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HIV Action Plan in Scotland: December 2009 to March 2014

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Appendix Four: HIV Action Plan Responsibilities

Action

Lead Responsibility

Other Key
Agencies

Performance
Indicators

Short Term Milestones

Medium Term Milestones

Long Term Milestones

Outcomes

1. An identified resource whose responsibility spans across NHS Board boundaries will be established to provide support and to facilitate the sharing of experience and expertise between the Boards so that they can most effectively address the prevention and treatment and care needs of their populations.

NHS Boards

( HIV Executive Leads)

Health Protection Scotland

Scottish Government

NHS Health Scotland

Regional Support Facilitation Teams established

Guidance on Regional HIV Facilitation Teams issued by Scottish Government by January 2010.

Regional HIV Facilitation Teams recruited by July 2010.

Regional clinical and public health leads identified by July 2010.

Regional HIV Facilitation Teams steering groups established and first meeting to have taken place by August 2010.

Actions one two and three will, by improving the co-ordination and effectiveness of monitoring prevention activities, by ensuring statutory and voluntary agency working and by providing a supportive sharing mechanism for the Boards ensure that Prevention, Diagnosis, Treatment and Care service provision for HIV infected persons and those at high-risk of acquiring infection throughout Scotland are optimal and equitable.

2. Standards for HIV Prevention, Diagnosis, Treatment and Care, as part of the NHSQIS Implementation & Improvement Programme for HIV, will be developed and implemented.

Quality Improvement Scotland.

National organisations

identified in this HIV Action Plan.

Regional HIV Facilitation Teams

NHSQIS Standards for HIV Prevention, Diagnosis, Treatment and Care

Draft standards to be developed and distributed by October 2010

Standards developed and published by March 2011.

3. A generic patient management system ( PMS) involving Scotland's principal HIV Treatment Centres will be investigated and, if appropriate, developed and implemented.

NHS National Services Scotland ( NSS) National Information Systems Group

Scottish Government

Regional HIV Facilitation Teams

Generic PMS considered subject to agreed approval and funding

Outline business case developed and submitted to e-Health at Scottish Government by Dec 2010.

Subject to approval by e-Health, an outline business case then submitted to NSS.

Subject to approval and agreed funding, Patient Management System developed and implemented by December 2012 and implemented thereafter.

4. NHS Board plans to maintain and, improve prevention, diagnosis and treatment and care services and initiatives will be developed and implemented, using the information gathered from the regional needs assessment.

Regional clinical and public health leads

NHS Boards

NHS Health Scotland

The HIV voluntary sector as represented by Scotland's national umbrella HIV organisation, HIV Scotland

Indicators of undiagnosed infection and new transmissions.

Measures of ART uptake and effectiveness

Measures of non- ART treatment and care (to be decided).

Needs assessment and service mapping by HIV Executive Leads completed by January 2011.

Three year NHS Board plans drafted by June 2011 and finalised by Sept 2011.

Plans implemented during 2011-2014.

Actions four and five will enable NHS Boards to understand the resources and developments required to address the current inconsistencies in HIV prevention activities across Scotland and the needs of people living with HIV.

The implementation of these actions will promote effective prevention activities, the optimal treatment and care of people living with HIV, including children and young people, and will lead to a potential reduction in the cost of ART for NHS Boards.

5. The potential for the block purchasing of anti-retroviral therapy ( ART) to reduce cost will be assessed.

National Procurement.

NHS Boards (implementation)

An appreciable reduction in the cost of ART to NHS Boards

Assessment to be undertaken by Dec 2009.

Procurement by April 2010.

n/a

6. An investigation into the reasons why some people living with HIV do not attend specialist clinical services will be undertaken

NHS Health Scotland

Health Protection Scotland

NHS Boards

The HIV voluntary sector as represented by Scotland's national umbrella HIV organisation, HIV Scotland

The number of people with HIV who are not in contact with clinical or care services

Investigation completed and recommendations drafted by March 2011

NHS Boards with Regional HIV Facilitation Teams to agree recommendations by September 2011

NHS Boards with Regional HIV Facilitation Teams to implement recommendations by March 2012

The findings will determine how to attract and retain in specialist clinical care those individuals who do not currently access services.

7. Systems to monitor risk behaviours and new HIV infections among persons at highest risk of acquiring infection will be reviewed, and, if appropriate, developed and implemented.

Health Protection Scotland

MRC Social and Public Health Sciences Unit ( MRCSPHSU).

NHS Health Scotland

The HIV voluntary sector as represented by Scotland's national umbrella HIV organisation, HIV Scotland

Regional HIV Facilitation Teams satisfaction that sufficient information to inform decision-making is available

Review undertaken and completed by July 2010.

Development and implementation of systems by December 2011

n/a

This action will lead to an improved understanding of the epidemiology of HIV transmission and HIV related behaviour. These data will inform the planning of services and the development of guidance (See Actions 4 and 9-10).

8. The development and implementation of social marketing materials for MSM.

NHS Health Scotland

(development and evaluation)

NHS Boards

(implementation)

Scottish

Government

An increased awareness amongst MSM around HIV prevention, diagnosis and transmission.

