Our recently published research on the cost-effectiveness of screening for HIV in primary care has caused a great deal of interest and widespread media coverage.
We have produced a BITE sized summary of the paper with the headline findings and links to further information of interest.
The research, published in The Lancet HIV, represents the first time a model to explore the cost effectiveness of screening for HIV in primary care has been applied to the UK.
Our data provide the most reliable analyses to date and justify the investment needed to deliver HIV screening in primary care in the 74 localities considered to have high HIV prevalence – essentially most UK metropolitan areas.
Researcher and practicing GP Dr Werner Leber from Queen Mary University London said:
“We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief. This is an important finding given today’s austerity. Financial pressures, particularly within local authority’s public health budgets, mean that the costs of HIV testing are under intense scrutiny, and in some areas investment in testing has fallen.”
New CLAHRC research published in The Lancet HIV has found that offering HIV testing to people on registration with a new GP in areas of high prevalence of the disease is cost-effective and will save lives.
Researchers based at the London School of Hygiene & Tropical Medicine and Queen Mary University of London (QMUL) carried out the study in areas with high prevalence of HIV – involving 86,000 people from 40 GP surgeries.
The promising results prompted CLAHRC researchers to call for a roll-out of HIV screening to all 74 high HIV prevalence local authorities in England (those with more than two diagnosed HIV infections per 1,000 adults).
HIV treatment is expensive, particularly when diagnosis is late. Early diagnosis means earlier intervention and treatment, saving the NHS money.
Building on earlier research from a trial in Hackney – a socioeconomically deprived inner London borough with an HIV prevalence rate of 8 per 1000 adults – the trial involved 40 general practices where they tested the effect of rapid fingerprick HIV testing as part of the standard health check during registration. They found it led to a four-fold higher HIV diagnosis rate.
Using a mathematical model that includes all the costs associated with HIV testing and treatment, the team now show that primary care HIV screening in high prevalence settings becomes cost-effective in 33 years (according to National Institute for Health and Care Excellence [NICE] criteria).
The CLAHRC North Thames study was carried out in partnership with NHS City and Hackney and involved University College London, Homerton University Hospital NHS Foundation Trust, University of Warwick, and University of British Columbia.
Dr Werner Leber from QMUL said: “We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief. This is an important finding given today’s austerity. Financial pressures, particularly within local authority’s public health budgets, mean that the costs of HIV testing are under intense scrutiny, and in some areas investment in testing has fallen.”
Read the full paper
Rebecca F Baggaley, Michael A Irvine, Werner Leber, Valentina Cambiano, Jose Figueroa, Heather McMullen, Jane Anderson, Andreia C Santos, Fern Terris-Prestholt, Alec Miners, T. Déirdre Hollingsworth, Chris J Griffiths.
The Lancet HIV. DOI:10.1016/S2352-3018(17)30123-6
Children and young people are a key population for everyone working in the NHS and Public Health. Involving them in commissioning and designing services makes for more appropriate care that’s more likely to be taken up by those who need it
Our ground-breaking diabetes project worked with young people impacted by the condition in east London – we trained young co-inquirers in research skills so they could run community engagement events and analyse feedback on how to improve local diabetes services.
Our work was integral in shaping new NHS “how to” guidance to help commissioners and providers think through and develop youth forums to support person-centred commissioning of children and young people in health and care services.
The ‘how to guide’ is a recipient of the NHS England’s Celebrating Participation in Healthcare grant award scheme and has been authored by the University of East London (UEL)
Andrew studied management science (operational research) at Lancaster University. He has worked in industry and spent five years at the Audit Commission. He joined the Department of Health Services Research and Policy at LSHTM after completing a MSc in Medical Statistics. His main research interests are in the area of health care quality improvement, service delivery and organisational research. Recent research has included work examing the routine use of patient reported outcomes measures (PROMs) in elective surgery and TABUL, a NIHR HTA-funded study comparing the performance of ultrasonography and temporal artery biopsy for diagnosing giant cell arteritis.
Dr Leber is a practising GP in Tower Hamlets as well as being an NIHR Clinical Lecturer in Primary Care. He is working on the CLHARC project investigating Improving the identification and management of people with HIV