Dean Street Express

Laboratory

Self screeningroom

Blood tests

Self check in

Presenter: Farhad Cooper (Specialist Registrar)Evaluation team: T. Appleby, L. Chislett, L. Freeman, E. Kershaw, A. McOwan, G.Whitlock

What is it?

● Nurse / HCA led ● Asymptomatic patients● Self-taken swabs● Rapid diagnostics● Results in 6 hours

A guided tour

Check in & history

Automated ordering

Given screening pack

Video guided self sampling

No lost samples Scan and place in Cepheid Infinity machine

Text to confirm correct mobile Automated

results

Aims & methods

- To see if:

● there was a change in the people using the service

● we were reaching high-risk MSM ● we were minimising periods of infectivity

- using questionnaires and notes review

Results: demographics

● No difference

M Fe t0.0%

10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

Het Bi MS

MWSW

Other/NS n/

a0.0%

10.0%20.0%30.0%40.0%50.0%60.0%

Sex

Sexuality

Age

Results: uptake, times to inform/treat

56DS DSETotal no screened 1500* 2868No of positive results

176 296

Time attendance to informing result (median hours, IQR)

183 (143 – 326) 3.7 (2.5-5.1)

Time attendance to treatment (median hours, IQR)

238 (170 – 452) 48.9 (27.2-96.6)

* Approxmation

Results: removing barriers to screening

56DS DSEWait to get an appointment

Up to 3 weeks

None

Maximum visit length

2hrs 32 min

Results: Infections detected at DSE

Infection Percentage of all positive results

Percentage of everyone screening

Chlamydia / Gonorrhoea

83% 10%

Syphilis 8% 1%HIV 6% 0.8%Hep B 0.9% 0.1%Hep C 0.9% 0.1%At least one infection

- 11.5%

% of all infections detected in MSM

- 84%

Results: feedback from our users

92% of users rated DSE as excellent as 76% previously

Uptake: 35,000 users screened so far

11.5% of users have an STI

Conclusions

● Highly efficient model ● Reaching high risk MSM● Results within 6 hours ● Embracing technology● Acceptable to users● Reducing periods of infectivity