Here is a short description of
some of our current and recent activities. To
find out more about any of our projects or to
suggest new ideas (including possibilities for
collaboration), please get in touch.
Standards
for psychological support for adults living with
HIV
In 2010, the National AIDS Trust
published a report
highlighting the mental health needs of people
with HIV and the variability of provision of psychological
support services for them. The report, based on
findings from a consultation exercise and an expert
seminar, recommended that professional bodies
should collaborate to develop standards for psychological
support for people living with HIV.
In response to this call, MedFASH
worked with the British Psychological Society
(BPS), British HIV Association (BHIVA) and a multidisciplinary
working party to manage the development of Standards
for psychological support for adults living with
HIV , the first of their kind in the UK. A
draft of the standards was issued for consultation
at BHIVA spring 2011 conference. The final version
incorporates changes in response to consultation
and was published in November 2011 with endorsements
from eight major professional organisations represented
on the working party
The Standards cover the range
of psychological support that should be available
to people living with HIV in community, primary
care or specialist hospital settings. Psychological
support as defined in the Standards is ‘any
form of support which is aimed at helping people
living with HIV to enhance their mental health
and their cognitive and emotional wellbeing’.
An educational grant from Abbott
has supported the development of this publication.
Abbott has had no editorial input or involvement
in its production. Additional contributions were
received from BHIVA, the FacHIV&SH (BPS) and
MedFASH.
The booklet calls for HIV testing
as a routine investigation when considering a
diagnosis or in new patient checks. This supports
the UK
National guidelines for HIV testing 2008 which
recommend the routine offer of HIV testing for
patients with clinical indicator conditions or
risk factors for HIV, and guidance
from the Health Protection Agency which recommends
the routine offer of a test in areas where HIV
prevalence is high.
The booklet also offers up-to-date
information on primary healthcare for patients
with HIV, covering day-to-day issues such as contraception,
immunisation and cervical screening as well as
side-effects of HIV antiretroviral drugs and potential
drug interactions. It advises that GPs can make
their practices accessible to patients with HIV
by reassuring them about confidentiality and making
links with local HIV specialist units.
Hard copies are available at £10
per copy singly, but discounts apply to bulk orders.
For details see ordering
information or you can email
us or call us on 020 7383 6345.
Halve
It
One in four people living with
HIV in the UK is unaware they have the infection
and therefore unable to access potentially life-saving
treatment. Halve
It is a new joint campaign aiming to halve,
within five years, the proportion of people living
with undiagnosed HIV infection and the proportion
of people diagnosed late with HIV. The campaign
is led by a coalition of HIV and healthcare experts,
including MedFASH.
The Halve It position paper Early
Testing Saves Lives, now in its second edition,
calls on government nationally and locally to
make HIV a public health priority. It was launched
on World AIDS Day (1 December 2010) at the Time
to Test for HIV multidisciplinary conference,
by British HIV Association Chairman, Dr Ian Williams
and MedFASH Chief Executive, Ruth Lowbury (view
their presentation).
HIV
testing guidance for Europe
On
World AIDS Day 2010, the European
Centre for Disease Prevention and Control
(ECDC) launched a
set of guidance documents on HIV testing. The
guidance was commissioned by the ECDC and produced
under contract by MedFASH and the UK's Health
Protection Agency on their behalf. The
aim of the guidance is to support governments
across Europe in increasing rates of HIV testing
and in monitoring and evaluating their programmes
for maximum effectiveness.
There
are three documents in the set: Guidance
on HIV testing contains core principles for
developing and implementing national HIV testing
strategies. This is supported by the Evidence
synthesis for Guidance on HIV testing which
reviews the scientific literature on the evidence
for strategies to overcome barriers to HIV testing.
A shorter summary
of the guidance is also available.
The
case for including sexual & reproductive health
and HIV as a central part of the Public Health White
Paper
Public consultation on the Coalition's
Programme for Government identified sexual health
as one of the top three public health priorities.
In response, MedFASH and other leading sexual
health and HIV charities and medical specialist
professional associations in sexual health have
produced a position
paper outlining the economic, health, social and
moral case for prioritising sexual and reproductive
health and HIV, and calling on the Government
to make it a central plank of public health policy
in England.
The White
Paper Healthy Health Lives, Healthy People,
published on 30 November 2010, recognises this
need and further detail on a new sexual health
strategy and how sexual health services will be
commissioned is expected in Spring 2011.
Standards
for the management of sexually transmitted infections
(STIs)
Changes to NHS policy in the last
decade have led to sexual health services being
offered in a wide range of settings, with increasing
numbers of primary and community healthcare providers
playing a role alongside GUM clinics in the management
of STIs.
The British
Association for Sexual Health and HIV (BASHH)
recognised that, although a number of existing
documents provided useful guidance, there was
no single set of agreed standards for the management
of STIs. Working in partnership with the Royal
College of Physicians (RCP) and other key
professional organisations, BASHH contracted MedFASH
to manage a project to define standards to
support the commissioning and provision of high
quality care for STIs and to promote consistency
of care across all settings where STIs are managed.
