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Knowledge Hub

HIV services at risk because of fragmented system

What can be done to better co-ordinate treatment and care for those with HIV?

Human immunodeficiency virus (HIV) patient care in England is in danger of deteriorating because of the complex nature of the way care is provided, a report published by King’s Fund analysts has argued.

Since the Health and Social Care Act 2012 HIV services are provided by a combination of NHS England, clinical commissioning groups and local councils. This will make it more difficult to deliver effective care as demand rises in the future.

As the number of older people with HIV increases the health and social care system must be co-ordinated to keep up with their rapidly changing needs.

The King’s Fund analysts said although the negative impact of fragmentation has not yet become evident, HIV services are now at a transition point.


  • The King’s Fund thinks decision makers across the health system must work together with HIV experts to maintain world-class HIV treatment and prevention. Is that happening in the areas you know? What would have to change to ensure that it does?
  • How could prescribing, the use of medicines and patient outcomes be improved by changes in the way HIV care is delivered?

Further information

BMJ: HIV services at risk from fragmentation, report warns

King’s Fund: The future of HIV services in England