PRESENTATIONS

The Practitioner Route to the UK Public Health Register – UKPHR

Provider Notification Audit – Implications for Practice – Fiona Johnston (Outreach Nurse), Richard Williams (Lead Health Adviser Western Sussex Hospitals Trust)

Partner notification for chlamydia by postal kit: pilot study results – Gill Bell (Nurse Consultant Sexual Health Adviser)

National Sexual Health Advising Competencies – SSHA NPC

“Here we go again” – Implications for SHA’s when implementing BASHH GC guidelines – Martin Murchie (Senior Sexual Health Adviser)

Ethical Dilemmas in HIV – Wendy Majewska( Senior Health Adviser, St George’s Hospital London)

A&E HIV Testing Pilot at St George’s Hospital – David Cox

Sexual Health Messaging Service – National Online HIV/STI Partner Notification – Dónal Heath (Project Manager, GMFA)

FEEDBACK

Evaluation Feedback – DOWNLOAD

Comments – DOWNLOAD

Sexual Health Advising – Widening the remit 

Brighton University 

Faculty of Health and Social Science

School of Nursing and Midwifery

Week 1 September  12^th – 16^th 2011

Week 2 October 10^th – 14^th 2011

This is a 10 day 20 credit module offered at Level 6

 About the Module 

This module has been designed in response to exciting developments that have raised the profile of sexual health on the political and health care agenda.  This is a vital time for health care professionals to consider and plan the future of sexual health care provision, particularly health advisers, who can respond to the challenges presented by developing and expanding their current role. The module aims to enhance effective and innovative practice.

The Aims of the Module 

• Critically appraise the developing role of the sexual health adviser in order to lead appropriate change in practice

• Explore personal and professional issues that may affect practice and demonstrate enhanced communication and interpersonal skills 

• Critically evaluate a variety of strategies for meeting the sexual health needs of clients

• Critically discuss and debate the changing political and health care context and the implications for sexual health care provision

• Demonstrate evidence-based knowledge of the clinical presentation and management of sexually transmitted infections and blood borne viruses

• Discuss and debate the ethical, legal and professional controversies related to sexual health, reflecting upon the implications for practice

 Assignment

Students will be asked to undertake a 2,500 word written assessment of theory and one 1,000 – word clinical link learning activities.  The assessment weighting is 50% for the written assignment, 50% for the clinical link activities.  Students will be expected to pass both components with a 40% pass mark.

Pre-requisites

Please note that applicants should be currently employed as a health adviser or have worked for at least the last 12 months in a role that involves addressing the sexual health needs of clients.

The cost of the module is £840 (subject to change for academic year 2010/11).  Students can either self fund, be funded by a named sponsor, or if their employing Trust is in partnership with the University of Brighton, the fees will be covered by Person Training Days (PTDs) equivalent.

For an application pack please contact the CPE Admissions Team

Telephone: 01273 644018 (extension)

 N.B Closing date for applications for semester one is 30^th June  2011 but places are limited and will be allocated on a first come first serve basis 

Background
Patients’ psychosocial needs, medical interventions and legal policy may all change in the months and years following an HIV positive diagnosis.  The WeSSI has been developed to set standards in Health Advising by addressing these needs and changes in an ongoing and structured manner.

Content
The WeSSI is a structured interview to be completed with all patients diagnosed HIV positive.  Issues covered include wellbeing, disclosure and confidentiality, occupation, safe sex and criminalisation of transmission of HIV and post exposure prophylaxis for a sexual exposure (PEPSE), partner notification, testing children, and prevention of mother to child transmission.
 

Rationale
Use of the WeSSI can help ensure that patients are well informed; services meet broader responsibilities by raising conventional risk management issues (such as discussing PEPSE, criminalisation and testing children); and information is documented and readily accessible to staff.

Audit and Patient Satisfaction
The WeSSI is designed to be easily audited.  Outcomes are whether patients have received any ‘new information’ or an ‘intervention’ (or ‘action’) as a result of its use.

Patient satisfaction is rated by a questionnaire.

Both the audit tool and the patient satisfaction questionnaire can be found on the Society of Sexual Health Advisers’ (SSHA) website.

Using the WeSSI

Setting
The WeSSI is designed as a health advising consultation and validated for use in Genito-urinary Medicine (GUM).  This is because interventions (for example provider notification, testing children) are best managed from GUM; interventions and incomplete WeSSIs can be followed up at the patient’s next attendance in 3-4 months; regular attendance means the WeSSI can be repeated annually; and patients found the issues raised ‘relevant and acceptable’ in a GUM setting.

