partner notification standards

(published in ‘The Clinical Management of Genital Chlamydia Infection’. Central Audit Group in Genitourinary medicine. Nov 1997)

These standards have been developed by the Society of Health Advisers in Sexually Transmitted Diseases using the documents ‘SHASTD Partner Notification Guidelines’ ratified at SHASTD's Annual General Meeting in 1995, and 'the Clinical Management of Gonorrhoea' (see Int J. STD AIDS 1996; 7: 301)

What follows is directed at departments of genitourinary medicine (GUM). Practitioners working in other settings should consider the advantage of referring patients to GUM services where these standards are operational. Consideration should also be given to other methods of joint working, such as by sending the department of GUM copies of positive chlamydia results, or employing health advisers to liaise between different services carrying out chlamydia testing.

Standards

I) Each clinic should have an adequate provision of health adviser time.

2) The health advisers should have soundproof rooms for interviewing patients, and sufficient administrative support.

3) All patients diagnosed with chlamydia should have partner notification raised with them when they are informed of their diagnosis.

4) All patients with chlamydia should be referred to a health adviser, or someone acting in that role in liaison with health advisers.

5) Failure or refusal to see a health adviser should be documented. The specific reason for refusal/failure should be noted. Partner notifrcation should then be undertaken by a doctor.

6) A full sexual history of the index patient needs to be obtained, including types of contact and condom use.

The relevant period for partner notification is often difficult to ascertain in chlamydia.

Recommendations are;

7) There should be a clinic protocol for the partner notification work of the health advisers. This will have been negotiated between the health adviser and consultant, and will be understood by all members of the GUM team.

8) Each clinic should have a clinic protocol for:

9) The agreed contact action should be documented for each sexual contact eg whether there is to be index referral, provider referral, contract referral or no referral

10) Partner notification resolution should be followed up and documented at subsequent visits

11) Documentation should be accurate and complete.

12) Verification of contact attendance should be sought where possible.

13) As a minimum standard 70% of index patients should have at least one contact attending.

14) The use of contact slips should be encouraged.

15) Each clinic should have a policy for the management of contact slips eg how the contact slip information is documented or cross referenced in the notes, how the contact slip is attached to the notes, and how it is returned to the health advisers.

16) Health advisers should return contact slips to the issuing clinic within 4 weeks of the contact's attendance.