FRONTLINE HIV Forum Meeting March 2010

FRONTLINE HIV Forum Meetings:

Members: General Members Forum held at The Kobler Clinic, 4th Floor
Date: 2nd March 2010
Time: 6:00pm – 8:00pm

Attendees: 9
Apologies: 3

• COMMUNITY NURSING

Shaun Watson, Community nurse specialist for people living with HIV within Hammersmith and Fulham Primary Care Trust, informed the forum of his work in the community providing education, assistance, and support for people with complex needs, of whom approximately 10% were HIV, and how he acted as liaison on their behalf with General Practitioners, Dentists, to establish their primary care. He also provides nursing assessments, referrals to other organisations such as The Alzheimer’s Society, Help the Aged, Supporting People, all with whom he works closely, and helps support the families of those affected. As clients have serious needs he also works closely with Social Services so that they may assess them and establish a support plan. In this way help with shopping, attending appointments, and adherence with taking medication, can all be facilitated.
Shaun has been involved with clients who have drug and alcohol problems and has set up, and wishes to set up clinics and opportunities for training with these problems within Hammersmith and Fulham.
Any source can refer to Shaun although it is more expedient if the referral comes through the Hammersmith and Fulham Trust, a hospital, or a GP, as information would already be on record. Shaun runs a clinic from River House on Wednesday afternoon in which he highlights issues of adherence with clients helping them to stay healthier and reduce their hospital visits.
The forum was concerned to find out that Shaun estimates the average age of his clients to be 38. With advances in science and an ageing cohort of HIV people it would seem that community nursing is a service that is definitely required now and in the future. There seems to be commitment for future funding in Hammersmith and Fulham with next years funding agreement almost guaranteed, but not yet signed off.

• MODEL OF CARE

DR. Anton Pozniak, Service Director for HIV Services, gave a talk to the forum on the new model of care which is required to rationalise costs by ten percent across all services, including HIV. Dr. Pozniak told of how, over the years, consultants had learned that healthier patients do not require blood tests taken every time they attend clinic, but only when needed. In diluting the frequency of blood tests it is hoped to make considerable financial savings, without cutting care. A similar model with phlebotomy has been up and running for some time at the Mortimer Market clinic. However, he stated that any patient who insists could have blood tests taken should they wish. It is intended that frequent blood testing would continue with patients with complex needs, and/or with high viral load counts, and/or with low CD 4 counts.
For healthier patients it is proposed to have an annual visit with a nurse, around the date of their birthday, to test viral load, CD4, sexual health screen, and to arrange for bone density scans for patients over fifty years of age, and to deal with any other needs.
It is hoped that some sort of system of virtual clinic could be established where patients could get their results by modern means of communication, say through text, skype, or video for example. The clinics, possibly, would like to send results of annual test of case managed patients to their GP’s to keep them updated and informed.
This document details the discussions held by the Frontline Forum members at the last meeting. They are not complete minutes, more notes or points loosely captured in no particular order; apologies for points missed. Many thanks go to those who participated, and well as to those who continue to contribute through the online forum.
Concern was raised that less consultation would lead to a loss of consultant to patient relationship, and that in future it would be noticed that money was being spent on a smaller cohort of patients, which could possibly lead to a diminished service.
Dr Pozniak assured the forum that there would be no cut in care for patients. Research would continue with patients with complex needs. There is no reduction in finances for the new ward. The pharmacy would have a years worth of HIV prescription drugs for every patient which they could pick up should they wish.

The work in establishing a patient representative is ongoing.

Ageing Project:

A meeting of the ageing project team is necessary to coordinate the process of paperwork and to make ready the presentation to the ethics committee.

Suggestions are welcome from patients on how to save money. It was proposed that some way to get gather ideas should be facilitated through posters, questionnaires, forms in clinic, and a web form on an e-mail address.

Someone from the forum should attend the forthcoming meetings with the hospital about patient care.
The Mortimer Market Clinic should be invited to advise on how they are proceeding with their model of phlebotomy.

FRONTLINE HIV Forum wishes to thank Shaun Watson and Dr. Anton Pozniak for their care and time.

IT Course Web design: - Tuesdays 13th April from 2.30-4.30pm (Weekly for 8 weeks)
IT course Learn to touch type: - Thursday 8th April from 2.30-4.30pm (Weekly for 4 weeks)
Yoga and Relaxation (Katya): - Wednesday 31st March 3 - 5pm, 12th, 26th April and 10th May 2.30-4.30pm
Community Meetings: - Wednesday 31st March 1.30 – 2.30pm These will now be every 6 weeks eg following two meetings will be 19th May; 30th June

Other Educational workshops at River House from March onwards:

HIV and Nutrition session: - Wednesday, 21st April 2.30pm - 4.30pm
Karen Percy, Specialist Dietitian
Chelsea and Westminster Hospital

Stigma, Discrimination and the Press: - Wednesday, 12th May 2.30pm - 4.30pm
Maurice Hebert National AIDS Trust

Drugs/alcohol and sexual health: - Wednesday, 26th May 2.30pm - 4.30pm
David Stuart - Substance Misuse Worker,
Antidote - Turning Point

Body image (including steroid use): - Wednesday, 16th June 2.30pm - 4.30pm
David Stuart - Substance Misuse Worker,
Antidote - Turning Point

Workshops coming up from April onwards:

The Food Chain’s Nutrition course: - Tuesdays 4th & 11th May 6.00 - 8.00pm in partnership with CARA:

Back to work course: - Introduction sessions days on Thursday 6th May and Friday 7th May 2.30 - 4.30pm, followed by sessions on Thursdays afternoon from 2.30-pm - 4.30pm for the next five weeks

Tai Chi with Alex: - Tuesday 11th May 11am -12.30pm (Weekly/ 12 weeks)

Living Well Positive Life Club: - Thursday 20th May 6.00 – 8.00pm (Weekly /6 weeks)