England's HIV services face complex new environment

Kirby, Tony; Thornber-Dunwell, Michelle

doi:10.1016/s0140-6736(13)62718-x

Cited by 4 publications

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“…In the future, new molecular testing technologies, such as multiplex and point-of-care tests, may improve access and facilitate prompt treatment, but their use will require appropriate stewardship in order to discourage unnecessary testing, false-positive results and consequent harm [100]. Major revisions to the commissioning and provision of sexual health services, especially in England, raise opportunities for STI control to be prioritized by local government, but equally present challenges, such as the potential fragmentation of services [101]. The effects of these changes on service access, service provision and quality of care, the size and behavior of at-risk populations, the impact of population-level interventions and evolving testing technologies will shape STI epidemiology in the UK over the coming decade.…”

Section: Future Perspectivementioning

confidence: 99%

The Epidemiology of Sexually Transmitted Infections in the UK: Impact of Behavior, Services and Interventions

Hughes

Field

2015

Future Microbiol.

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Sexually transmitted infections (STIs) are a major public health concern. The UK has some of the most advanced STI surveillance systems globally. This article uses national surveillance data to describe remarkable changes in STI epidemiology in the UK over the last century and explores the behavioral and demographic shifts that may explain these trends. The past 10 years have seen considerable improvements in STI service provision and the introduction of national public health interventions. However, sexual health inequalities persist and men who have sex with men, young adults and black ethnic minorities remain a priority for interventions. Technological advances in testing and a shift in sexual health service commissioning arrangements will present both opportunities and challenges in future.

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Section: Future Perspectivementioning

confidence: 99%

The Epidemiology of Sexually Transmitted Infections in the UK: Impact of Behavior, Services and Interventions

Hughes

Field

2015

Future Microbiol.

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“…Sexual health services, which are commonly co-located with HIV services, sharing resources and workforce, are now commissioned by local authorities (Public Health England, 2015), and are subject to tendering arrangements which may result in transfer of the contract to another NHS or a non-NHS provider. The impact of separate funding arrangements on the quality of care provision for both sexual health and HIV services has been identified as a major concern (All Party Parliamentary Group on HIV, 2015; Kirby and Thornber-Dunwell, 2014; Lucas, 2015; White, 2016).…”

Section: Introductionmentioning

confidence: 99%

A workforce in jeopardy: identifying the challenges of ensuring a sustainable advanced HIV nursing workforce

Piercy

Bell

Hughes

et al. 2018

Journal of Research in Nursing

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Introduction HIV services in England face substantial challenges arising from financial pressures and changes to commissioning. A sustainable HIV specialist nursing workforce will be vital to enable them to respond to those challenges. This paper examines the current workforce situation in HIV services across the country. Methods This mixed method study involved semi-structured interviews with 19 key stakeholders and with 44 nurses / physicians from 21 purposively selected HIV services across England. Data were interpreted using a framework analysis approach. Findings 'Building a career in HIV nursing' identified problems associated with retention and recruitment. Changes in commissioning are disrupting common career routes from sexual health to HIV nursing and a perceived lack of clear career pathway was seen as a barrier to recruitment. 'Developing a specialist workforce' explored professional development of the current workforce which was hampered by poor access to funding or study time for advanced study, and the absence of an HIV-specific advanced nursing qualification. Conclusion The HIV nursing workforce, which provides an increasing proportion of HIV care, is facing serious recruitment and retention challenges. A strategic approach to workforce 2 development and training is essential to overcome systemic barriers and secure the next generation of skilled practitioners. Key messages • The role of the HIV specialist nurse needs to develop and expand to deliver advanced community based HIV care • The separation of commissioning for sexual health and HIV threatens the main career pathway for specialist HIV nursing. • A more robust training programme is needed to prepare HIV nurses to deliver advanced specialist care across settings • A strategic approach to workforce development is needed to ensure a sustainable workforce, capable of delivering high quality care.

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“…It was also envisaged that the reforms would lead to greater integration of sexual and reproductive health services. Prior to the reforms contraception and sexual health (CASH) services and genitourinary medicine (GUM) services had traditionally been delivered as separate services in many areas, but there were now opportunities for them to be delivered as one service 10,11 .…”

Section: Introductionmentioning

confidence: 99%

“…A good example is HIV where prevention is now the responsibility of the local authority, HIV treatment that of the CCG and HIV drug costs that of NHS England 12 . The impact of the reforms on SRH workforce development, training, governance and accountability were also uncertain 10,12,13 . This led to fears that the changes could result in worsening care, reduced access to services and marked variations in service provision between areas 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Redesign and commissioning of sexual health services in England – a qualitative study

2016

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England's HIV services face complex new environment

Cited by 4 publications

References 0 publications

The Epidemiology of Sexually Transmitted Infections in the UK: Impact of Behavior, Services and Interventions

The Epidemiology of Sexually Transmitted Infections in the UK: Impact of Behavior, Services and Interventions

A workforce in jeopardy: identifying the challenges of ensuring a sustainable advanced HIV nursing workforce

Redesign and commissioning of sexual health services in England – a qualitative study

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