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Clinical Audit Report 2012-13

Thursday 12th December 2013

Key audit findings and recommendations

This year's main audit investigated why some people known to have HIV are not reported as receiving care. Previous studies have suggested that around 5% of people with HIV are "lost to follow-up" from one year to the next. BHIVA collaborated with clinical services and Public Health England to get a better understanding of this:

  • Only 1.1% of all adults who had been diagnosed or seen for HIV care during 2010 were thought to have gone on living in the UK without attending for care in 2011

  • For 1.5%, the outcome was unknown - some of these may also have remained in the UK without attending for care in 2011

  • 1.4% probably left the UK

  • 1.2% probably did receive care in 2011 although incomplete reporting and data matching initially suggested loss to follow-up.

Despite uncertainties, this provides reassuring evidence of excellent retention in care among people living with HIV in the UK. However, there was a high risk of disease progression among those who did not attend for care - 12% became sick and needed care in 2012, with nine inpatient admissions and seven AIDS-defining illnesses among 230 people. Non-attendance for care may also be associated with onward HIV transmission. Hence it remains essential to encourage regular attendance.

HIV clinics tried to contact 79.6% of patients who were thought to be living in the UK but not attending for care. But clinics often did not involve the patient's GP even when the latter was aware of the HIV diagnosis.

Recommendations:

  • HIV services should monitor attendance and seek to re-engage patients when necessary. This should include liaising with general practice and checking patient details via national personal demographics services.

  • Public health agencies should support this by providing services with annual lists of patients reported one year but not in the following year.

Separately, a survey found that only 39% of relevant BHIVA members were confident of being ready for the new English HIV AIDS Reporting System.
 

Download the British HIV Association Clinical Audit Report 2012-13