These standards bring together
for the first time the key elements of best practice
that people seeking help in relation to STIs are
entitled to expect, whichever service they choose
to attend. The effective management of STIs, as
specified in the standards, will improve health
outcomes for individuals, protect the broader
public health and contain costs to the NHS.
To download the standards and related documents,
go to our publications
page.
Tackling
HIV testing: increasing detection and diagnosis
A teaching resource pack for HIV
specialists who wish to support their colleagues
in other specialties to offer HIV testing more
routinely in their daily practice. It has been
produced to help increase rates of HIV diagnosis
in hospitals and contains educational slide sets,
template documents and background information.
The resource pack was launched
at the 2009 British
HIV Association (BHIVA) Autumn Conference
and all the pack materials available to download
from the Tackling
HIV Testing section of our website.
The SHout Loud project is intended
to help local people and organisations have a
say about sexual health, contraceptive and HIV
services in England. This is a collaborative project
between the six of the leading national sexual
health charities: African
Health Policy Network (AHPN), Brook,
fpa, MedFASH,
National AIDS
Trust (NAT) and Terrence
Higgins Trust (THT).
Here's what can you do to help
make the case for good, well-resourced sexual
health services:
1. Sign up at www.shoutloud.org.uk.
The site provides information about the sexual
health in your local area, contact details for
decision makers and current sexual health policies.
2. Encourage others to make their
voices heard as well by signing up, writing to
their MP and/or the Health Secretary or Public
Health Minister.
3. Take action and lend your support,
individual or organisational, to our call. Please
use your influence to ensure sexual health is
included as an integral part of the Public Health
White Paper.
Royal
College of General Practitioners (RCGP) Introductory
Certificate in Sexual Health
To obtain the certificate, participants
need to complete the e-learning module Sexual
Health in General Practice on the RCGP website's
Online
Learning Environment and attend a face-to-face
training day. For more information about the course
and dates of future face-to-face training days
please visit the Introductory
Certificate in Sexual Health section of the
RCGP website.
Progress
and priorities - working together for high quality
sexual health. Review of the National strategy for
sexual health and HIV
The Independent Advisory Group
(IAG) on Sexual Health and HIV was formed to advise
the Government on the implementation of the National
strategy for sexual health and HIV. In 2007, it
commissioned MedFASH to undertake a review of
the strategy, funded by the Department of Health.
We gathered information through desk research,
expert groups and regional meetings with multidisciplinary
professional stakeholders and with service users.
The review report, Progress
and priorities - working together for high quality
sexual health. Review of the National strategy
for sexual health and HIV, was published in
July 2008 and launched at the House of Lords by
Baroness Gould, Chair of the IAG.The report highlights
the changing context since the strategy's publication
in 2001, outlines progress to date and identifies
drivers and barriers to the strategy's implementation.
It provides recommendations in five strategic
priority areas for action at local, regional and
national level.
Conference:
More progress, same priorities? Review of the National
strategy for sexual health and HIV and beyond -
the challenges of implementation
The National strategy for sexual
health and HIV (2001) set out an ambitious ten-year
programme to tackle sexual ill-health and modernise
sexual health services in England. A review of
the strategy and its implementation was undertaken
in 2008, resulting in the report Progress and priorities - working
together for high quality sexual health, produced
by MedFASH for the Independent Advisory Group
(IAG) on Sexual Health and HIV.
One year on from the publication
of Progress and priorities, this conference provided
a unique opportunity to learn about the Government's
response to the review and to explore the practicalities
of implementing its recommendations at local and
regional level.
We are very grateful to the speakers who have
all agreed to share their presentations via the
MedFASH website. To download them, please click
on the presentation title:
London
sexual health needs assessment and service mapping
In 2008 MedFASH managed the first
sexual health needs assessment and service mapping
for London, in partnership with the London
Health Observatory (LHO) and the Health
Protection Agency (HPA).The project was established
to assist the NHS in London in its task of further
developing and delivering high quality and world
class sexual health services. It set out to provide
a detailed picture of sexual health needs and
the current commissioning and configuration of
sexual health services.
It also aimed to provide national
learning for the Department of Health about the
process of undertaking a regional needs assessment
and service mapping.Commissioned by Lambeth PCT
on behalf of all the London PCTs for the London
Sexual Health Programme, the project was jointly
funded by the DH Sexual Health Policy Team, the
DH National Support Team for Sexual Health and
the London Sexual Health Programme. In managing
the project, MedFASH commissioned the LHO which
worked with the HPA to produce the needs assessment.
A Project Advisory Group, whose membership was
drawn from commissioners and providers across
London, offered expert advice and guidance throughout
the project. The following project reports were
published by MedFASH in November 2008:
In addition, the LHO has produced
an interactive web tool enabling comparison between
sexual health indicators at London borough level
and a workbook with supplementary tables. The
web tool can be accessed at the LHO website.
HIV
for non-HIV specialists
In 2008, following on from the
success of HIV
in primary care, MedFASH developed a booklet
for healthcare professionals in secondary care
settings who are not HIV specialists. HIV
for non-HIV specialists is designed to help
them improve their skills and confidence in diagnosing
HIV. The booklet complements new national HIV
testing guidelines and supports the aims of the
2001 National strategy for sexual health
and HIV to reduce the prevalence of undiagnosed
HIV and the stigma associated with HIV infection.
