The future of HIV services in England

The King’s Fund has published ‘The future of HIV services in England’. This report explores the challenges and opportunities facing HIV services in four areas in England, and makes recommendations on future development to those in national and local leadership roles.

Care for people with HIV is now highly effective, and increasing numbers of people are living with HIV into older age with normal life expectancy. For example, in London there are now around four times as many people over the age of 50 living with HIV as there were 10 years ago. HIV services need to adapt to this changing demographic, co-ordinating more closely with the other health and care services that older people need and focusing on overall quality of life as well as clinical treatment.

England has an outstanding record of achievements in HIV prevention, treatment and care. Increasing numbers of people with HIV have normal life expectancy, so there are now more older people living with HIV who may have other care needs associated with ageing. The purpose of this research was to make recommendations to those in national and local leadership roles on how HIV services should develop over the next 5–10 years.

Models for co-ordinating long-term care already exist and some other services, such as those for cancer, have similarly evolved from providing specialised treatment to including long-term care. Local HIV services need to work out how to learn from these and adapt them as appropriate to join up care.

The King’s Fund suggests that HIV services must be designed locally to reflect the diversity of needs. But national NHS bodies should set the overall strategic direction and expectations, and ensure accountability. We recommend these should be more tightly defined. Stronger national leadership is needed to take action to reduce stigma, both in general and in non-HIV-specialist health care, and to support and co‑ordinate the roll-out of future models of HIV care and develop the HIV workforce.

Read the full report here

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