11 October 2012
Doctors need to share medical information about patients with HIV but not about those with other STIs (sexually transmitted infections), the Department of Health has been told.
In a written response to the DH’s consultation on STI regulations, sexual health doctors say they should be amended but not repealed.
The DH is reviewing a wide range of secondary legislation in light of the Health and Social Care Act. Rather than just updating all related secondary legislation to reflect new organisational structures, it is examining regulations and directions to see if they need radical updating or repeal.
The National Health Service (Venereal Diseases) Regulations 1974 and the NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases) Directions 2000 stipulate that health authorities must not disclose any information that could identify a patient being treated for sexually transmitted diseases, unless it is necessary to communicate with a medical practitioner who is treating the disease or to prevent the spread of the disease.
The CC dermatology and venereology subcommittee view is that there is a ‘sensitivity and embarrassment’ around sexual health that means many people do not want information to be shared with their GP. This makes it vital that GUM (genito-urinary medicine) services maintain anonymity through separate patient systems and records, as the regulations and directions permit them to do.
The subcommittee considers there are two separate groups of patients that need separate considerations — those living with HIV, and GUM patients.
As HIV is a chronic life-long condition, people living with HIV will experience non-HIV related illnesses for which they will need to consult their GP. Some HIV-related illnesses and complications may require the input of several other specialists. It is therefore no longer practical for an HIV patient to be covered by the regulations and directions.
The medication used to treat HIV has interactions with a number of commonly prescribed drugs so for anyone providing medical care, knowledge of someone’s HIV status, and medication, is very important.
However the same issues do not apply to people attending GUM clinics, where most visits related to single distinct episodes of care where the problem is treated and resolved with no ongoing health issues.
If the rules relating to this group of patients change there is a risk people would not obtain sexual health care, which could cause problems for the individual as well as risks for the whole community.
CC dermatology and venereology subcommittee chair Colm O’Mahony says in the response to the DH: ‘In summary, the VD [regulations are] a great hindrance to us in managing the long-term chronic condition of HIV but [are] of enormous value in allowing us to keep one-off sexually transmitted disease episodes like syphilis, gonorrhoea, chlamydia, warts, herpes, etc, out of general hospital case notes.’