HIV care 'at risk from NHS changes', specialists warn

HIV test - yellow means positive, clear negative HIV testing is still carried out at genitourinary medicine clinics - but care for people found to be positive is separate

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HIV care is at risk from the changes to the health service in England, specialists are warning.

As part of NHS reorganisation, sexual healthcare became the responsibility of local authorities, while HIV care remains within the NHS.

The British HIV Association says many specialists feel the split has worsened patient care, and worry the situation will deteriorate even further.

The government said the NHS and local authorities should work together.

A survey by BHIVA, released to mark World Aids Day, found a third of the 100 HIV specialists questioned thought care for people with HIV was poorer since the reorganisation in April this year.

And two-thirds thought care was set to deteriorate further.

In the past, HIV and genitourinary medicine (GUM) services were integrated, sharing staff and resources.

But the reorganisation transferred responsibilities for tackling public health issues such as obesity, smoking prevention and sexual health - but not HIV care - to local councils.

Around 100,000 people in the UK live with HIV.

'Threatened with closure'

Dr David Asboe, chair of BHIVA and a consultant in HIV medicine at the Chelsea and Westminster Hospital, said: "Key to the concerns uncovered in this survey are fears about the separation of HIV care from broader genitourinary medicine."

Start Quote

The way the system has been created has made an artificial divide”

End Quote Dr Steve Taylor HIV specialist, Birmingham Heartlands Hospital

He added: "There are HIV services being threatened with closure without adequate care arrangements made for the people living with HIV attending these services."

Dr Janet Wilson, president of the British Association for Sexual Health and HIV (BASHH), said: "Sexual health clinicians have been sounding the warnings around restructuring since the introduction of the government's health reforms.

"We are already hearing about tendered GUM services being prevented from undertaking partner notification on people newly diagnosed as HIV-positive even though this is the most effective public health intervention for identifying undiagnosed HIV infection."

She added: "We need government, national and local agencies to urgently work together to prevent HIV and GUM care going backwards."

Dr Steve Taylor, lead consultant in HIV Services at Birmingham Heartlands Hospital, said there was an issue with staff who had worked for joint HIV and GUM services in the past moving to a new sexually transmitted infection centre and being lost to the HIV services: "The way the system has been created has made an artificial divide between classic GUM services and HIV.

Contact tracing

"There's not been recognition of the fact that these specialties are delivered by the same people."

And he suggested anything not in the GUM service contracts risked being lost or downgraded, such as contact tracing to find current and former partners, data collection and training.

Dr Taylor added: "It's about who is going to pick up the responsibility for all of those things that appear to be falling in the middle of what's being covered by NHS England and by local authorities."

A Department of Health spokesman said: "Public Health England's report on HIV care last year reported an increase in people being diagnosed and prompt integration into care.

"However, the NHS and local authorities should work together to make sure that sexual health services are convenient and work for patients."

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