ssha conference 2014 elizabeth kershaw senior health adviser, 56 dean street
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Express Sexual H ealth: maintaining quality of care for new HIV diagnoses alongside new technology. SSHA Conference 2014 Elizabeth Kershaw Senior Health Adviser, 56 Dean Street. 56 Dean Street. - PowerPoint PPT PresentationTRANSCRIPT
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Express Sexual Health: maintaining quality of care for new
HIV diagnoses alongside new technology
SSHA Conference 2014Elizabeth Kershaw
Senior Health Adviser, 56 Dean Street
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56 Dean Street
• One of three sexual health clinics run by Chelsea and Westminster NHS Foundation Trust, based in Soho
• Full range of staff and sexual health services
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Dean Street Express
• New walk in clinic for asymptomatic sexual health screening
• Latest technology to process samples and deliver swift results within 6 hours
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Patient attendances Feb. – Sept.
Month Feb. Mar. Apr. May June Jul. Aug. Sept. (20th)
56 Dean St
3948 4259 4039 4358 4419 4792 4129 2980
Dean Street Express
2966 4171 4120 4764 4899 5795 5974 4085
Total 6914 8430 8159 9122 9318 10587 10103 7065
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Attendances Feb – Sept. 201456 Dean Street Dean Street Express
Male 76% 78%
- new patients 13% 33%
Female 24% 22%
- new patients 29% 57%
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Patient flow at DSE
• Up to 330 patients in a 12 hour day• Up to 220 patients on a Saturday 6 hour day• Infinity test cycle 90 minutes• Infinity machine capacity 620 samples per day
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Preliminary results
from test to results From test to
treatment
0123456789
10
Dean St Express
56 Dean St
Dean St Express56 Dean St
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Preliminary patient details
• 72% of men attending are MSM• 94% of women attending are heterosexuals
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Role of health adviser at DSE
• DSE a largely automated service, incl. results management
• Each patient sees staff member for serology • Risk assessment questions as standard• HAs available to provide advice and support to
staff and for patient referrals• HAs manage new HIV diagnoses in the clinic
and through recall after serology
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Managing an HIV reactive result at DSE
• HIV INSTI POCT reactive at DSE• Determine test set running by nurse/HCA• Health Adviser on call via 56DS• HA attends to confirm results, discuss with
patient, take first HIV bloods and provide support and information
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HIV resultsClinic
Jan Feb. Mar. Apr. May June July Aug. Sept YTD
56 DS
34 15 40 18 20 23 27 26
203
DSE
- 15 23 11 34 28 19 22
152
Total 34 30 63 29 54 51 46 48
355
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Follow up
• All patients see health adviser at diagnosis and are offered an HA appointment one week post diagnosis
• All patients offered first medical appointment at 56 DS, usually available within 2/52 post result
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Patient ethnicity in new HIV diagnoses
White
British
White
other
White
total
Indian/P
akist
ani
Chinese
Africa
n
Caribbean
not stat
ed0
20
40
60
80
100
120
140
56 Dean StDean St Express
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Age range in new HIV diagnoses
<20 21-29 30-39 40-49 >500
10
20
30
40
50
60
70
80
56 Dean StreetDean St Express
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Gender of new HIV diagnoses
56 Dean StreetDSE
020406080
100120140160180
female
male45
165
147
femalemale
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Risks and testing history
• 9% of newly diagnoses were testing for the first time
• 23% reported >10 sexual contacts in last 3/12• 68% reported UPAI within last 3/12• 32% reported drug use within last 3/12
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Partners
• Where partners subsequently tested, 33% tested positive
• In cases where there had been unprotected sex in the last 72 hours, 75% of partners started on PEP
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Challenges
• Managing the flow of patients• Language diversity• Patient expectations from express screen• Clinic environment
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Thanks to the 56 Dean St Health Advisers
• Daniel Dennehy• Jen Fearnley• Chris McCormack• Gaynor Lawrenson