known)

Patient management Health Adviser rings patient to discuss: Diagnosis Treatment options (SHS, or GP if chlamydia) Partner notification ( patient or provider referral) Repeat test of cure / re-infection PN discussed further face to face if attending SHS for treatment

Outcomes for gonorrhoea positives tested in primary care: September 2014 – August 2015 Informed Confirmed treated PN discussed Partners believed attended per case 46 (31 female) 45 (98%) 98%) 37/46 (0.80)

Outcomes for chlamydia positives tested in primary care: September 2014 – August 2015 Informed Confirmed treated PN discussed Partners believed attended per case 457 (352 female) 440 (96%) 448 (98%) 450/457 (0.98)

Key points Centralised management of gonorrhoea and chlamydia results is feasible and effective Treatment rates exceed NCSP standard of 95% PN outcome rates exceed national standard of 0.6 Additional resources required: HA workload increased by 10%

BASHH Statement on Partner Notification (2012) The number of all contacts whose attendance at a sexual health …was documented as reported by the index case, or by a HCW, within four weeks of the date of the first PN discussion. BASHH PN outcome standards: Chlamydia: 0.6 for all areas Gonorrhoea: 0.4 in London; 0.6 outside London

Alternative interpretations of PN: impact on Sheffield outcomes Measure Gonorrhoea Chlamydia Number of all contacts attending before or after the index, reported by the index case, or by a HCW, within four weeks of the date of the first PN discussion. 37/46 0.8 450/457 0.98 Number of all contacts [attending] after the index, reported by the index case, or by a HCW, within four weeks of the date of the first PN discussion. 29/46 0.63 349/457 0.76