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Homeless Sexual Health and Blood Borne Virus Outreach service

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Homeless Sexual Health and Blood Borne Virus Outreach service

  1. 1. Homeless Outreach Service Joe Phillips and Theresa Burns Senior Staff Nurses 56 Dean Street/Dean Street Express
  2. 2. Service Background Monthly service Based in Great Chapel Street Medical Centre Booked and Drop-in Service Started in April 2013 Clinic Team consists of –Consultant in Infectious Diseases - Health Advisor –Sexual Health Nurse/BBV –Homeless Outreach Nurse Practitioner
  3. 3. The Team
  4. 4. Aims of the Service ●Outpatient HIV and Viral Hepatitis Management ● Point of Care Tests for HIV and Hepatitis C (HCV) ● Sexual Health Screening ● Vaccinations for Hepatitis A (HAV) and Hepatitis B (HBV) ● Harm reduction advice; needle sharing, endocarditis, co-infection and re-infection with HCV, substance misuse, mental health etc ● Referral to appropriate additional services ●Referral for contraception services
  5. 5. Engagement ● Taking ownership of own health care ● Flexible clinic to meet patients health needs; drop in appointments both GP and ID consultant care delivered simultaneously- able to deal with multiple issues in one consultation ●Community Group support to help bring patients to the clinic; using peer support workers from Groundswell and other networks ●Hostel and outreach staff (multi-agency)actively aware of clinics and proactively bringing people in/reminding them to attend.
  6. 6. A Flexible Clinic! ●Changing the clinic time to suit the needs of our clients ● Introduction of HCV treatment assessment at the clinic
  7. 7. Service Evaluation Results ● We conducted a review of the service in April 2014 ● Results indicated high rates of HCV
  8. 8. Results Male Female Tested Negative Known Positives Declined Test
  9. 9. HCV Point Of Care Test (POCT) HCV negative HCV new Positive HCV Known Positive HCV Declined
  10. 10. Patient A ● Street homeless ●Tested HCV Ab +ve via INSTI Test ●HCV PCR +ve ●Counselled regarding hep c on diagnosis ●Referred to Chelsea and Westminster hepatology ●Accessing housing support via nurse at GCS ●Preparing for HCV treatment
  11. 11. Patient B ● Homeless ● HIV and HCV co-infection (cleared) ● IVDU ●Endocarditis, valve replacement ●On warfarin, antiretrovirals ●HIV Community CNS, pharmacy, District nurses
  12. 12. Points to consider ● Look for opportunities ● Multi-agency working to achieve the same goal ● Requires good communication between teams – email excellent for this (nhs.net) ● Be flexible ● Interpreters
  13. 13. ●Dean Street Express
  14. 14. ●Dean Street Express
  15. 15. ●Dean Street Express
  16. 16. ●Dean Street Express
  17. 17. ● Any Questions
  18. 18. ● References for places/organisation s referred to ? ● Great Chapel St www.greatchapelst. org.uk ● Groundswellhttp://w ww.groundswell.org .uk

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