The development of materials targeted at men who have sex with men by March 2010.

Implementation of materials targeted at men who have sex with men by May 2010.

Evaluation of these materials in 2011-14

These actions will result in increased awareness of existing and future evidence and guidance on prevention which will contribute to a reduction in the rate of new transmission of HIV among MSM and persons from areas of high prevalence, particularly African countries.

9. Existing guidance on prevention of HIV transmission in MSM will be tailored to national/local circumstances. New guidance on interventions to prevent and reduce HIV transmission in MSM will be developed, whilst also recognising the needs of people living with HIV in preventing onward transmission. Guidance will be implemented at a local and national level.

NHS Health Scotland (review and contribution)

NHS Boards (implementation)

MRCSPHSU and academic institutions.

The HIV voluntary sector as represented by Scotland's national umbrella HIV organisation, HIV Scotland

An increase in access to interventions which are informed by best available evidence as reducing levels of HIV transmission among MSM.

Review of and contribution to guidance by Dec 2010

Guidance to be implemented during 2011-2014

Further review of evidence in 2014.

These actions will result in increased awareness of existing and future evidence and guidance on prevention which will contribute to a reduction in the rate of new transmission of HIV among MSM and persons from areas of high prevalence, particularly African countries.

10. Existing guidance on prevention of HIV transmission in persons originating from areas of high prevalence, particularly African countries, will be tailored to national/local circumstances. New guidance on interventions to prevent and reduce HIV transmission in persons originating from areas of high prevalence, particularly African countries will be developed, whilst also recognising the needs of people living with HIV in preventing onward transmission. Guidance will be implemented at a local and national level.

NHS Health Scotland (advice on contribution)

NHS Boards (implementation)

MRCSPHSU and academic institutions.

African health projects in voluntary sector.

An increase in access to interventions which are informed by best available evidence as reducing levels of HIV transmission among persons originating from areas high prevalence, particularly African countries.

Review of and contribution to guidance by Dec 2010.

Guidance to be implemented during 2011-2014

Further review of evidence in 2014.

These actions will result in increased awareness of existing and future evidence and guidance on prevention which will contribute to a reduction in the rate of new transmission of HIV among MSM and persons from areas of high prevalence, particularly African countries.

11. An exploration of the educational and training needs of the HIV related workforce will be undertaken. Priorities will be identified and educational solutions developed and implemented.

NHS Education Scotland (development of educational solutions)

NHS Boards (Implementation of solutions)

n/a

Increased knowledge and its application in the HIV-related workforce, including Primary Care, in preventing and reducing transmission of HIV.

An identification of workforce, education and training needs based on a client/patient centred approach by October 2010.

Development of educational solutions by March 2012, subject to funding and solutions determined.

The uptake and monitoring of education and training priorities for the HIV workforce. From March 2012 subject to funding and solutions determined.

This action will lead to the HIV-related workforce, including those working in Primary Care and other non-specialist services, being more informed about current HIV knowledge and skills.

12. Scottish Government will commission an evaluation of BBV prevention services in Scotland

Scottish Government (Commission)

NHS Health Scotland (Evaluation)

NHS Boards

Health Protection Scotland

Identification of core BBV prevention activities

Investigation completed and recommendations drafted by March 2010

Final report signed off by NHS Boards by June 2010

NHS Boards with Regional Support Facilitators to implement recommendations by March 2011

Improved budgetary accountability will lead to a more efficient use of funding.

13. Scottish Government will review the existing BBV Prevention budget spend and produce guidance on the recommended future spend of the BBV Prevention budgets. NHS Boards will provide information on current and proposed future annual spend of the BBV Prevention budget against local priorities as informed by the regional needs assessment (Action 4) the outcomes of Action 12 and Scottish Government guidance.

Scottish Government ( BBV prevention budget review and guidance)

NHS Boards

(Current and future spend)

HIV Executive Leads of NHS Boards

Monitoring of the BBV prevention and diagnosis budget spend in line with Scottish Government guidance.

Detailed BBV prevention budget report for 2009/2010 by May 2010.

BBV prevention budget reports reviewed by September 2010.

Guidance will be issued to NHS Boards by December 2010.

Report on previous year's spend by May of each year.

Report on proposed future spend by January of each year.

Improved budgetary accountability will lead to a more efficient use of BBV Prevention funding

14. The HIV Action Plan will be delivered using a Programme Management approach, supporting those involved, notably the Regional HIV Facilitation Teams. The Scottish Government, NHS Board HIV Executive Leads, the Regional HIV Facilitation Teams and specified national agencies are responsible for delivering identified actions.

Health Protection Scotland

Organisations and networks which have lead responsibility for the delivery of actions.

Project management delivery of HIV Action Plan.

Performance management approach defined by February 2010 and process agreed by April 2010.

Establishment of APGB by April 2014.

Implementation of Performance Management approach from Dec 09-March 2012.

Accountability structures will ensure the actions are delivered efficiently, effectively and to timescale.