15th Annual Conference of the British HIV Association 1-3 April 2009, Liverpool, UK

MEETING THE CHALLENGE: SEEING ALL NEW DIAGNOSES WITHIN 2 WEEKS?

HIV Med 2009 Apr 1-3 (Suppl 1);15:18 (abstract no. P12)

E Draeger and H Noble
Newham University Hospital, London, UK

BACKGROUND: BHIVA standards for HIV care were released in 2007. Patients should be offered assessment by a doctor who provides HIV care within 2 weeks of diagnosis. In our clinic, time to next available routine appointment exceeds 6 weeks for all doctors. In late 2007 our clinic began to ring-fence a total of nine new patient slots per month spread between 2.5 doctors working in 33 outpatient clinics per month. In addition intervals between routine appointments for stable patients were lengthened from 3 months to 4 or 6 months. Retrospective notes review.

METHODS: Time to first appointment was compared for new patients presenting to the clinic from January–August 2007 and January–August 2008. Data were analyzed using an Excel database.

RESULTS: 153 new patients in that time, 123 sets of notes reviewed – 89 new diagnoses (52 in 2007, 37 in 2008), 31 transfers of care (13 in 2007, 18 in 2008), three returners. In 2007 mean time between date given diagnosis and first offered doctor appointment was 16 days. 57.7% were offered in 2 weeks, 82.7% in 4 weeks, 94.2% in 6 weeks. In 2008 mean time was 25 days. 32.4% were offered in 2 weeks, 54% in 4 weeks, 83.8% in 6 weeks. Those with CD4 count less than 200 were offered appointments sooner – in 2007 79.2% within 2 weeks and in 2008 53.8% within 2 weeks. The DNA rate was low – only 8.3% of the initial appointments offered were not attended.

CONCLUSIONS: Time to first offered appointment has lengthened despite interventions designed to reduce it. Between January and August 2008 a mean of 10 new patients a month presented to the clinic and overall our clinic numbers are increasing. In order to achieve the BHIVA standard more new patient appointments need to be created at our clinic. Further interventions such as a nurse-led stable patient clinic are being implemented but considerable innovation will be required to meet the target.

2009-04-01
P12

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