Case study:
North Central London
The GPs in North Central London ICB area are working on a project trialling a local service with proactive management in primary care for people living with HIV. This has been funded by Fast-Track Cities London.
The service will identify people living with HIV in a practice and ensure their care meets the standard of care set out by the British HIV Association (BHIVA).
GP Champions:
Dr Samantha Preston
Dr Meredith Moore
Dr Katherine Lloyd
Secondary Care HIV Consultant Lead:
Dr Tristan Barber
Pilot Aims
The North Central London team are working towards tackling local challenges with:
- NCL has a population of 1.4 million including the 5 boroughs of Islington, Camden, Harringay, Barnet and Enfield.
It is a large and diverse area of North London with varied levels of deprivation and a high prevalence of people living with HIV. - The team’s main focus was to provide education across the ICB area and focus on increasing testing at key moments such as mental health reviews and community gynaecology clinics.
Work so far
- The main approach was education for GPs and across the primary care team to increase knowledge around HIV, encourage testing and reduce stigma. These sessions have been across the ICB area as well as smaller borough-based sessions, local GP training schemes and sessions tailored to different health professionals like clinical pharmacists and nursing teams.
- The team have also worked on increasing testing for vulnerable patients including in mental health reviews and routine testing in community gynaecology clinics, as well increasing awareness of indicator conditions. They also engaged with colposcopy services to encourage HIV testing for high-risk conditions and added HIV testing into some cancer referral pathways, as well as working to add pop ups onto clinical systems for smear reminders for people living with HIV.
- The GPs worked with their local HIV clinics to increase collaboration and build links. They lead a meet the GP session with one of the local clinics to share learning and support.
- They developed statin initiation guidance. Dr Sam Preston was awarded funding for a project where practice pharmacists initiate statins across Islington as well as education sessions on the statin guidance across the borough and encouraged GP trainees to undertake a project on statin initiation.
- The team updated the ICB GP website HIV section. They collaborated with local HIV clinicians to create an HIV results flowchart to support GPs when they make an HIV diagnosis and provide them with resources to support testing and management.
- They organised a World Aids Day celebration event with pop up HIV and STI testing as well as sharing communications with GP surgeries with key testing points. They also celebrated one practice in Islington on becoming the second in London to become an HIV Confident practice. Efforts continue in promoting the scheme to the practices.
Impact
- Feedback from education sessions showed that 100% of participants felt that the sessions improved their knowledge of HIV and 78% of participants strongly agreed that the sessions encouraged them to increase their HIV testing practices.
- All participants felt the sessions tackled HIV stigma, with 82% strongly agreeing that the session increased their confidence in discussing HIV testing with patients.
- A small project was done to identify people living with HIV out of care . Of the 11 people potentially identified as out of care, all were either engaged in care or were no longer living in the UK
Testimonials
“Great session, would recommend all GPs have the training”
“The HIV training session with Sam was really good. She helped to explain the relevance of testing and symptoms to be aware of. She made me feel more confident in discussing the condition with patients in the future. She presented really well – thank you.”
“This was such an informative session which I felt really benefited my clinical practice, thank you so much!”
“Best session this year with both speakers being amazing. I think I will do a HIV statin QUIP.”
Evaluation and data
The GP champion programme is being evaluated by Kings College London, and we will be presenting the pilot data in the summer of 2025.
If you would like any further information, please contact the Fast-Track Cities London programme team at rf-tr.londonftci@nhs.net.