The purpose of the project was to normalise consideration
of HIV in non-HIV specialist clinical settings,
and thereby increase opportunities for early diagnosis
of HIV infection and also to improve the quality
of healthcare for people with diagnosed HIV in
those settings. To order copies, go to our publications
page.
The booklet now forms part of
our new teaching resource pack Tackling
HIV Testing: increasing detection and diagnosis
produced to help increase rates of HIV diagnosis
in hospitals. It contains educational slide sets,
template documents and background information
to assist HIV specialists who wish to support
their colleagues in other specialties to offer
HIV testing more routinely in their daily practice.
The resource pack materials are available to download
from the Tackling
HIV Testing section of our website.
10
high impact changes for genitourinary medicine 48-hour
access
The 10 high impact changes best practice
guide arose from the National Review of GUM Services
and outlines quick and simple measures to help
GUM services meet the 48-hour access target for
access.
The guide was commissioned by
the Department of Health and we used an expert
reference group to help us collate feedback, provide
comments and case studies, and draft the guide
which was published in December 2006.
National
review of genitourinary medicine services
In 2004 we were commissioned by
the Department of Health to manage a national
review of genitourinary medicine (GUM) services,
as part of the implementation action plan for
The National strategy for sexual health and HIV.
The review aimed to:
undertake an assessment of
each GUM service in England, highlighting
factors which help or hinder their ability
to offer a prompt and high quality service
offer recommendations for service improvement
and modernisation arising from each assessment,
relevant for GUM service providers, their
local primary care trusts and strategic health
authorities
provide findings and recommendations
from the review to the Department of Health
Initiated in partnership with
the British Association
for Sexual Health and HIV (BASHH), the project
started in June 2004 and the programme of visits
was completed in May 2007. During the project,
we produced a top tips guide to support delivery
of the 48-hour access target for GUM. This guide
drew on lessons learnt from reviews of GUM services
and was circulated to SHA chief executives with
a covering letter.The more recent
10 high impact changes for genitourinary
medicine 48-hour access expanded on this to
give more detailed practical guidance for providers
and commissioners.
Recommended
standards and networks for sexual health services
In March 2005, we published Recommended
standards for sexual health services. A key
tool for providers, commissioners, performance
managers and service users, the standards support
local delivery of commitments in the public health
White Paper and the National strategy for sexual
health and HIV. Covering 10 aspects of service
provision, including guidance on service networks,
they are relevant to all settings providing NHS-funded
sexual health services, including general practice,
hospital and community-based clinics, pharmacies,
and organisations in the voluntary and independent
sectors. Supported by an expert advisory group,
MedFASH developed the standards through consultation
with a wide range of stakeholders.MedFASH also
commissioned a review of the evidence supporting
each recommended standard. Summaries of references for key interventions
are also available).The recommended standards
are based on the principle of delivery through
service networks. In May 2005 MedFASH organised
a national
conference on sexual health service networks
and published a practical guide to the development
of sexual health and HIV networks in 2006.
Recommended
standards and networks for NHS HIV services
In October 2003 we published Recommended standards for NHS HIV
services. This document became a cornerstone
of the National Strategy for Sexual Health and
HIV, and covers 12 aspects of service provision
for people with HIV, offering guidance on planning
and auditing the development of managed service
networks. They also provide a framework for commissioning
and a resource for partnership working between
service users and providers. The House of Commons
Health Select Committee recommended their use
by strategic health authorities in the performance
management of trusts.
We researched network development in HIV and in
other areas of healthcare to draft a practical
guide to HIV network development. The development
process included five multidisciplinary seminars in different parts of
England. Participants were given a working draft
of the practice guide and their feedback, along
with that of stakeholder organisations, was used
to inform the document's development.
In 2001 we
mapped and facilitated the development of HIV
service networks in the NHS in four parts of England:
the South-East (Kent, Surrey & Sussex), West
and North Yorkshire, the South-West and the West
Midlands.
The project report contains recommendations
and key findings. You can also find a short description
of what we learnt in an article in the July 2001
edition of the AIDS and Hepatitis Digest from
the Royal Society of Medicine Press.
See our publications
page to order a printed copy.
Promoting
wider availability and use of HIV testing
MedFASH has prioritised work in
this area for many years. In addition to the various
activities described above, earlier work included
partnership with the Sheffield Department of GU
Medicine to develop and pilot a patient leaflet
on testing in GUM clinics - see Use
of a leaflet to replace verbal pretest discussion
for HIV: effects and acceptability, published
in the journal of Sexually Transmitted Infections
(2003;79:243-245). A leaflet for non-HIV specialists,
published in 1998, Take the HIV Test, is still available
to download from our publications archive.
Policy
work and consultations
MedFASH provides authoritative
responses and briefings to government and other
policy makers on current policy issues.
Details of our current and past
work in this field are currently being updated
and will be available soon.
