£1bn UK HIV Care Costs
posted: 24/01/2011
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The cost of providing HIV treatment in the UK could reach £758 million by 2013. Adding HIV social care costs to this total means the total state spending on HIV care could be over £1 billion a year in 2013.
The UK has the fastest growing HIV epidemic in Europe, with rising numbers using NHS HIV services. People are continuing to get HIV, and because modern HIV treatments work so well, few are dying early. Both of these trends increase the total cost of HIV care, every year.
Annual costs from 1997
The study looked at how much it cost the NHS to provide treatment and care to people with HIV between 1997 and 2006. They also calculated the costs for future years, to 2013.
Using information from 14 clinics, they divided people up, depending on the stage of their HIV illness (no symptoms; with illness symptoms; an AIDS diagnosis), and their HIV treatment. They used routinely collected NHS HIV service use data to work out typical care for the different stages of HIV illness.
Triple the people, quadruple the bill
The total using NHS HIV services tripled from near 17,000 in 1997 to just over 52,000 in 2006. At the same time, the cost of treatment and care more than quadrupled from £104 million in 1997 to £483 million in 2006.
Social Care
Adding in social and community care costs increases the total health and social care costs from £104 to £164 million in 1997, and from £483 to £683 million in 2006.
The proportion of the money spent on treatment rose between 1997 and 2006, but spending on social care fell.
Treatment cost between £18,000 to £41,000 a year
In 2006, medical care and HIV treatments costs just over £18,000 for each person without symptoms, £21,500 for people with HIV symptoms, and over £41,000 for people with AIDS.
Estimating future costs
By 2013 the researchers estimate there will be 78,370 people using NHS HIV clinics, with their treatment and care costing between £720 million and £758 million.
Adding in social and community care costs raises the total state spending on HIV treatment and care in the UK to as much as £1,065 million.
“The direct cost for treatment and care for PLWHIV [people living with HIV] has risen 4.6 fold between 1997 and 2006,” say the investigators, with costs projected to increase “1.5 fold” between 2007 and 2013.
What’s pushing up costs?
People should start HIV treatment by the time their CD4 count has fallen to around 350. But late diagnosis is a major problem in the UK and this means many people start treatment late, which is always much more expensive. There’s now a national target to reduce late diagnosis, and this will increase the number of people on HIV treatment and therefore the total bill. But the researchers believe that this is well worth it.
“Starting PLWHIV on cost-effective regimens earlier, will maintain them in better health, resulting in fewer health or social services and thereby generating fewer treatment and care costs, while enabling them to remain socially and economically active members of society.”
Cut the bill – spend to prevent HIV
The continuing rise in HIV treatment and care costs really matters when the NHS and council social care budgets are being cut. The authors say trimming the amount it costs for each person would probably worsen HIV patient care, and save little.
Instead they say invest more in prevention, to reduce the number of new people needing HIV treatment every year. “Only comprehensive prevention strategies, responding directly to the epidemic dynamics operating in each country, will be able to reduce HIV incidence,” they argue.
“Policy makers and other relevant stakeholders need to use evidence-informed HIV prevention, treatment and care strategies…which will prolong life, reduce morbidity and ultimately deliver the best for both the individual and public health agendas.”
Source, with reference
Free, complete article online
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Professionals for HIV Teens to Adults
posted: 21/01/2011
Professionals in the North of England interested in supporting young people with HIV to make the change from childrens to adult services, are invited to regional meetings.
Growing numbers of HIV teens to adults
Many of the children now growing up with HIV are becoming adults and will need to switch to services for adults. Children's and adults' services staff need to think, plan and work together, for a smooth transition between children’s and adult HIV and other services.
Invitation to regional focus group
The Children and Young People HIV Network has arranged focus groups for professionals in the North of England, (and meetings for other regions) to make a start on developing age transition services locally.
The HIV Network invites all children's and adults' professionals (health sector, social care, and community sector) who are, or will, deliver services to 10 – 24 year old young people living with HIV.
