The HIV Consortium patient pathway identifies primary care as an access point into HIV care and treatment (see section 6.7). The pathways also expect protocols for HIV services to support GPs through the provision of specialist advice and support where required. Funding to HIV services includes costs of some non ARV drugs for HIV related health needs, but not as an alternative provision for primary care.
4.2 Brighton and Hove PCT’s Local Enhanced Services (LES) In 2008 Brighton and Hove PCT introduced a Local Enhanced Service (LES) to address the primary care needs of PLHIV and support greater access to GPs. Elements of this LES include: •
Maintaining lists of PLHIV and all their drugs including HIV medications
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Monitoring patient adherence to HIV medications
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Managing cardio vascular disease (CVD) risk and mental health
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Providing sexual health checks and contraception, vaccinations and annual cervical cytology
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Advising on alcohol and recreational drug use and safer sex
All practices signing up to the LES are required to: •
Attend comprehensive 2-day training, accredited by the Royal College of Nursing, addressing managing specific conditions such as mental health and coprescribing, attend HIV educational updates at least yearly
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Have at least five HIV positive patients registered
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Meet competencies in the Royal College of General Practitioners ‘Minimum standards of care for HIV in General Practice 2003’
Initially only eight practices signed up when LES was introduced, this had risen to 26 practices by September 2009, out of a total of 48 practices in the PCT, an uptake of 54%.
Since the LES was introduced in 2003, it has been audited on a yearly basis by Brighton and Hove PCT. This has been the mechanism through which standards are set and through which GP practices show that they are meeting the requirements of the LES it
Primary Care Access
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