contact slips

contact slip standards in a GU setting

This information has been prepared by a SHASTD working group principally for Health Advisers. It has been circulated and agreed as a standardised practice in the UK by AGUM and GUNA.

Standardisng the format and use of Contact slips in the UK

The aim of improving the format and use of contact slips in the UK is to enable contacts of an infection to access genitourinary screening tests and therefore reduce the spread of infection. SHASTD acknowledges that at present contact slips are the most effective way of facilitating attendance and therefore screening and epidemiological treatment. They encourage discussion, responsibility and compliance by the index patients and their contacts.

Rationale for developing/ changing contact slips

SHASTD looked at the name ‘Contact Slip’ and decided that this should remain the same as no better alternative could be found. Points in favour of keeping this included:

	contact does not necessarily have a sexual connotation
	it removes problems about the definition of a ‘partner’
	the word ‘contact’ is not a value laden term

SHASTD considered other alternative names to ‘contact slip’ and ruled out the terms ‘screening form’ ‘check-up slip’ and ‘notification form’ as it was felt that this may deter some people from attending. Screening is not always mandatory and the other terms may be associated with having a notifiable disease. The term ‘slip’ was seen as more appropriate than ‘card’ or ‘form’.

The use of the contact slip book stubs has been left to the individual discretion of each clinic. SHASTD acknowledges that some clinics may use stubs to assist in the documenting of resolution of partner notification. If this is the case then the group felt it would be useful to have headings for resolution on the reverse side of the stub.

A minimum amount of information has been put on the proposed contact slip with the expectation that they can be readily tailored to individual clinic needs. Maps may or may not be necessary. Times are useful, but an advice number may be more versatile, recognising that contact slips are more likely to go out of date sooner if they include more information.

SHASTD Guidelines for Health Advisers in the management of contact slips within the clinic

Health advisers should take the lead in co-ordinating and clarifying the roles and responsibilities of staff and the development of clinic policy for partner notification in the GU setting.

Health advisers should be involved in the training of new members of staff so that they are clear of their role with partner notification.

Giving index patients contact slips

Contact slips should routinely be given to patients who have traceable contacts of the following infections:

infectious syphilis, gonorrhoea, chlamydia, non gonococcal urethritis, trichomonas vaginalis, pelvic inflammatory disease, infectious hepatitis and chancroid. (clinics may decide to give out contact slips for other infections such as herpes or warts depending on the clinics protocol and individual situations)

Contact slip administration is a multidisciplinary team responsibility, they can be issued by doctors, health advisers and nurses within GU clinics. Within clinics there may need to be clarification of:

who issues the contact slips.

what should be covered in a discussion with the index patient when giving out contact slips to aid their use.

what should be documented in the patients notes re contact slip administration.

Contacts attending with a contact slip

There is a need to develop clinic systems to enable contacts to be screened and possibly treated without a loss of their own or their partners confidentiality. Within clinics there may need to be clarification on:

Where they are handed in at a clinic

How the contact slip information is documented or cross referenced in the notes. Because of the confidential nature of this information this data should be documented where it cannot be seen by the index patient.

Recorded information on contacts should include:

name of the contact

their clinic reference number

the clinic of their attendance

the date they attended

their diagnosis

How the contact slip is attached to the notes so it is seen at the consultation and then returned to the health adviser for processing (e.g. stapling inside the front of the notes)

Where a patient has a contact slip issued from another clinic and more information is required the health adviser may telephone the health adviser at the issuing clinic. The health adviser should be able to gain access to all the relevant information required to resolve partner notification.

On information being given to contacts/ partners

The contact/ partner will often volunteer the name of the index patient and the infection that they have. This then permits further discussion about the infection without a breach of the index patient’s confidentiality.

Confidentiality

General principals of index and partners/ contacts confidentiality should include

The index patient’s or contact’s/ partner’s identity should not be disclosed

Where patient’s ask to see their medical notes they can only see information written about themselves and therefore not their contacts/ partners.

Notes should not be left unattended with a patient

If the contact does not know the name of the infection then they should not be informed of this but may be given general information ‘we will do a routine screen for infections which includes the infection you may have been in contact with. (for women)….. The screen will be for infections including Chlamydia, Gonorrhoea, Syphilis, Thrush, B.V. Trichomonas, if we find these infections we will be able to treat / get rid of them. It is possible to have the antibiotics that will treat the infection that you may have. I suggest we do a check for these infections see if they show anything up and then decide whether you have any treatment today’ (men discussion re infections could include Chlamydia, Gonorrhoea, Syphilis, and N.S.U.)

Patients may be informed that ‘I do not have any reason to believe that you are at risk of HIV but if you would like to be tested for HIV we also offer this as a screening test at this clinic, would you like to discuss HIV testing?’

Patients who ‘demand’ to know what the infection is need to be told that they have a right to know their own diagnosis but not their contact’s/ partner’s.

On contact slips being returned to the issuing clinic

Health advisers should return contact slips to the issuing clinic within two weeks of the contacts attendance (two weeks will allow time for results of the screen to be included and updating of the diagnosis).

Contacts attending without a contact slip

All staff should encouraged when taking a sexual history to ask all patients ‘did anyone ask or advise you to come in. ’Where patients volunteer that they have been asked to attend then they should be asked for more information ‘ Did you get given a letter by another doctor or get a letter or slip of paper from a partner’

Try to ascertain the contacts name / details (DOB and address) and the clinic that they attended for their treatment. The health adviser may phone the health adviser in the relevant clinic to clarify this information. If the contact information/ infection cannot be ascertained then there will need to be a longer discussion on what they know about their partners infection.

DRAFT SHASTD CONTACT SLIP

Resolution Information

Contact No:.........................

Date Attended:....................

DOH Code:..........................

Other relevant info:

This side of the form is for clinic use only

PLEASE RETURN TO THE HEALTH ADVISER AT THE ISSUING CLINIC

Contacts Ref No:............................ DOH Code:.........................

Clinic Name:.................................... Date:....................................

Clinic Address:

Health Adviser Telephone No:

DRAFT SHASTD CONTACT SLIP

Date of issue:................

Index Ref No:...............

DOH Code:..................

IF YOU ARE GIVEN THIS CONTACT SLIP YOU NEED TO ATTEND A GENITOURINARY MEDICINE CLINIC AS SOON AS POSSIBLE. PRESENTING THIS FORM WILL ENABLE THE MEDICAL STAFF TO GIVE YOU THE CARE YOU NEED

Ref No:........................ DOH Code: .................... Date of Issue: ......................

Clinic Name:

Address: Map and travel

xxxxxxxxxxxxxxxxxxxxxx information

xxxxxxxxxxxxxxxxxxxxxx

Tel No for advice and

appointments:

If you are unable to attend this clinic, please telephone the above number for information about your local services

Men are advised to avoid passing urine for 2 to 3 hours before attending the clinic

postal address: SHASTD, MSF Centre, 33-37 Moreland Street, London, EC1V 8HA.

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