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Tenders for sexual health contracts could leave HIV services 'unviable'

Plans to put sexual health services out to competitive tender could make it “unviable” for some NHS trusts to continue offering HIV treatment and care, the Department of Health has warned.

NHS deputy chief executive David Flory wrote to primary care trust clusters yesterday seeking details of any plans to run competitions for the contracts to provide sexual health services offered in genito-urinary medicine (GUM) clinics.

He warned that the way some of these competitions are structured may mean affected trusts will “no longer find it viable to continue to provide HIV treatment services”.

The letter explains that since the 1980s many HIV services have shared staff, premises and facilities with GUM clinics, and in “many areas HIV treatment and care is dependent on the wider infrastructure provided by GUM”.

However, under the government’s NHS reforms responsibility for these two areas of healthcare is to be split between different commissioning bodies. From April 2013 the NHS Commissioning Board will be responsible for commissioning HIV treatment, while local authorities will commission sexual health and GUM services, and HIV prevention and testing.

Meanwhile, a number of NHS commissioners have already put their local GUM contracts out to tender, or plan to do so, the letter explains.

“Because of the forthcoming changes in commissioning responsibility it appears that some of the [contract] specifications exclude the provision of HIV treatment services,” it continues.

That means that if the contract is won by a new provider “the NHS trusts that previously provided joint GUM and HIV treatment services may no longer find it viable to continue to provide HIV treatment services independently from GUM”.

This in turn could have “implications for HIV patients with their services transferred to a new provider”.

The letter adds: “As part of the process of transition to new systems and ways of working it is important that we work together to minimise the risk of action being taken that may have unintended consequences.”

It states that the department’s priority is to “ensure a smooth transition to the new commissioning arrangements” avoiding “fragmentation” and continuing to provide “high quality services for all patients”.  

Readers' comments (1)

  • This separation of responsibilities is a direct consequence of the legislation, policy framework and organisation restructure. To feign surprise of the emerging collateral damage at this stage is deeply disingenuos.

    Perhaps it would be more useful if Mr Flory could offer some advice to commissioners on the issue of

    "How do we avoid a reference to the Competion and Collaboration Commission for including in our specification for GUM services requirements to provide HIV services which are outside our sphere authority and which have the effect of prefering the existing NHS provider"

    Unsuitable or offensive?

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