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Better Primary Care for HIV

posted: 11/02/2011

filed under: HIV GP clinic primary care report

cover of the book HIV in Primary CareHow should HIV clinics and GPs work together caring for people living with HIV, when HIV clinics look after the HIV, and the GP is responsible for general healthcare? Lots of people with HIV, GPs and HIV doctors find this split rather clumsy. Two central London NHS Trusts asked Positively UK to investigate what people want and how we can make things work better.

Their report gives Manchester as one example of how to offer better primary care for people with HIV.
 

Manchester Primary Care Trust did this by introducing compulsory HIV awareness training for GPs and offering guidelines about disclosure and confidentiality. It made this a compulsory part of every GPs contract.

Another way of improving GP care for people with HIV is being used in Brighton. There they didn’t try compulsion, but invited GPs there to sign up to offer a Local Enhanced Service (the doctors are paid extra for this) where there is HIV training, see a minimum number of HIV+ patients, and carry out some extra health tests and checks.

This Positively UK study surveyed people with HIV, primary care staff and HIV clinics about what would help patients make the change from using the HIV clinic for everything, to using a GP for day to day, non-HIV healthcare. The report includes these 15 recommendations.

15 suggestions for action and improvement

  • Increase people with HIV’s use of primary care by providing services in new ways 
  • Provide short training sessions for all general practices to raise awareness of HIV, patients’ concerns and to boost practice confidence
  • Introduce enhanced GP services for HIV using a 2-day training course and annual update training
  • All staff (including receptionists) of practices that offer an enhanced service for HIV must attend HIV awareness training
  • Develop quality standards on the basic information GPs should gather on patients’ HIV health and medications; increase standard length of appointments for patients living with HIV; agree protocols for protecting patient confidentiality
  • Incorporate these quality standards into the existing GP Quality Outcomes Framework, to help implementation and monitoring of progress
  • Provide enhanced HIV services to patients outside the practice catchment area where people with HIV have no local practice offering an enhanced HIV service
  • Encourage practices already offering an enhanced local STI service or HIV testing to extend this by offering an enhanced HIV service
  • PCTs consider providing primary healthcare for people with HIV in any ‘one-stop shops’ that are developed
  • Base a GP at HIV clinics to offer short-term primary care as a step to using a local GP for primary care
  • Consider how to manage the transfer to primary care of people using clinics in another PCT district
  • Provide a ‘hotline’ at HIV clinics for GPs with concerns about HIV patient care
  • Use the CQUN standards as a basis for routine sharing of information between HIV clinics and General Practice
  • Following past recommendations appoint a nurse specialist and community lead as ‘champions’ to promote good practice and care shared between General Practice and HIV Clinics
  • Provide information for people with HIV about finding a GP, patient rights and telling the doctor.

Primary Care Access: GPs responding better to the needs of people living with HIV – executive summary and recommendations
 

Primary Care Access full report and recommendations 
 

free to download HIV in Primary Care book from MedFash


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