NHS England has shelved plans to offer #PrEP to at risk groups:
As set out in the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013, local authorities are the responsible commissioner for HIV prevention services.
Including PrEP for consideration in competition with specialised commissioning treatments as part of the annual CPAG prioritisation process could present risk of legal challenge from proponents of other ‘candidate’ treatments and interventions that could be displaced by PrEP if NHS England were to commission it.
While NHS England is not responsible for commissioning HIV prevention services, we are committed to working with local authorities, Public Health England, the Department of Health and other stakeholders as further consideration is given to making PrEP available for HIV prevention.
Specifically, given the potential benefits in this area, NHS England is keen to build on the excellent work to date and will be making available up to £2m over the next two years to run a number of early implementer test sites.
These will be undertaken in conjunction with Public Health England and will seek to answer the remaining questions around how PrEP could be commissioned in the most cost effective and integrated way to reduce HIV and sexually transmitted infections in those at highest risk. These test sites will aim to provide protection to an additional 500 men at high risk of HIV infection as well as inform future arrangements for the commissioning and provision of this innovative intervention.
Saving Lives positive ambassador and editor of Beyond Positive magazine, Tom Hayes, has a representative round-up of the community’s opinions about this delayed and disappointing decision, including this trenchant response from Deborah Gold of the National AIDS Trust (who have made available this useful leaflet on why PrEP is needed):
NAT shares the anger and distress felt by many thousands of people across the country at NHS England’s decision to abandon its work to provide PrEP, near the very end of the process. In a shocking U-turn, NHS England has pulled the plug on over 18 months of hard work which demonstrated the need, efficacy and cost-effectiveness of PrEP.
Instead of a long-term policy to give PrEP to all who need it, there will be £2 million over two years for 500 gay men ‘most at risk’. The decision is not informed by any due process; the amount of money is arbitrary; the claim that more ‘testing’ of PrEP is needed is disingenuous. 500 does not remotely cover the number of gay men at high risk of HIV nor meet the needs of heterosexuals at risk. There is no clarity within the Department of Health, the NHS or Public Health England as to who long-term is responsible to commission and fund PrEP.
This is simple maladministration with serious consequences. Over 5,000 gay men will get HIV over the next two years – very many of whom would not have done so if PrEP had been delivered as proposed.
Saving Lives echoes these concerns and shares the community’s disappointment with NHS England’s decision. PrEP could improve health outcomes and reduce new infections; it is a vital part of a comprehensive treatment response to HIV, and NHS England’s announcement this week robs doctors, campaigners and most importantly people living with HIV of a crucial tool in the fight against the infection. We will continue to join our voice to the calls for a rethink.
