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‘Labyrinthine’ health system slowing progress of HIV treatment

Progress being made to meet the needs of HIV sufferers is being held back by an overly complex system, a report has today revealed.

The research conducted by think tank the King’s Fund, called ‘The future of HIV services in England’, argued that the Health and Social Care Act 2012 had created a fragmented system for HIV care, as responsibility for delivering services was spread between NHS England, local health organisations and councils – making it harder for areas to make co-ordinated changes across separate HIV services.

The findings also concluded that though the number of new cases of HIV had fallen overall, infection rates were still going up amongst gay and bisexual men – meaning that there needs to be more of an emphasis put on prevention as well as treatment.

A number of recommendations were also raised by the influential think tank, including calling on NHS England and Public Health England to work together to make pre-exposure prophylaxis (PrEP) more widely available and to also increase HIV testing.

Last year, NHS England was locked in a dispute with the Court of Appeal about whether the NHS or local government were responsible for PrEP, and back in December announced that it would be made available through trials.

London was also found to be a region where reform was desperately needed, as nearly half of all people with HIV in England access services in the capital, and the area also had the largest number of diagnoses.

Assistant director of policy at the King’s Fund, Alex Baylis, said that care for HIV in England was amongst the best in the world and something to be proud about. However, he warned that the “labyrinthine” structures set out in the Act made it hard to focus on the needs of patients, and represent a threat to future quality of care.

“The health needs of people with HIV are changing rapidly, but health care for people with the condition is too fragmented to be able to keep up with this pace of change,” Baylis explained.

“The number of older people with HIV is rising and they are more likely to need care from other parts of the health and social care system, and so joined-up working will be vital to them getting the care they need.”

His colleague Nancy Mahon, global executive director of the M·A·C AIDS Fund, which funded the report, added: “The HIV epidemic has shifted dramatically in the past decade. Advances in treatment and care mean that many individuals living with HIV have normal life expectancies and, as their needs evolve, we must ensure that health services adapt accordingly.”

Mahon then argued that the report was a “landmark” for ensuring that decision-makers across the health system were able to navigate the system and collaborate well to tackle the HIV epidemic in the UK.

“At M·A·C, we believe we will see a future without HIV in our lifetime, and we are proud to be funding this work by the King’s Fund which will help make this a reality,” she concluded.

Earlier this month, Public Health England said it was close to preparing trials for PrEP, saying: “Considerable progress has been made in preparing for the HIV pre-exposure prophylaxis (PrEP) trial that was announced by NHS England and PHE last December as a major extension to the national HIV prevention programme.

“The trial, called the PrEP Impact Trial, will include at least 10,000 participants over the next 3 years and will answer key outstanding questions on the extent of need, uptake and duration of use of PrEP in the setting of sexually transmitted infection (STI) clinics in England.

“Our aim is to have the trial started by the summer of 2017.”

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