This is part of a three-year project to improve the transition of young people living with HIV from children's to adults' services. The project aims to develop capacity by improving partnership working and enabling quality service development, both clinical and social care.
These focus groups will
- find out any current local arrangements for young people living with HIV making the transition from children's to adults' services
- explore the successes and challenges of transition, in different areas, with different numbers of young people, and identify needs
- provide a networking and discussion opportunity for professionals interested in better transitions.
Transitions won't wait
Despite the current upheavals in health, community and social care, young people’s needs for a better transition will not wait. Each area’s professionals need to become involved.
This networking and sharing opportunity will provide professionals with some useful resources on HIV and transition, lunch, and even travel expenses help for some.
Manchester, Sheffield, Newcastle, Birmingham
- For Greater Manchester, Merseyside, Cheshire and Lancashire – Manchester, 15 March, 14.00-16.30
- For North, West & South Yorkshire, East Riding, and Lincolnshire – Sheffield, 10 March, 13.30-16.00
- For Tyne and Wear, Co. Durham, Cumbria and Northumberland – Newcastle, 2 March, 10.00-12.30
- For West Midlands, and Leicestershire, Warwickshire, Worcestershire, Herefordshire, Shropshire, Staffordshire, Derbyshire and Nottinghamshire – Birmingham, 15 March, 12.00-14.30.
Join the group where you would have the most service links. No transition arrangements yet? All the better if you attend.
People working with affected families of HIV-positive adolescents are also welcome, although the focus will be on the transition needs of the HIV+ young people.
Book a place
Please email the Children and Young People HIV Network, telling them which one you would like to attend. All places must be booked in advance so they can book suitable accommodation and cater effectively for all. Live elsewhere? - email the Network for details of meetings in other regions
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HIV Money for Councils
posted: 21/12/2010
The Government have now said how much each council will receive for HIV social care in the next two years. This used to be paid as 'AIDS Support Grant'.
Increased Grant
Remarkably the funding identified for ‘AIDS Support’ is increased from £25.5 million this year (2010/11) and will rise to £36.2 million by 2014/15.
HIV community organisations worked hard to keep the amount for HIV listed within the overall grant to councils. This will mean people can ask what this HIV funding is really being spent on.
psending Ring-Fence Gone
The bad news is that this HIV money is no longer 'ring-fenced'. This means the council could spend the HIV money on anything. We need local people to help be our eyes and ears and put pressure on councils to spend the cash on HIV and nothing else.
MPs welcome increase
“This is a huge achievement.” said Simon Kirby MP, Vice Chair of the All Party Parliamentary Group for HIV and AIDS, who pushed for this increase. “With many councils having to make savings of up to 10% this year, there is no doubt that there will be pressure on all services including HIV services. But if councils receive a specific named ‘AIDS Support Grant’ people living with HIV have a good case to argue that the money should be spent on them.”
The All Party Parliamentary Group policy adviser, Veronica Oakeshott, says that HIV campaigners will still have a fight on their hands to ensure the grant “does what it says on the tin.”
Cuts presssure
Because of the cuts to council spending the government announced last week (the maximum 8.9% cut hits Manchester and other councils) there are great financial pressures on local authorities. Councils will be tempted to spend this HIV money on other, more popular services.
We encourage people to tell their local authority to spend all its 'HIV/AIDS Support' allocation on social care for people with HIV.
Tell your councillors what they should be spending on HIV
You can find details of your local councillors using your email address and then send an email at WriteToThem
NW England table showing HIV funding (April 2009 to April 2013) from central government to councils that provide social care services
HIV money for each council for the year April 2011 - April 2012
HIV money for each council for the year April 2012 - April 2013
More information on HIV social care on NAT's website
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Rise for HIV in Spending Review
posted: 09/11/2010
The Government has commited itself in the recent Spending Review to include specific amounts for HIV social care needs within the local authority grant for the next five years. Remarkably the funding identified for ‘AIDS Support’ is increased from £25.5 million this year to £36.2 million by 2014/15.