A central aspect of the role of the health adviser in GUM is to raise psychosocial and medicolegal aspects of care with patients (for example in pre and post HIV test discussion).  Independent of patients’ medical treatment and care, the specific and boundaried role of the health adviser is well suited to a consultation using the WeSSI.  The WeSSI has also been used by a Clinical Nurse Specialist (CNS) in HIV/AIDS.

Knowledge and skills
As the WeSSI raises potential risk management issues health advisers need to have a high degree of knowledge and expertise in a range of areas ranging from criminalisation, transmission, PEP, and occupational guidance. 

A consultation using the WeSSI means that patients are asked about highly emotive issues including their mental health, disclosure and its effects, concerns about confidentiality, informing partners, and testing children.
 
As the WeSSI suggests rather than prescribes formatted questions it is recommended that staff have both well developed counselling and communication skills, and are trained in motivational interviewing techniques around prevention.

All of the above require staff to receive appropriate supervision.

Staff should identify and address the patient’s own concerns before commencing the consultation with the WeSSI.  This both enables staff to focus on the patient’s needs first and facilitates the discussion of other issues not raised by the WeSSI.

Timescales
Patients’ circumstances may change following their initial interview with the WeSSI; for example they may meet new partners or their untested children may come to the UK.  Therefore it is also recommended that patients are re-interviewed annually.
Each session takes approximately 45 minutes – 1 hour.  It is anticipated that repeat consultations are shorter.

December 2010

DOWNLOAD AUDIT TOOL

Undiagnosed and late diagnosis of HIV remains a concern in the UK and expanding testing will result in earlier diagnosis with benefits for the individual as well as the population. This conference aims to review the evidence in order to inform best practice to address this problem. We believe that this is a very important and urgent issue and that the time is right to discuss what effective action can be taken at a local and national level to help reduce the unnecessary and avoidable morbidity and mortality amongst undiagnosed HIV-positive people. It is believed that the number of undiagnosed HIV-positive people living in the UK can be reduced rapidly by the dissemination of best practice.

The conference intended to bring together relevant groups and stakeholders to understand the extent of the problem, and to present the results from projects funded by the Department of Health to underpin the new BHIVA/BASHH/BIS guidelines on HIV testing. In addition, the conference included poster presentations for review and specific time dedicated to open discussion in order to define best practice across the sectors and make recommendations.

Click here for presentations

There are approximately 500 Sexual Health Advisers employed in the United Kingdom at present (SSHA 2007). They are employed within genitourinary medicine services, in community sexual health advising services and within the national chlamydia screening programme. The majority (421) are nurses; others are from a range of backgrounds.

There has been no nationally recognised programme of preparation for the sexual health adviser role, nor registration and regulation by one professional body; some sexual health advisers remain unregulated.

The Government’s Sexual Health and HIV Strategy (2001) highlighted that Sexual Health Advisers are an important group “who have a pivotal role in partner management, information provision, and liaison between community sexual health provision and GUM services.” The strategy highlighted the need to better define the roles and responsibilities of health advisers, including the development of a health advising qualification. Health Advisers also have a key role in implementation of NICE guidance “One to one interventions to reduce the transmission of sexual transmitted infections (STIs) including HIV, and to reduce the rate of under 18 conceptions, especially among vulnerable and at risk groups.

DOWNLOAD THE FULL BRIEFING DOCUMENT

Photo by www.paulmadden.info

Here are the presentations from this years SSHA conference. A full conference report will be published soon.

Conference Programme

A European Methodological Model of HIV Prevention in Men who have Sex with Men – Ben Tunstall (Senior Practitioner – Terence Higgins Trust)

Partner Notification and Primary Care – Chris Harbut & Sam King (Community Sexual Health Adivser – Sandyford, Glasgow)

Working with Young People with HIV - David Cox (Sexual Health Adviser – Courtyard Clinic, St Georges Hospital, London)

A window of opportunity: psychological work in a women’s prison – Dawn Whittaker (Sexual Health Adviser, Women’s Health Clinic, HMP Holloway)

Provider-initiated HIV testing in primary care - Gavin Bryce (Health Promotion Specialist, NHS Brighton and Hove)

Counselling Within Sexual Health Advising – Ethical Considerations - Ian Boss (Sexual Health Adviser)

