1. Chlamydia Screening & Treatment Pathways Jo Wilson Lead Nurse Chlamydia Screening Kelly Ferrari Chlamydia Screening Co-ordinator Hertfordshire Chlamydia Screening Programme (HCSP)

2. Why screen for Chlamydia? • 1 in 10 sexually active young people under 25 currently infected with Chlamydia • Also known as the ‘silent’ infection • 75% of women and 50% of men with Chlamydia have no symptoms

3. Symptoms - Females Women may notice: • Unusual vaginal discharge. • Bleeding between periods. • Bleeding after sex. • Heavier periods • Pain (and/or bleeding) during sex. • Pain when passing urine. • Lower abdominal (pelvic) pain

4. Symptoms - Males Men may notice: • A white/cloudy or waterydischarge from the penis. • Burning and itching in thegenital area. • Pain when passing urine. • Painful swelling of the testicles

5. Potential complications • Without treatment 10-40% of women will develop Pelvic Inflammatory Disease (PID) which could result in… • Tubal factor infertility • Ectopic pregnancy • Chronic pelvic pain Men • Painful inflammation of the testicles • May lead to reduced fertility or infertility • Reiter’s syndrome (more common in men)

6. Chlamydia Screening • Males and females age range 15-24 • Screening for Asymptomatic clients only (Symptomatic clients refer to GUM) • Please encourage to screen in house (wherever possible) • All sites must have an individual site code

7. Chlamydia Screening • Urine Kits for men and women– need to wait one hour prior to providing a urine sample and use first part of urine stream • Self taken vaginal swabs for women – no need to wait an hour • Two forms of contact needed for results • To test annually or at every change of sexual partner • Kits contain everything needed (screening form not inside kit)

8. Chlamydia Screening • Test results can take up to 2 weeks • Name, date of birth, two forms of contact and site code needed on screening form • £5 for every sample that reaches the lab (all relevant information must be included on the screening form for payment including site code) • £15 per patient or partner treated at the pharmacy (payment only made if completed treatment form is returned to HCSP • Testing and treatment are free to patients

9. Results • Results by text, letter or telephone call within 2 weeks of screening • Negative result: All is well, no need for further contact C-sure 01707 369501 • Positive or equivocal result: Please call C-sure asap on 01707 369519 (will include lab. Number)

10. Treatment from Pharmacists • Well placed to offer treatment • Long opening hours and High Street presence • Already offering some other sexual health services including EHC & Chlamydia screening • National Average: 10% of treatment from pharmacies • East of England Average: 20%

11. Treatment in pharmacy • Age range 16-24 for index patient • 16 and upwards for partners of index • All clients presenting for treatment should have had contact with HCSP prior to attending • Please test and treat partners if referred for treatment by HCSP

12. Chlamydia ScreeningTreatment • Management of positive clients and partner notification undertaken by HCSS Health Advisors • Some initial screening by Health Advisors for symptoms, risk of pregnancy, breastfeeding, and allergies • Health promotion advice regarding safe sex and condom use • Advise to abstain from any sexual contact for 7 days post treatment • Positive patients & partners will be referred to pharmacists using faxed treatment form

16. Treatment forms • A form will be sent for every client referred for treatment • Forms should be returned by fax within 48 hours of treatment • Partners can also be treated but should also have contact with HCSP initially for health advising and contact tracing

17. A few reminders…… • Any change to fax numbers please inform HCSP • Please ensure counter staff are trained to offer Chlamydia screening • Payments made quarterly based on inclusion of relevant details and site code on screening form and return of treatment forms to HCSP • Support available from team, please call for advice or support visit

18. Contact details Hertfordshire Chlamydia Screening Team NHS Hertfordshire Charter House Parkway Welwyn Garden City Hertfordshire AL8 6JL Jackie Lamb, Screening Results Officer/Enquiries Telephone: 01707 369519 Jo Wilson: 01707 369463