PN guidelines update SSHA 2012 Justine Mellor Heather

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 • Email – Trust Information Governance policies vary – Illegal to read others’ emails – 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: (40 + 40) / 100 = 0. 8 • Verified: 40 / 100 = 0. 4

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