Tower Hamlets Contraception PLT August 2018 Insights
Explore insights on National & Local Contraception, contraception services, and data on under-18s conception rate, total abortion rate, and prescribed LARC rates in Tower Hamlets. Discover key trends and statistics in sexual health services.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
Tower Hamlets Contraception PLT 2nd August 2018 Dr. Jane Hutchinson Primary Care Lead in Sexual Health jane.hutchinson@bartshealth.nhs.uk
Talk outline National & Local Contraception (focussing on LARC) and TOP data What is in the Public Health commissioned sexual health enhanced service contract Support & training provided by Barts Health to support delivery of a full range of contraception services in GP
National & Local Contraception (focussing on LARC) and TOP data
Under 18s conception rate/1000: Tower Hamlets TH London (no./1000) England (no./1000) Year Count (no. /1000) 2014 74 18.0 21.5 22.8 2015 87 21.1 19.2 20.8 2016 53 12.6 17.1 18.8
Total abortion rate/1000 aged 15-44 years: Tower Hamlets TH London (no./1000) England (no./1000) Year Count (no. /1000) 2012 1530 18.5 22.4 16.6 2013 1566 20.3 22.8 16.6 2014 1514 19.1 21.8 16.5 2015 1568 19.2 21.6 16.7 2016 1437 17.1 20.8 16.7
Total prescribed LARC excluding injections rate /1000 aged 15-44 years: Tower Hamlets TH London (no./1000) England (no./1000) Year Count (no. /1000) 2014 2359 28.9 35.3 50.2 2015 2594 30.8 35.5 48.2 2016 2724 31.8 34.5 46.4
GP prescribed LARC excluding injections rate / 1000 aged 15-44 years: Tower Hamlets TH (no. /1000) London (no./1000) England (no./1000) Year Count 2011 753 10.0 15.8 29.2 2012 986 12.8 16.5 30.4 2013 1,101 13.9 16.1 31.3 2014 1,052 12.9 16.1 32.3 2015 926 11.0 14.9 29.8 2016 939 11.0 13.9 28.8
SRH prescribed LARC excluding injections rate /1000 aged 15-44 years: Tower Hamlets TH London (no./1000) England (no./1000) Year Count (no. /1000) 2014 1,307 16.0 19.2 17.8 2015 1668 19.8 20.5 18.3 2016 1785 20.8 20.6 17.6
IUCD (Copper coil) insertions including inter-practice referrals (IPRs) IUCD insertion (IPRs) (2015-16) IUCD insertion (IPRs) (2016-17) IUCD insertion (IPRs) (2017-18) Network 1 24 (1) 27 (1) 24 Network 2 35 40 60 Network 3 4 1 1 Network 4 36 (1) 29 (6) 49 (5) Network 5 29 (1) 36 8 Network 6 22 (8) 61 (5) 42 (5) Network 7 50 71 44 Network 8 44 41 34 Total 244 (11) 306 (12) 262 (10)
IUS (Mirena) insertions including inter-practice referrals (IPRs) IUS insertion (IPRs) (2015-16) IUS insertion (IPRs) (2016-17) IUS insertion (IPRs) (2017-18) Network 1 13 (2) 26 (1) 29 (1) Network 2 18 35 40 Network 3 0 0 0 Network 4 34 (3) 23 (2) 40 (2) Network 5 20 (1) 32 13 Network 6 9 (4) 43 (3) 35 (3) Network 7 33 31 36 Network 8 37 23 20 Total 164 (10) 213 (5) 213 (6)
Sub-dermal Implant insertions including inter- practice referrals (IPRs) Implant insertions (IPRs) (2015-16) Implant insertions (IPRs) (2016-17) Implant insertions (IPRs) (2017-18) Network 1 35 (1) 35 (1) 42 Network 2 45 44 (1) 58 Network 3 25 31 (3) 11 (6) Network 4 84 (2) 85 (1) 79 (3) Network 5 55 (1) 46 28 Network 6 88 45 44 (2) Network 7 103 94 66 Network 8 71 (1) 59 76 Total 506 (5) 439 (6) 404 (11)
Borough wide total LARC insertions (IPRs in brackets) Network IUCD insertions (IPRs) IUS Total IUT insertions (IPRs) SDI Total LARC insertions (IPRs) insertions (IPRs) 24 29 (1) 53 (1) 42 1 95 (1) 60 40 100 58 2 158 1 0 1 11 (6) 3 12 (6) 49 (5) 40 (2) 89 (7) 79 (3) 4 168 (10) 8 13 21 28 5 49 42 (5) 35 (3) 77 (8) 44 (2) 6 121 (10) 44 36 80 66 7 146 34 20 54 76 8 130 262 (10) 213 (6) 475 (16) 404 (11) Total 2017-18 879 (27) 306 (12) 213 (5) 519 (17) 439 (6) Total 2016-17 958 (23)
