Promoting collaboration between the NHS, public health authorities and voluntary organisations is the final pillar of the action plan
The fifth and final pillar of the action plan acknowledges the need for collaboration to achieve its goals. ‘Ending new HIV transmissions by 2030 will only be possible through strengthened and co-ordinated collaboration at every level of the health and care system,’ it says.
It points to the need to join up efforts between NHS services, local government public health, voluntary and community organisations and national agencies.
The plan also puts a strong emphasis on local collaboration, as a standardised national approach is ‘not sufficient’ to tackle HIV effectively.
‘Local leaders must be empowered to work together across boundaries to design place-based solutions, while national bodies support with data, a strategic direction of travel, and clarity on organisational roles and responsibilities,’ it says. ‘Together we can deliver tailored solutions that make a real difference.’
The action plan calls for local needs assessments to be conducted in the 2026 financial year to deliver targeted, joined-up care for populations in the area.
Key takeaways for ICBs
- Local assessments will inform HIV plans, which should take into account local needs but ‘align with national objectives’
- Multi-agency local groups will form part of the drive to provide more joined-up care
Local needs assessments
Under the plan, local public health directors are charged with carrying out a comprehensive HIV needs assessment in conjunction with local partners, using ‘existing data tools and engaging with communities to identify service gaps and priorities’.
The findings will be used to create local HIV plans across the country, which should ‘align with national objectives and reflect local population needs’.
The large variations in local needs are hammered home by voluntary organisations. At least 40% of people living with HIV are in London, says Fast Track Cities London co-chair Professor Jane Anderson, meaning the capital often informs initiatives elsewhere in the country.
High-prevalence areas will naturally have a stronger focus on HIV prevention, testing and treatment. However, BHIVA chair Tristan Barber says it is nonetheless important to increase efforts in areas with lower HIV prevalence, to tackle the ‘final mile problem’ in terms of geography.
‘We have good streams of work going on in places such as London, Manchester and Brighton, but we need HIV on the radar in areas where historically there has been a lower prevalence,’ he says. ‘There, those undiagnosed numbers are going up.’
Joined-up care
Providing a joined-up approach to care across the system is a key goal of the HIV Action Plan. It calls for co-ordination of HIV efforts across local areas through the establishment or strengthening of a multi-agency group during the 2026 financial year.
West and North London ICB is one of the pioneers on this front. It has established a Joint London Sexual Health and HIV Board with local authority colleagues and third sector partners, says ICB chair Mike Bell.
By forming these local pools of knowledge, lessons can be more easily shared across the country, points out Professor Anderson of Fast Track Cities London. ‘At Fast Track Cities, we have a place where all the cities come together – we meet online every two or three months and have a national get together every year. It means we can look at what each city is doing.’
Professor Anderson also envisages a more joined-up care pathway for HIV – from the testing phase to the provision of care. ‘I see the HIV test as a gateway. You turn right if you’re positive to receive treatment and left if you’re negative with a set of interventions to keep you that way. For example, if everyone who had a negative test had info about PrEP, the information would get out immediately.’
Such a system would require strong collaboration between primary and secondary care, which was one of the key tenets of the North Central London HIV GP Champions pilot, funded by Fast Track Cities London.
‘As part of the pilot, GPs worked in partnership with hospital consultants and the voluntary sector,’ says Professor Anderson. ‘It showed the benefits of a whole system approach. You need to make sure all the players are doing their bit, and they must be supported to do it together.’
That collaborative model is welcomed in principle by the RCGP. ‘While specialist services will continue to lead on HIV care, there is scope for closer working between general practice and specialist services in the community to support people living with HIV,’ says RCGP president Professor Victoria Tzortziou Brown.
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