DOH Guidelines and HIV infected Health Care Workers - Mike Jones & Dr. Duncan Churchill  Claude Nicol Clinic/Lawson Unit, RSCH Brighton)

But we’ve always been here! Male Same-sex Practice in African Communities - Paul Clift (HIV Representative, Kings College Hospital)

The role of non-professional staff in health adviser/GUM practice – finding the right recipe – Paul Driscoll (Lecturer, University of Suffolk)

Young People, Sex and Alcohol, Can Health Advisers Help With the Hangover? – Richard Betournay (Sexual Health Adviser, West London Centre for Sexual Health)

Goodbye….and thanks for the syphilis! - Robert Palmer (Lead Adviser/Sp.Psych, Guy’s and St. Thomas’ Hospital)

We want you as a new recruit! Sexual Health Awareness in an Army Preparation College - Jonathan Roberts and Jules Davies (Health Advisers, Claude Nicol Centre, Brighton)

Tendering for Sexual Health Services – The Role of the Health Adviser – Richard Williams (Lead Health Adviser – Western Sussex Hospitals NHS Trust)

Who’s transmitting HIV? Is it really the undiagnosed?- Dr. David Pao (Locum Consultant in GUM /HIV Brighton and Sussex University Hospitals)

11.02.03

Ellen Mulholland, Health Adviser
Gum Dept
University Hospital of Hartlepool,
Holdforth Rd.
Hartlepool TS24 9AH
Tel: 01429 522577

If the research work is complete, when was it completed?

January 2003

Summary of research topic:

Previous research has identified perceptions of social stigma as a main barrier to attendance for sexual health screening. Although published research surrounding the psychology of social stigma in relation to common sexually transmitted infections is lacking, a wide body of evidence has accumulated suggesting that only a minority of people hold highly negative views of people suffering from HIV, within which gender differences have been found (eg Yong & Miller 1993).

This is in direct contrast with the felt stigma of those infected (Green 1995). As negative attitudes among the general public towards stigmatised people are important sources of enacted stigma, the current study employed a simple survey design to investigate participants own attitudes towards people with STIs in comparison to their perceptions of others attitudes and to identify any attitudinal differences between genders.

30 (15 male/15 female) members of the general public were invited to complete a two-part likert style attitude questionnaire, adapted to investigate attitudes towards people who have STIs.

A series of t-tests were performed and the results indicate that:

1. A significant difference exists between participants own positive and negative attitudes (t = 8.706; df = 29; p = .000; < 0.05) indicating an overall liberal attitude towards people suffering from STIs
2. A significant difference exists between participants perceptions of the general public’s attitude and their own, with the general public’s attitude perceived as generally more negative (t = 3.238; df 29; p = .0015; < 0.05)
3. No significant differences were found between males and females

Main conclusion:

As the participants essentially form part of the general public, and social stigma is proposed to be a manifestation of social standards (Goffman 1963), these findings appear counterintuitive.

This raises questions regarding why the general public perceive others to hold negative attitudes towards STI sufferers when they themselves don’t, and how has such a viewpoint become stereotypical. Further research is required to investigate this phenomenon.

• A management qualification
• At least four years as a Health Adviser two of which should have been as a Senior

ACCOUNTABLE TO: Clinical Issues to the Consultant in GUM/ HIV
MANAGERIALLY RESPONSIBLE TO: A relevant Senior Manager/ Business, Directorate Manager

JOB SUMMARY

• A principal health adviser will be responsible for one or more teams of health advisers.
• The Principal may work across clinics and may be managing one or more senior health advisers or other personnel.
• To work with the health advisers in developing a health adviser’s strategy, in order to develop the health adviser’s role
• To manage major health adviser’s projects and develop new initiatives within the service.
• To manage, supervise and develop the HA service to ensure provision of:
  Advice, information, education and counselling to patients diagnosed with a sexually transmitted infection such as chlamydia, gonorrhoea, herpes, syphilis and hepatitis B & C.
• To carry out partner notification, to ensure the attendance and treatment of contacts. To provide ongoing support and counselling for those with associated concerns e.g. rape, termination of pregnancy, sexual identity, relationship and psychosexual issues etc.
• To provide pre test HIV discussion and post test discussion and/ or counselling.
• To provide follow up counselling and psychosocial care for HIV antibody positive patients as required.