Borough wide total LARC insertions for Q1 2018-19 (IPRs in brackets) Network IUCD insertions (IPRs) IUS Total IUT insertions (IPRs) SDI insertions (IPRs) insertions (IPRs) Total LARC 1 16 3 9 4 12 2 27 9 10 8 19 3 1 0 0 1 0 4 33 4 6 23 10 5 18 3 6 9 9 6 13 (1) 5 (1) 4 4 9 (1) 7 41 17 5 19 22 8 44 11 12 21 23 Total Q1 193 (1) 52 (1) 52 89 104 Total 2017-18 879 (27) 262 (10) 213 (6) 475 (16) 404 (11)
Borough summary of LARC insertions (IPRs in brackets) 2013-14 2014-15 2015-16 2016-17 2017-18 Total LARC insertions 1002 906 (2) 914 (26) 958 (23) 879 (27) % change from previous year N/A 9.5% (-) 0.9% (+) 5% (+) 8.2% (-)
Total LARC insertions in General Practice 1020 1002 1000 980 958 960 940 914 920 906 900 879 880 860 840 820 800 2013-14 2014-15 2015-16 2016-17 2017-18
Borough summary of LARC insertions & removals (IPRs in brackets) 2015-16 2016-17 2017-18 Insertions Removals Insertions Removals Insertions Removals Borough totals 914 611 958 717 879 583 (26) (12) (23) (11) (27) (15)
What is in the Public Health commissioned Sexual Health & Contraception NIS
Aims of the Sexual Health & Contraception enhanced service are to increase uptake of effective methods of contraception to reduce the number of unwanted pregnancies increase STI screening increase diagnosis & effective management of STIs reduce the spread of STIs
The Sexual Health & Contraception enhanced service contract Your network or practice earns money for carrying out certain activities: LARC insertions & removals Reaching coverage targets for STI screening Diagnosing someone with an STI Treatment and Partner Notification of patients with Chlamydia Vaccinating someone against Hepatitis B if they are at risk of acquiring it sexually
LARC IUCD/IUS IUCD / IUS insertion & follow-up checks 1-23= no payment 24-49= 90 per insertion (including for 1-23) >50= 90 per insertion in addition 288 bonus. >100= 90 per insertion in addition 612 bonus >150= 90 per insertion in addition 1,212 bonus >200= 90 per insertion in addition 2,400 Per network: to qualify for payment will need to insert a minimum of 24 IUCD / IUS 23 per removal
LARC implants Sub dermal contraception implant insertion 1-11=no payment 12-49= 50 per insertion (including 1-11) >50= 50 per insertion in addition 288 bonus >100= 50 per insertion in addition 612 bonus >150= 50 per insertion in addition 1,212 >200= 50 per insertion in addition 2,400 bonus Per network: to qualify for payment will need to insert a minimum of 12 Implant removals 33 per removal
Womens Health template To ensure your practice gets paid for LARC activity remember to enter patient onto Women s Health template
Sexual Health & Contraception NIS specification 2018-19 Blood test with HIV and/or Hep B and/or Syphilis and 2) CnG is undertaken (payment for both or one test). Denominator- number of patients aged 15-59 years registered with practices in the Network on 1st April 2018
Sexual Health & Contraception NIS specification 2018-19 Managing patients with positive STI results. For Chlamydia: Treat and advise abstinence Help patients to identify relevant sexual partners and advise patients to notify those partners Follow up consultation to verify patient has taken treatment, ,abstained as appropriate and has advised partners to test For Genital Herpes simplex or warts: 60 per positive Treat and advise patients about partner notification For all other STIs (Gonorrhoea, Syphilis; HIV, Hep B, Hep C): Refer to Ambrose King Centre or Grahame Hayton Unit or Hepatology for treatment and partner notification You can have initial conversation about partner notification to help patient identify others who might be at risk and recommend early testing Advise abstinence until seen by specialist
