New standards for HIV services in England were released today by the Medical Foundation for AIDS and Sexual Health (MEDFASH).
The document contains standards for twelve aspects of service provision in HIV prevention, HIV diagnosis, empowerment of people with HIV, clinical care, primary healthcare, social care integrated with healthcare, sexual health care, HIV and pregnancy, care of families with HIV, emergency care, admission to hospital, respite, rehabilitation and palliative care. Each standard offers an evidence-based rationale, key interventions, implications for service planning, guidance on practice, and suggested audit indicators. Reading lists for supporting evidence, policy documents and professional guidelines are appended.
It also recommends the development of managed HIV service networks, a mechanism for co-ordinating clinical and other services in a given area, so that people with HIV can experience consistent quality of care wherever they live.
Dr Patrick French, a member of the government’s Independent Advisory Group for sexual health and HIV, and chair of the expert group which helped develop the standards, said “About a third of people living with the virus do not even know they are infected and risk severe illness if not diagnosed. They may present with symptoms in a variety of healthcare settings, such as primary care or A&E. The recommended standards should help healthcare staff in such settings to work together with HIV specialists, and to access appropriate training and support through HIV service networks.”
The House of Commons Health Select Committee recently recommended Strategic Health Authorities use the standards in managing the performance of trusts. However, the standards do not have the force of a Department of Health guidance note, and speaking at an information forum organised by NAM earlier this week, MEDFASH Executive Director Ruth Lowbury said that the service standards would require active monitoring to ensure that services were up to the mark. She also noted that whilst the initial standard setting project was funded by the Department of Health , the London NHS HIV commissioning consortium, the British HIV Association and the National Association of NHS Providers of AIDS Care and Treatment, no money has yet been allocated to audit compliance with the standards by NHS trusts in England.
The standards only apply to NHS services in England, and it is possible that separate standards documents will have to be developed to cover NHS trusts in Wales and Scotland, Lowbury said.
The standards document can be viewed at the
website of the Medical Foundation for AIDS and Sexual Health.