George House Trust and other HIV organisations have been in a campaign over the last few months lead by NAT (National AIDS Trust), to persuade the government to at least specify an amount for HIV within local authority budgets.
Following the Spending Review all the grants for special needs – including the AIDS Support Grant – are absorbed into the block grant given to councils, known as the Formula Grant.
However, the government says it will tell councils how much of their Formula Grant is for HIV. These are the figures.
Deborah Jack, Chief Executive of NAT, says:
‘NAT is extremely pleased to see a commitment from the Government to increase funding for HIV social care following our recent campaign. This commitment shows an acknowledgment of the importance of funding these services, and recognition that the rising numbers and ageing population of people living with HIV will result in both continuing and increasing social care needs within this group.
‘However, we do remain concerned that with the removal of the ring-fence around this funding and the increased emphasis on local flexibility, there is a risk that HIV social care funds could be spent elsewhere. NAT encourages all local authorities to ensure the needs of people living with HIV in every area are met, and this means using the funding committed to HIV social care to provide the services necessary.’
Further information (including the figures above) are in a
letter on Local Government and the Spending Review from the Secretary of State for Communities and Local Government
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Health and Care Standards
posted: 28/10/2010
There is a new law regulating health and adult social care services in England. From the start of this month every health and adult social care service in England is legally responsible for making sure it meets new essential standards of quality and safety.
The Care Quality Commission registers, licenses and monitors health and care services using these standards. The standards apply to most health services, council social services and care homes, nursing homes, councils, home care, and shared lives schemes.
The essential care quality standards
1. You can expect to be involved and told what’s happening at every stage of your care
- You will always be involved in discussions about your care and treatment, and your privacy and dignity will be respected by all staff.
- You will be given opportunities, encouragement and support to promote your independence.
- You will be able to agree or reject any type of examination, care, treatment or support before you receive it.
2. You can expect care, treatment and support that meets your needs
- Your personal needs will be assessed to make sure you get care that is safe and supports your rights. You will get the food and drink you need to meet your dietary needs.
- You will get safe and co-ordinated care where more than one care provider is involved or if you are moved between services.
3. You can expect to be safe
- You will be protected from abuse or the risk of abuse, and staff will respect your human rights.
- You will be cared for in a clean environment where you are protected from infection.
- You will get the medicines you need, when you need them, and in a safe way.
- You will be cared for in a safe and accessible place that will help you as you recover.
- You will not be harmed by unsafe or unsuitable equipment.
4. You can expect to be cared for by qualified staff
- Your health and welfare needs are met by staff who are properly qualified.
- There will always be enough members of staff available to keep you safe and meet your health and welfare needs.
- You will be looked after by staff who are well managed and have the chance to develop and improve their skills.
5. You can expect your care provider to constantly check the quality of its services
- Your care provider will continuously monitor the quality of its services to make sure you are safe.
- If you, or someone acting on your behalf makes a complaint, you will be listened to and it will be acted upon properly.
- Your personal records, including medical records, will be accurate and kept safe and confidential.
How is the new system different?
The Care Quality Commission looks at the care people get, rather than at any systems and processes. They say they listen to what people say about their treatment, care and support. They check how care services are meeting essential standards now, rather than looking at the past.
The Commission has wide powers to act if they find that a care service is not meeting the essential standards. It regulates:
- Medical and clinical treatment given to people of all ages, including treatment given in hospitals, ambulance services, and mental health services.
- Care provided in residential homes, in the community, in people’s own homes for adults, and in residential care homes for children. The Commission focus on more vulnerable people, including people with physical disabilities and long-term health conditions (such as HIV).
- Services for people whose rights are restricted under the Mental Health Act.
- Care provided either by the NHS or independently.
More information at their website and booklet
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