Sexual Health & Contraception NIS specification 2018-19 For patients who have completed a course of Hepatitis B vaccine AND had a post vaccine (sAb) check at least six weeks after completion 177.75 Hep C screening for specific and documented high risk groups 10 per test
Targeted Hepatitis C screening for those in the following groups Patients born in certain high prevalence countries (EMIS prompt added) Bangladesh Pakistan Poland Romania Somalia History of injecting drug use including steroids HIV positive patients Men who have sex with men with previous history of an STI e.g. Chlamydia, Gonorrhoea or Syphilis
Sexual Health NIS template To ensure your practice gets paid for STI screening activity remember to enter the patient onto Sexual Health NIS template
Support & training provided by Barts Health to support Sexual & Reproductive Healthcare in General Practice
Work package 2: supporting non-specialists to deliver sexual healthcare & LARC Leadership across the system including non- specialist providers eg General Practices; Community Pharmacies; midwives; school nurses etc Training for primary care & other professionals Provision of PGDs
What support are Barts Health offering? Training Clinical governance support STI screening pathway Failsafe Failsafe Support around development of new models of care
Training offer: Contraception Competency training for GPs, nurses & midwives to gain the Letters of Competence (LoC): Implants Intra uterine devices SRH Essentials courses for practice nurses DFSRH / NDFSRH Preparation for the eKA workshops Courses of 5 next one is Tuesday 25thSeptember Clinical attachments as part of the DFSRH for GPs, practice nurses and midwives Protected Learning Time (PLT) sessions on Contraception 2ndAugust
Training offer: STIs Bespoke training sessions up to 2 hours duration for GP localities to multi- disciplinary staff Protected Learning Time (PLT) sessions on STI screening & management for each borough Targeted training for Health Care Assistants who are involved in STI screening BASHH STIF courses
Training offer: PGDs PGD training for all Community Pharmacists contracted to provide sexual healthcare across the 3 boroughs PGD training to at least two members of nursing staff in other non-specialist settings in each borough where STI treatment & emergency contraception is being delivered
Training offer: other C-card training course for frontline staff eg in Community Pharmacies; youth services Introduction to sexual health - half day courses for non-clinical health & social care staff in social services or the youth service to include
Work package 2: supporting non-specialists to deliver sexual healthcare & LARC Useful email addresses Useful email addresses 1. 1. BHNT.Advice-Sexual-Health-Barts@nhs.net This is for all primary care staff (GPs; Community Pharmacies; other similar groups) across the sub-region to contact us for non- urgent clinical, operational or teaching advice/info 2. bhnt.bartssexualhealth@nhs.net Use referral forms on EMIS to refer patients who need STI treatment (eg Gonorrhoea) or help with Partner notification
STI screening pathway Failsafe Expand BHSHS Centralised Patient & Partner Management Bureau ensuring all patients diagnosed with an STI in any setting have rapid access to Treatment Partner management Re-testing either at location of diagnosis or through prompt referral into specialist services if required
