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LPC 'hopeful' for HIV testing service after successful pilot

Pharmacies in Cumbria have conducted 30 HIV finger-prick tests since the pilot began
Pharmacies in Cumbria have conducted 30 HIV finger-prick tests since the pilot began

Cumbria local pharmaceutical committee (LPC) is "hopeful" it will be commissioned to deliver an HIV testing service after a successful pilot.

Sixteen pharmacies across Cumbria have already delivered 30 free finger-prick HIV tests, with four more pharmacies looking to join the pilot after they receive training, the LPC’s development manager Lynn McFarlane told C+D today (June 1).

The pilot is one of 13 HIV prevention projects that received a share of Public Health England's (PHE) £600,000 National HIV Prevention Innovation Fund. 

At the time of the pilot's launch, PHE said pharmacies in Cumbria with high testing rates would receive "sustained support through the local authority and local NHS provider", once the pilot ends in November 2018.

The "spread of 20 pharmacies" providing the service "may be adequate", Ms McFarlane said, but "we are hopeful" the service will be commissioned further once the pilot has ended.

Read more about the pilot below.

Interest from LPCs across the country

Pharmacist Mark Stakim of Dalston Pharmacy in Carlisle, Cumbria told C+D: "We’ve had enquiries from other social health bodies and LPCs from up and down the country asking us what the impact of the service has been."

His pharmacy has completed the most tests in the district – alongside one other pharmacy – with “five or six” so far, he said. However, “it's not been a service where people have been trampling the door down”.

Some of these patients were referred to the pharmacy by their social health service, Mr Stakim continued, as they wanted an "instant result".

Patients will travel to a pharmacy “a few miles away” from their homes “for the sake of anonymity”, Mr Stakim said. He stressed that it’s a "good service to offer" because "you get to see more people that you don't normally see".

Ms McFarlane explained that pharmacies receive £15 from PHE for each rapid test provided, whether the patient is reactive or not. PHE has budgeted for 1,000 tests.

Pharmacies record the results through PharmOutcomes, including the satisfaction of the user and the pharmacist, according to PHE.

How did the service come about?

In 2015, Cumbria was highlighted as an area of high risk of late diagnosis of HIV – two thirds of all HIV diagnoses in the area are late, PHE said at the time of the pilot's launch. There were two deaths in Cumbria in 2015 which could have been prevented by an earlier diagnosis, it stressed.

Non-profit lesbian, gay, bisexual and transgender group OutReach Cumbria is hosting the project with Cumbria LPC and Cumbria Partnership NHS Foundation Trust, with support from Cumbria County Council.

The project aims “to make HIV testing an everyday occurrence” in pharmacies, PHE said. The pharmacies rolling out the service are in areas with greater levels of high risk groups, it added.

Where are the pharmacies located?

Map credit: Cumbria LPC

Would you like to be commissioned to deliver an HIV test service?

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

I think the question should be 'How many pharmacists would be happy to provide this service?'. I for one would not. 

Charles Whitfield Bott, Pharmacist Director

A position born of ignorance I am afraid. Service is easy to do, well paid, and has great value to the patient.

Also you dont tell anyone that they have HIV nor do you council them. You inform them that the test was either reactive or none reactive. Neither outcome is definative, reactive tests will need a dired blood spot test done in a lab and follow up from sexual health services, and a none reactive test result has to be given with the warning that any recent infection will not be deteacted etc.

Thomas Wilde, Community pharmacist

I'm sorry but you really need to look at your uni notes again if you think you can catch HIV from doing a finger prick test on someone. Unless you are planning on rubbing their blood into any open bleeding wounds you have, there isn't any reason to have that sort of over-reaction, not to mention the fact that post-exposure prophylaxis medication is available readily. That sort of ignorance leading to turning down services to people with HIV is one of the reasons that people are afraid to get tested.

Ben Merriman, Community pharmacist

Why not? 

Reasons for:

The sooner a diagnosis is made, the better the prognosis for the patient.

Service allows complete anonymity as any pharmacy can be used - you can travel out of town if so desired.

Just one positive test will mean the entire service will be in the black due to the earlier diagnosis.

Yet another service community pharmacy can offer.

Test is easy to perform - simple finger prick test with addition of a couple of solutions.  No more tricky or risky than calibrating a blood glucose meter.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Two reasons - see the other post for reason one. Reason two - I'm not a trained counsellor and have no desire to be one - how do you tell someone they have HIV??

Andy Burrells, Community pharmacist

Just to play devils advocate though...

Pharm is running busy pharmacy and stressed. Questioning his life and decisions and the area management telling pharm they need more MURs and they're losing yet more staff and cutting salaries to £16.50 an hour.

Person comes in, asks for test, accident happens due to absent mindedness then cross infection occurs. How does pharm go home to household and tell partner they're now at risk of HIV? Possibly have it? What strain would that put on their home life? All the time the big green sign above the door says they weren't following SOP's so are at fault and won't offer any financial or medical support

I know it's a bit far fetched but this is pharmacy, the land of the far fetched...

Just not worth it in my opinion.

Ilove Pharmacy, Non Pharmacist Branch Manager

Hitting the targets that multiples will no doubt conjure up should be fun. Poor  Pharmacists will have to start seeking out smack heads and flyering brothels to avoid disciplinaries.

Ben Merriman, Community pharmacist

How would cross infection occur if single use, retractable lancet is used?  Does everyone ask for the presence of blood borne diseases before doing a blood glucose check or gcholesterol check as part of a health check?  

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