FRONTLINE HIV Forum Meeting 4th August 2009

FRONTLINE HIV Forum Meetings:

Members: General Members Forum
Date: 4th August 2009
Time: 6:00pm – 8:00pm

Attendees: 9
Apologies: 2

The meeting on Tuesday 4th August 2009 was held at the new Soho Health Centre at 56 Dean Street, London W.1. In addition to the members of the FRONTLINE Forum, the meeting was also attended by Dr Simon Barton, Clinical Director, Kobler Clinic, and Dr
Jake Dunning. Registrar, Thomas Macaulay Ward, Chelsea & Westminster Hospital.

Dr Simon Barton gave a talk on Payment By Results, a new initiative by the Department of
Health (DOH), which will aim to categorise patients according to the level of clinical care
required. At the present time the Trust receives an agreed payment from the DOH for each patient seen
at a GUM (Genito Urinary Medicine) Clinic, and subsequent reduced payments for follow up
visits. With the new system, currently being undertaken at clinics, a Survey of Prevalent HIV
Diagnosed Infections (SOPHID) will attempt to categorise all patients on a floating system (i.e.:
a patient may move from one category to another depending on the level of treatment/care
currently being required).

The three categories are:

• Category 1 – First Year of Diagnosis or started HAART within the last 12 months.
• Category 2 – Monitoring and care of patients not on HAART or on HAART for more than 12
  months (approx. 80% of attendees currently fall into this category and require 2-6 appointments
  per year).
• Category 3 - Highly Complex Patients – Patients with Co-infections and other complex
  conditions (care will require generally more than 6 and up to 12 or more appointments per year).

A question was raised by a member of the Forum as to the anonymity of patients on the survey.
It has been subsequently established following the meeting that only the first part of the UK
postcode will be required, and not the whole postcode, therefore protecting anonymity.
The aim of this survey is to establish the approximate number of patients in each HIV Centre in
each category to appropriate money on the needs and requirements of the patient cohort.

A presentation was given on Swine Flu by Dr Jake Dunning who is currently on a PhD Research Study on Influenza and has been working as a Registrar within the Thomas Macaulay Ward at the Chelsea & Westminster Hospital. It would appear on present data that the first wave of the pandemic, as being seen at the present time, shows a mild disease (people that have died to date appear to have had underlying health problems). The second wave is anticipated to arrive in the Northern Hemisphere in the autumn and current indications are that despite it not having an aggressive gene, it is more contagious than initially thought.
Despite early concerns, it would appear that there have been no additional risks for HIV individuals over the general population although concern has arisen for those patients with a CD4 count of less than 100, and also for those with chest/pulmonary issues.
With Tamiflu being identified as the most effective treatment for the condition, concern was expressed as to the interaction between Tamiflu and HAART medication. At the present time it would appear that there are no interactions, although further investigation is being undertaken.
Stricter contingency plans are being considered should the pandemic develop and the Health Authorities have various plans that will be implemented as and when the conditions require, particularly concerning hospitals and hospital resources.
Any HIV patients who are concerned as to their status and interaction with medications are being urged to consult their HIV Clinician, and extra caution is being given to those HIV individuals who are within one of the following categories: renal issues/diabetes/smokers/asthma sufferers/ and chronically obese.
Dr. Dunning has agreed to attend further meetings of the Forum with updates and further advice/information as and when required.
Please see the current advice that follows these meeting notes.

• THT Health Trainers – This issue is still under review.
• Councillor Antony Lillis, Hammersmith & Fulham. It was with regret that the Forum learned
  of the untimely death of Councillor Lillis who has, over the years, been a great supporter of
  HIV/AIDS issues within the Borough, and was influential in securing and protecting HIV funding.
  In the past couple of years, Councillor Lillis was Chair of the Board of Trustees at the River
  House, a HIV drop in centre in Hammersmith, and was highly active in long term plans and
  strategies for the development of the Centre at a time when so many other HIV support centres
  have been closed due to lack of funding. The Forum extends its thoughts to the immediate
  family and wishes to note Antony’s work over the years for the HIV community.

G.P. walk in plans for the Kobler Centre – this issue is still being discussed within the Trust
and HIV Directorate and updates will be given as and when known.

• Steering Group re Charity Status – Plans for the Frontline Forum to become a Registered
  Charity is still under investigation.
• HIV & Ageing – the survey instrument is in the final stage of completion and all necessary
  documentation has been completed for submission to the Ethics Committee at the Trust. It is
  anticipated that this will occur within the September/October timeframe and once approved, the
  Pilot Survey (50 patients being interviewed/surveyed) will be undertaken, hopefully by the end
  of 2009.