MAIN RESPONSIBILITIES

1. To work strategically with the health advisers to develop and coordinate their role. To have a prospective plan for the health adviser team, and to develop a five year business plan in conjunction with the relevant manager
2. Plan and implement additional services as necessary.
3. To supervise and develop the health adviser service, to ensure the provision of their key duties which are: partner notification, pre and post test discussion/ counselling, sexual health promotion, counselling and administrative duties i.e. recall of patients.
4. To coordinate and supervise the health advisers/ senior health advisers rota and ensure continuous provision of a health adviser service, including outreach work and education in the community e.g. schools and voluntary organisations
5. To standardise the quality of the health advisers work throughout the service.
6. To initiate coordinate, implement and evaluate health advising policies, protocols through a research and audit programme
7. To coordinate the representation of health advisers, senior health adviser(s) at multidisciplinary team meetings and other relevant meetings
8. To recruit new health advisers/ senior health adviser(s) to the service. To provide an induction, orientation and training programme for new staff.
9. To implement a system of appraisal incorporating individual performance reviews for all health advisers/ senior health adviser(s).
10. To provide regular ongoing management supervision of health advisers/ senior health adviser(s), to promote and encourage their professional development.
11. To coordinate the clinical supervision of the health advisers / senior health adviser(s).
12. To act as a first line managers to health advisers / senior health adviser(s) i.e.-coordinate annual leave, rotas, statistical returns.
13. To monitor and evaluate the workloads of the health advisers/ senior health adviser(s) through statistical returns and address future development needs.
14. To ensure the effective use of resources within the HA team.
15. To develop and maintain links with related health, social and educational services available in the area and to liaise as necessary with statutory and voluntary agencies.
16. Liaise with other principal/ senior health advisers within the region/ nationally in order to standardise the quality of the health adviser service.
17. To manage an appropriate teaching/ training programme for other health professionals as required e.g. for nursing staff, medical students or other statutory or voluntary bodies i.e. school teachers or pupils.
18. To ensure staff work within the legal responsibilities as laid down in the Venereal Diseases Regulations 1974 and the NHS Trust Act 1991.
19. To ensure staff work within SSHA guidance e.g. Code of Ethics, Code of Conduct, Guidelines for Good Practice, PN Policy

CLINICAL RESPONSIBILITIES

(It is expected that these will be a small component of the Principal’s work)

1. To provide information to patients diagnosed with a sexually transmitted infection: how they are acquired, transmitted and treated.
2. To provide education and counselling on preventing or minimizing the risk of infection.
3. To provide effective partner notification to ensure contact(s)’ attendance and treatment by index (patient) referral as detailed in the SSHA PN policy
4. To stress the importance of medical treatment and follow-up.
5. To discuss HIV with patients who may have been at risk or are worried
6. To provide pre HIV test discussion and post HIV test counselling.
7. To provide initial post-test HIV counselling for newly diagnosed patients, their partners, significant others and offer ongoing counselling and psychosocial care dependant on the health advisers training, experience and supervision.
8. To provide a safe environment whereby patients can discuss their concerns and ask questions.
9. To provide comprehensive assessment of patients’ other social, emotional or sexual difficulties and to follow up or refer on as appropriate.
10. To record interventions accurately and concisely in patient files.
11. To ensure patients are followed up adequately if they need to reattend for results treatment or counselling by letter, phone, or home visit, or through GP, FHSA or other means.
12. To keep confidential records for the purpose of partner notification.
13. To take a lead in sexual health promotion work within the clinic and community.
14. To keep statistics on all patient contacts and interviews to enable audit and evaluation of services
15. To liaise with other health advisers in GUM and exchange relevant information in order to facilitate partner notification.
16. To liaise with other local or national agencies as appropriate.
17. To establish good working relationships with medical, nursing, and administration staff within the clinic, as well as with professionals from other departments e.g. Accident and Emergency, Gynaecology, Psychiatry.
18. To take part in teaching programs as required for nursing staff, medical students or other statutory or voluntary bodies.
19. To continue professional development and training by attendance and contribution at relevant clinic/ Trust/ regional/ national meetings, seminars, workshops and conferences.
20. To participate in regular supervision and staff appraisal.
21. To be aware of the confidential nature of the clinic and work within the legal responsibilities as laid down in the Venereal Diseases Regulations 1974 and the NHS Trust Act 1991.
22. To work within SSHA guidance e.g. Code of Ethics, Code of Conduct, Guidelines for Good Practice, PN Policy.