Leading charities in the fight against HIV, Hepatitis B and Hepatitis C have joined forces to call on Public Health Minister Neil O’Brien and NHS England Chief Executive Amanda Pritchard to fund testing for blood borne viruses in emergency departments across the country.

In an open letter launched today, we're asking that the Government’s successful opt-out testing programme is extended to all areas with a high prevalence of HIV – from Birmingham to Portsmouth, and Derby to Peterborough.

More than 1,000 people have been found with HIV, hepatitis B and hepatitis C in London, Brighton, Manchester and Blackpool in just nine months of opt-out testing. Every time someone has their blood taken in emergency departments in these areas, they are tested for blood borne virus – with remarkable results. 

If we are to meet the ambitious targets to eliminate Hepatitis C in England by 2025 and HIV transmissions by 2030, testing must become routine across the country.

That’s why we’re writing to the Public Health Minister and NHS England to extend opt-out testing to 40+ new hospitals in 32 areas.

Add your voice to the call to make every contact count – sign our open letter today.

This project has been funded by the Gilead Need to Find Grant.

Dear Neil O’Brien and Amanda Pritchard,

The government has set ambitious targets to end new HIV transmissions by 2030 and eliminate hepatitis C in England by 2025. To do this, testing for HIV and hepatitis must become routine across the country. We are writing to ask that you extend the government’s opt-out HIV and hepatitis testing programme to all areas of ‘high’ HIV prevalence outside of London.

Opt-out blood borne virus testing is saving lives and saving money. In London, central Manchester, Brighton and Blackpool, more than 360 people have been newly diagnosed with HIV or re-engaged in care in just nine months. They can now access effective treatment that means they can live a healthy life and can’t pass on the virus. Many were already unwell but hadn’t been tested before.

In the same time, 727 people have been diagnosed with Hepatitis B and 315 with Hepatitis C. An estimated 40-50% of those with viral hepatitis are undiagnosed - we must find these people and ensure they can access the care they need. Opt-out testing is doing just this, on a remarkable scale.

It’s also not a coincidence that people diagnosed in emergency departments through opt-out testing are more likely to be Black African, women or older people – groups who are at higher risk of being diagnosed late. 45% of people diagnosed with HIV in the first opt-out testing pilots were of Black African, Black Caribbean or Black ‘other’ ethnicity, more than twice as many as the nationwide average of 22%. A further 35% were women and 10% aged 65 or over. This is because opt-out testing is finding people who are less likely to access a sexual health clinic or to be offered a test if they do go.

That’s why we can’t stop here. Areas outside of London that are classed by the UK Health Security Agency as having a ‘high’ HIV prevalence – including Birmingham, Portsmouth, Derby and Peterborough – should also benefit. Opt-out testing more than pays for itself, but these areas need funding to get started. An estimated £18 million is needed to expand opt-out blood borne virus testing to just over 40 emergency departments in 32 local authority areas.

In the first 100 days, the programme in the highest prevalence areas has so far cost £2 million but saved the NHS an estimated minimum of £6-8 million in care costs. It is also relieving pressure on other parts of the health service. In fact, in Croydon University Hospital, when they first started opt-out testing the average hospital stay for a newly diagnosed HIV patient was 34.9 days. After two years of opt-out HIV testing, the average stay is now just 2.4 days.

We could be the generation that ends new HIV transmissions and eliminates Hepatitis C in England. We have all the tools we need and we know what works. We urge you to seize this opportunity and make the funds available to make opt-out testing available in more areas.

Yours sincerely,

Ian Green, Chief Executive, Terrence Higgins Trust
Anne Aslett, Chief Executive, Elton John AIDS Foundation
Deborah Gold, Chief Executive, National AIDS Trust
Pamela Healy, Chief Executive, British Liver Trust
Rachel Halford, Chief Executive, Hepatitis C Trust
Sophie Strachan, Sophia Forum
Karen Skipper, Chief Executive, Spectra
Christine Ansell, Chief Executive, Wandsworth Oasis
Liz Foote, Chair, NHIVNA
Tom Doyle, Chief Executive, Yorkshire MESMAC
Gavin Brown, Chief Executive, Trade Sexual Health
Matthew Hodson, Executive Director, NAM aidsmap
Rami Ghali, Chief Executive, Brigstowe
Aydin Djemal, Chief Executive, BHA for Equality
Monty Moncrieff MBE, Chief Executive, London Friend
Sarah Macadam, Chief Executive, TVPS
Amanda Ely, Chief Executive, CHIVA
Pip Gardener, Chief Executive, Kite Trust
Professor Yvonne Gilleece, Chair Elect, British HIV Association (BHIVA)
Dr Claire Dewsnap, President, The British Association for Sexual Health & HIV (BASHH)
Paul Desmond, CEO, Hepatitis B Trust
Amdani Juma, Director, African Institute for Social Development (AISD)