Case Study: In-Clinic Peer Support for HIV Clinics in North East London
Positive East, NEL clinics
1. What problem are we trying to solve or what is the aim?
The aim of this initiative is to address the inconsistent access to in-clinic peer support for individuals with the greatest need in North East London (NEL) HIV clinics. This issue has been exacerbated by inconsistent assessments of need, making it difficult to ensure that peer support is consistently provided to those who would benefit most. The goal is to improve access to targeted in-clinic peer support services, enhance the understanding of peer support versus other services like advice and signposting, and introduce a new Wellbeing Assessment across clinics.
2. What did we do?
The program focused on increasing referrals from clinical staff and raising awareness about what peer support entails, differentiating it from other services. Training for peer support staff was provided to ensure they were proficient in using the new Wellbeing Assessment system. Efforts were made to embed in-clinic peer support into existing pathways, such as Barts ELIA (Early Link Into ART) pathway, and to normalize peer support by introducing opt-out referrals for newly diagnosed patients.
The initiative also fostered strong relationships with key Trusts, including Barts and BHRUT, to improve integration with clinical services, including joint home visits for disengaged patients and collaboration with health advisers for newly diagnosed individuals.
3. What outcome have we achieved so far?
There has been significant progress in embedding peer support into clinic pathways and raising awareness of its benefits. Notable achievements include:
- Barts: Formal embedding of peer support into the ELIA pathway, with plans to provide weekly lists of newly diagnosed patients and opt-out referrals for peer support.
- BHRUT: Continued strong collaboration with monthly psycho-social MDTs, and joint home visits for disengaged patients, helping to re-engage individuals who are harder to reach.
- Increased understanding of the difference between peer support and advice provision, leading to a rise in peer support uptake.
- Initial data from May to November 2024 shows that 108 people received in-clinic peer support, though this number is likely an under-estimate due to inconsistent coding.
- Stronger relationships with Trusts’ BBV leads have improved the uptake of opt-out testing.
Efforts are ongoing to clean and analyse the data for a more detailed report in January 2025.