Ministers have been urged to expand opt-out testing for HIV and hepatitis in emergency departments across the country after a successful rollout in several English cities, including London.
Leading charities on Friday delivered an open letter to the Government calling on them to fully-fund an opt-out testing regimen across England.
Routine opt-out testing for blood borne viruses – including HIV and Hepatitis B and C – began in all EDs in the capital in April last year as part of efforts to reduce transmission in areas with the highest rates of undiagnosed HIV. It has also been launched in Manchester, Brighton and Blackpool.
In an opt-out testing regimen, patients are informed that they are receiving an HIV or hepatitis test but can decline if they wish. It has been implemented in maternity services since 2000 and is particularly effective identifying people with HIV who are disproportionately affected by higher rates of late diagnosis, including women and people from Black African communities.
New data shows that since opt-out testing launched in 2022, almost 1,700 people have been found with HIV, Hepatitis B and Hepatitis C in the first 10 months of the three-year programme. Of this number, 450 have been diagnosed with HIV.
The letter, signed by the bosses of 22 major health charities and addressed to public health minister Neil O’Brien and NHS England boss Amanda Pritchard, says that the policy is “saving lives and saving money”.
It notes that those diagnosed with opt-out testing are more likely to be Black African, women or older people – groups who are at higher risk of being diagnosed late.
The letter reads: “That’s why we can’t stop. Areas outside of London that are classed by the UK Health Security Agency as having a ‘high’ HIV prevalence – including Birmingham, Portsmouth, Derby and Peterborough – should also benefit. Opt-out testing more than pays for itself, but these areas need funding to get started.”
Figures show that 45 per cent of people diagnosed with HIV in the first opt-out testing pilots were of Black African, Black Caribbean or Black ‘other’ ethnicity, more than twice as many as the nationwide average of 22 per cent.
A further 35 per cent were women and 10 per cent were aged 65 or over.
An estimated £18 million would be needed to expand opt-out blood borne virus testing to just over 40 emergency departments in 32 local authority areas, the signatories write.
They argue that, while the programme has so far cost £2 million, it has saved the NHS an estimated £6 to 8 million in care costs.
The letter continues: “We could be the generation that ends new HIV transmissions and eliminates Hepatitis C in England. We have all the tools we need and we know what works.
“We urge you to seize this opportunity and make the funds available to make opt-out testing available in more areas.”
Signatories of the letter include the chief executives of the National AIDS Trust, Terrence Higgins Trust, Elton John AIDS Foundation and the British Liver Trust.
Deborah Gold, Chief Executive of National AIDS Trust said: “The case for action is now clear, opt-out HIV testing in A&Es works. This crucial action is needed to diagnose everyone living with HIV and to end all new cases by 2030. It also saves the NHS money through reduced hospital stays and quicker diagnosis.
“Any delay expanding this pilot would mean missing the opportunity to diagnose hundreds of people with HIV in towns and cities across the country. Why should someone only be tested in London and not in Luton, Liverpool, Leicester or Leeds?”
