1. Tudor Centre Services Partner Notification Health Advisor Service Dawn Hall Senior Health Advisor October 2010

2. Tudor Centre Services Tudor Centre is located at Hillingdon Hospital behind the Maternity Building. Telephone No 01895 279537. Walk-in clinics every day. Asymptomatic patients wanting a check-up can have an appointment with a nurse.

3. Tudor Centre Opening Times Monday (walk-in)8.30am-11.00am Monday (Young@Tudor YAT for Under 18’s)3.00pm–5.30pm Monday contraceptive clinic for under 25’s3.30pm–5.30pm Tuesday (walk-in)8.30am-11.00am 1.45pm-4.00pm Wednesday (walk-in)8.30am-10.30am 1.45pm-4.00pm Thursday (walk-in)1.45pm-6.00pm Friday (walk-in)8.30am-10.30pm Closed at Weekends

4. Available Services Screening and treatment for sexually transmitted infections HIV testing and counselling (same day results by appointment) Referral for termination Emergency contraception

5. Available Services Contraceptive clinic (CASH) – free contraception, implants, injections and patches Hepatitis C screening Hepatitis B testing and vaccination Information and advice on sexual health Cervical smears, if indicated

6. Available Services Support and referral following sexual assault (male and female) Female doctor – by prior arrangement if possible. Sexual dysfunction services – under review Treatment and care for people with HIV infection Psychology services Specialist Dietician

7. Definition of partner notification “A public health activity that aims to control infection by identifying key individuals and sexual networks, warn the unsuspecting and attempt to break the chain of infection” John Potterat 1997

9. Rationale for PN Break the chain of transmission Prevent re-infection of the index patient Prevent complications of untreated infection Duty to inform

10. Partner notification methods Patient referral (contact slips) Provider referral

11. Securing co-operation with PN Non-judgemental and supportive approach Emphasise patient choice / control Confidentiality Patient risk of re-infection Partner at risk from untreated infection Risk of transmission to others

12. Identifying partners at risk Look-back periods Thorough and explicit sexual history Condom use may not protect Memory prompts may help recall Document details to track progress

13. Contact slips Provide anonymity and confidentiality for the index patient Enable sexual contacts to seek medical advice or treatment Inform the contacts clinic of index patients diagnosis, reference number and date of diagnosis Enable cross-referencing and evaluation of partner notification action

14. Provider referral methods Tracing partners from incomplete data Contact methods – telephone, letter, text message etc Encouraging attendance

15. PN resolution Follow-up for each partner identified Re-interview patient if partners not attended Audit outcomes against national standard (0.5 – 0.6 contacts verified screened per case)

16. PN in primary care Advise patients with an STI that partner(s) will need testing / treating Consider local care and referral pathways for management of patient with STI to include PN arrangements

17. Management options for STIs dia Refer patient to GUM for all management Treat and refer to GUM for TOC / PN Treat and refer to GUM / Community Health Advisor for PN only (HA to telephone patient, no trip to GUM needed) Treat, interview patient re partners, pass details to HA if provider referral requested Manage all aspects of PN in-house, including provider referral and follow-up

18. HIV testing and management We provide same day HIV TESTING. This involves pre-test HIV discussion and risk assessment. Methods of giving HIV results, including face-to-face counselling for the HIV positive patient and significant others

19. Working with specific patient groups African people Young people under 16 years Gay men Lesbians Interpreters Sexual assault Worried well Pregnancy options

20. Reasons to contact Health Advisor A patient has been diagnosed with a positive infection, A HIV test is needed ie chlamydia, adherence to treatment and partner notification is required Four reasons to contact A Health Advisor A young person under 16 isDiagnosed + whilst in hospital Sexually active and needs with an STI advice

21. Contact Please contact Dawn Hall Senior Health Advisor Tudor Centre Extension 3236