Case study:
South West London
The GPs in South West 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 Anirban Gupta
Dr Gaj Sivadhas
Dr Ruby Uddin
Secondary Care HIV Consultant Lead:
Dr Lisa Hamzah
Pilot Aims
The team aimed to address the challenges in south west London which are:
- Lack of awareness about local HIV prevalence rates.
- Stigma around discussing and testing for HIV in primary care.
- Variability in testing practices across specialties and localities.
- Limited understanding of the benefits of universal and routine HIV testing.
Work completed so far:
1. Innovative approaches to testing
- Collaborated with NHS England and cancer care pathway leads to rally to include HIV testing in core diagnostic sets at rapid diagnostic centres.
- Initiated discussions re engaging with GI and respiratory specialties to broaden HIV testing pathways.
- Engaged with HIV GP champions and acute trusts to scale testing interventions.
2. Reducing stigma
- Hosted events with Fast-Track Cities London HIV ambassadors to educate health and social care professionals at bespoke events targeting GPs and social prescribers, about the impact of stigma.
- Promoted supportive, person-centred language for primary care interactions.
- Advocated for routine, normalised HIV testing to reduce barriers.
- The Croydon GP Training Event brought together healthcare professionals, including GPs, HIV Ambassadors, and HIV Clinical Leads, to enhance knowledge and skills in HIV prevention, diagnosis, and care.
3. Collaborative work and education
- Leveraged the knowledge and experience of established GP HIV Champions in other parts of London, particularly Southeast London.
- Collaborated with Hepatitis-C GP Champion to co-present a webinar fostering cross-specialty integration and shared learning.
- Collaborated with HIV Clinical Lead Dr Lewis Haddow and HIV Consultant Dr Daniel Trotman from Kingston Hospital to advance our initiatives and developed a podcast series titled “Spotlight on HIV in Primary Care” targeting primary care staff, featuring secondary care clinicians, HIV Clinical Leads, HIV Ambassadors, and an HIV Lead Pharmacist. Topics included HIV testing, stigma, lived experiences, and HIV pharmacotherapy in primary care. The series will be published on Spotify.
4. Engagement with local HIV voluntary and community organisations
- Partnered with Spectra to promote awareness of HIV and provide GP assisted HIV testing on a mobile bus, with on-site counselling.
5. Statin implementation and comorbidities
- Collaborated with HIV Clinical lead to draft GP letter regarding statin use according to BHIVA guidelines.
- Highlighted the importance of statin usage for people living with HIV during cardiovascular network webinars.
- Developed training programs for GP registrars to audit and promote best practices for managing comorbidities in people living with HIV.
Impact
- Secured senior-level agreement, including diagnostics/testing leads, to include HIV in core testing sets, starting in south west London and expanding across London.
- Early data showing a 15% increase in testing rates across south west London
- Targeted primary care professionals participated in awareness and education initiatives.
- 60% of GP practices in Croydon signing up to HIV Confident charter mark to tackle stigma towards people living with HIV.
- Enhanced visibility and stronger relationships with local HIV support networks.
- Recorded three training podcasts.
- 240 people attended a training event in Croydon which covered NICE guidance and HIV testing.
- Increased testing in cancer pathways.
Testimonials
“HIV Ambassadors gave us real-world insight into the challenges and how we can help overcome stigma.”
“The resources provided helped me feel more confident discussing HIV testing with my patients. The stigma-focused training was particularly enlightening.”
From a patient: “I was initially sceptical about routine HIV testing in GP practices in Kingston, thinking it was a low-prevalence area. After learning through the local newsletter that the practice kindly shared, I realised the importance of these efforts.”
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.
