Public health and HIV prevention

Local Authorities will therefore be responsible for commissioning sexual health services including HIV prevention and HIV testing services. A new body, Public Health England, will be set up to coordinate public health work nationally including responsibility for prevention initiatives in sexual health that require a country-wide response.

Increased HIV testing will continue to be part of local HIV prevention strategies in areas of high prevalence. This has led to tests being offered more often and in more settings such as GP surgeries, Accident and Emergency departments and community settings in particular areas of cities like London, Manchester and Brighton.

The Government has identified that health care and prevention services should be integrated and Local Authorities will face the challenge of ensuring that commissioning is not fragmented. Local Authorities have the potential to be successful at this type of commissioning as many of the factors influencing poor sexual health, such as social deprivation, social care and education, are also within their remit.

However, HIV and sexual health in general is not at the top of the list when the public are asked about health priorities (ref below). It is important that the organisations like Terrence Higgins Trust and members of the public with a special interest in this public health area continue to remind Local Authorities of the importance of HIV prevention and other sexual health work.

Timeline for developing Public Health England

Coordinating and Integrating Services

As a result of the planned changes, HIV services will be commissioned at two very different ends of the health spectrum. HIV health care and treatments in England will be commissioned by the national NHS Commissioning Board and on the other hand HIV testing, STI services and HIV prevention services will no longer be funded by the NHS at all but by local authorities.

How the NHS Commissioning Board will coordinate its HIV work with the rest of HIV preventative health and social care is still to be fully established, although the board will be required to consult patients, carers and the public in their commissioning decisions. It may be that some aspects of health services may be devolved further.