Gay and Living in Blackpool?

posted: 10/02/2011

Blackpool NHS is asking gay men and LBT residents to join their survey about your NHS. Gay and bi men in Blackpool, with or without HIV, can help make a difference.

The NHS, like all public bodies must create Equality Action Plans by April and HIV should be part of these, particularly in a town like Blackpool – both HIV prevention and HIV treatment and care.
 

Equality Action Plans must take these five steps

• Survey how service affects the protected groups (people with HIV are treated as ‘disabled,’ and LGBT are another protected group)
• Consult widely, involve people – that’s why they want your views now in this survey
• Assess the impact of their current policies and practice
• Use this evidence to decide action objectives and priorities
• Take the actions

The Blackpool NHS survey is to find out if different groups of people are treated unfairly and is secure and anonymous. Please take part before Monday 28 February. The survey takes about 5 minutes here on SurveyMonkey.

More information on the Blackpool NHS consultation please email Lorraine Moffat
 

GP Guide - Migrants' Health

posted: 26/01/2011

The Migrant Health Guide is a free new online “one stop information shop” for GPs and practice nurses who are working with migrants.

It comes from the Health Protection Agency who have produced it because migrants health needs are often more complex than for other people. HIV is included.

The online guide gives doctors and nurses easy access to the facts, so they can improve their patients’ care and quality of life.
 

Although most migrants to the UK are healthy, TB and HIV and other conditions are more common.

The guide supports diagnosing and managing a range of typical migrant health conditions. Early diagnosis and prompt treatment of HIV and other conditions is important for the health of the individual and to reduce onward transmission.
 

Produced by experts working with primary care practitioners, it comes with the blessings of the Royal College of General Practitioners and the Royal College of Nursing.

Key Recommendations

• Know your local migrant population and their rights to care
• Teach patients how the NHS works
• Assess new patients using the checklist and their country page
• Vaccinate and immunise as normal
• Watch and test for infectious diseases and conditions typical of their country
• Check and advise on any plans to visit friends and relatives abroad.

The Migrant Health Guide has

• detailed information for each country
• tools for assessing migrant patients – new patients, patients with symptoms, identifying more vulnerable patients
• how to talking about the NHS with migrants – explaining it, migrants rights to treatment, languages and interpreters, cultural awareness
• sections about migrant health conditions (including HIV), infectious diseases, vaccinations

Migrant Health Guide

HIV in Primary Care : The best HIV guide for GPs and primary care is (free download) HIV for non-specialists, by MedFash.

HIV Future - National and Council

posted: 24/12/2010

In plans just published for shaking up public health services in the NHS, the Department of Health propose that HIV testing, treatment and care services should be funded and co-ordinated nationally, by the future NHS Commissioning Board.

At the same time, a wide range of sexual health services - including STI clinics, contraception and abortion services - will become the responsibility of local councils, as part of their new public health role.
 

The government announced radical reforms for the English National Health Service (NHS) after the election in May. The main proposal is to abolish primary care trusts (PCTs). Most of the PCT responsibilities for co-ordinating and funding services (“commissioning”) will be transfered to local consortia of family doctors. And the public health services that PCTs commission will be handed over to local councils to manage.
 

NHS shake up worries

Many health professionals have big concerns about any major NHS shake up while big spending cuts are also being forced through. The risks are significant. And one of these worries is that where there are relatively few HIV-positive people, the new GP consortia would not have the skills, experience or interest to commission high-quality HIV services.

However the proposals now published show that GP consortia will not be expected to manage HIV clinical commissioning and HIV prevention.

How will local authorities in areas where there are few people with HIV manage HIV and sexual health prevention and care well?

HIV testing, treatment and care – a job for new NHS national commissioning board
The government has just released further details of their plans for commissioning. HIV testing, treatment and care will, in fact, be commissioned nationally by the NHS Commissioning Board.
The government document states that these arrangements will allow efficiencies to be made in the procurement of drugs and services.

“We’re pleased that HIV treatment is not going directly to inexperienced GP consortia,” commented Lisa Power, head of policy and public affairs at the Terrence Higgins Trust.
 

Local HIV prevention and health promotion – a new service from councils
Another key part of the government’s reforms is that responsibility for public health programmes will shift from NHS primary care trusts to local authorities. They will be allocated a ring-fenced budget that must be spent on public health activities. Notably, this will affect local HIV prevention and health promotion projects.
 

STI clinics, contraception, abortion – a new council service
However the government also revealed today that a very wide range of open-access sexual health services which contribute to public health will be commissioned by local authorities.
 

This includes services for the testing and treatment of sexually transmitted infections (STI clinics), as well as partner notification, STI services in primary care, termination of pregnancy and contraceptive services that are not provided by GPs. Local authorities are likely to be legally required to provide open-access sexual health services, but with some flexibility about how they do so.
 

Lisa Power of Terrence Higgins Trust estimates that providing open-access sexual health services will swallow around 20% of the budget for public health activities in relation to all health conditions.
 

Drug services – a new council responsibility
Drug services, including prevention and treatment, will also be co-ordinated and funded by local authorities.
 

