The complexity of England’s health system is holding back progress in HIV care, a report from the King’s Fund said.
Due to advances in treatment, people diagnosed with HIV are living longer, with 30% of those with the condition being aged 50 or over – a figure projected to rise to 54% by 2028. When the disease first rose to prominence around 30 years ago, it was considered a death sentence by healthcare experts.
Health services are now being advised to focus on quality of life rather than just suppressing the virus, as well as co-ordinating with care for other long-term conditions common in older people. However, the King’s Fund report found the Health and Social Care Act 2012 created a ‘complex and fragmented system’ for HIV care.
King’s Fund assistant policy director Alex Baylis said: ‘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.
‘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, so joined-up working will be vital to them getting that care.’
Responsibility for delivering services is spread between NHS England, local NHS organisations and councils, which has made it harder for areas to make co-ordinated changes across HIV services.
While the number of new cases of HIV has fallen overall, infection rates are still increasing among gay and bisexual men. The report calls for NHS England and Public Health England to work as quickly as possible to make pre-exposure prophylaxis (PrEP) more widely available – as it has recently become via NHS Scotland – and to further increase HIV testing.
The report, funded by the MAC AIDS Fund, argues that sustainability and transformation plans (STPs) provide an opportunity for much clearer and stronger leadership for HIV services, and for NHS organisations and councils to work together on HIV care in their area.
MAC AIDS Fund global executive director Nancy Mahon said: ‘The HIV epidemic has shifted dramatically in the past decade and we must ensure that health services adapt accordingly.
‘This landmark report is critical to ensuring that decision-makers across the health system in England are able to navigate a complex system and work together to best address the HIV epidemic over the next decade.’