The government's proposals also make clear that tracking HIV and other conditions (currently done by the Health Protection Agency) will be moved to the new body Public Health England, which will become part of the Department of Health.
 

The proposals say nothing about the national HIV-prevention programmes CHAPS and NAHIP (for gay men, and for African people respectively). However they do say some national campaigns may be commissioned by Public Health England.
 

Public Health 'outcomes', not 'targets'

The new government doesn't like 'targets' but sets 'outcomes' instead. Maybe you can spot if there is any real difference between the two. The Department of Health has published its proposed Public Health Outcomes Framework. These are the indicators they will use to judge how well the public health system is performing. The list of 'outcomes', includes the proportion of new people diagnosed late with HIV, the rate of Chlamydia diagnoses among young people, and treatment completion rates for TB.

Cash for testing early 'outcomes'

The Government has included prompt diagnosis of HIV in their important ‘outcomes framework’.
That means money rewards will provide a cash incentive to the health system to diagnose HIV early.

Andrew Lansley, health secretary, commented: “I want to hear views from the people that this new [public health] service will benefit and from those who provide the services we seek to improve; this is your chance to comment on our proposals and to let us know how you think key elements of the service should be designed.”

The consultations and proposals

The proposals are open for public comment until 31 March 2011.
 

Healthy Lives, Healthy People: consultation on the funding and commissioning routes for public health, 2010.

Healthy Lives, Healthy People: Transparency in Outcomes. Proposals for a Public Health Outcomes Framework, 2010.

Health and Social Care Department of Health website about the various health and social care changes

Source

The current Department of Health Sexual Health Commissioning Toolkit for the NHS and Councils

Guide to HIV Healthcare Confidentiality

posted: 15/12/2010

A new guide for people living with HIV explains your rights to confidentiality in healthcare and what you can expect. The guide, Personal information and the NHS, goes through common concerns people living with HIV have about how the NHS treats the privacy of information about HIV status.

It explains how personal information will be handled, and gives practical advice about what to do if people have any concerns.

Know the facts and take action

This guide helps people with HIV understand confidentiality and privacy rights. It encourages people to ask questions and make concerns known, which NAT hopes will help improve things for everyone. If a person with HIV feels that their personal information has been mishandled, armed with the facts in this guide, they can take action.

Confidentiality is protected in the NHS in the following ways:

• NHS staff should not talk about someone to anyone else either inside or outside the NHS without the patient’s consent; this includes talking to family members and friends of the patient
• NHS staff should not leave names visible anywhere. They should therefore cover up names on paper files or close computer screens and electronic medical records
• All paper records should be kept in a secure place and all computerised records should have electronic protection, such as secure logins and passwords.

Deborah Jack, Chief Executive of NAT (National AIDS Trust), told us:

‘Many people living with HIV have experienced concerns relating to confidentiality of their status and in healthcare this is especially important. In order to receive the best healthcare, sometimes this does mean sharing your personal information but people living with HIV should be able to do that and feel confident that their information will only be shared appropriately and with their consent. NAT has developed this guide in order to set out the basic principles of confidentiality within the NHS, as it can be a confusing area and many people do not fully understand what the rules – or their rights – are.’

guide: Personal information and the NHS is here
 

NAT's policy report Confidentiality in healthcare for people living with HIV provides useful background 

Guidance on Cuts, Equality and Fairness

posted: 28/10/2010

In making cuts and changes to services, public bodies have to obey equality law. Equality law does not prevent public bodies from making difficult decisions about reorganisation, relocation, redundancies, and service cuts, nor does the law stop public authorities from making decisions that may affect one group more than another.

A Must: Equality Impact Assessments
But the public equality duties do enable public authorities to show they are making decisions in a fair, transparent and accountable way, considering the needs and the rights of different members of their community.

The law says public bodies have to carry out an assessment of the impact that changes to policies, procedures and practices could have on different equality groups. These assessments help public bodies make better decisions, based on robust evidence. Public bodies must then 'have regard to' the impact any changes and cuts would have on sections of the community protected by equality law.

The assessment does not have to be a document called an Equality Impact Assessment, although this is what the Equality and Human Rights Commission recommends, as it helps public authorities:

• ensure they have a written record of the equality considerations they have taken into account
• ensure that their decision includes a consideration of the actions that would help to avoid or mitigate any unfair impact on particular equality groups
• make their decisions based on robust evidence
• make the decision-making process more transparent
• comply with the law.

If an Equality Impact Assessment is not done, then the public body must use an another method to systematically assess any adverse impact of a change in policy, procedure or practice.

It is a legal obligation which should remain a top priority, even in times of economic difficulty. Failure may result in authorities facing costly, time-consuming and reputation-damaging legal challenges.

The Equality and Human Rights Commission has launched a short guide to help put fairness and transparency at the heart of the difficult financial decisions through meeting the legal obligation to assess equality impact. The guide covers:

• What the law requires now
• What the law requires from April 2011
• Guidance (for practitioners and decision-makers)
• Relevant case law
• Best practice examples
• FAQs Public authorities and service providers
• FAQs Service users and organisations

Short Guide

Full details