London specialist HIV clinic under threat

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Europe’s only HIV rehabilitation clinic, based in London, is under threat of closure because of a substantial drop in NHS referrals.

The Christian-run Mildmay clinic, in Shoreditch, East London, is Europe’s only HIV centre for those with HIV-related neurocognitive impairment or complex physical rehabilitation needs.

Due to a drop in the number of patients being referred, the clinic has closed one of its two wards, reducing the number of beds from 16 to seven.

This year, 20 referrals were made in May and 19 were made in June. In contrast, May 2010 saw 33 referrals and June 2010 saw 32.

There are now fears that the centre may have to close completely.

Fi McLachlan, chief executive of Mildmay, said the drop in referrals could not be ascribed to a lack in the number of HIV patients needing the intensive support the clinic offers.

She said: “The current situation we face has happened very suddenly and is certainly not down to a lack of need.

“The ongoing reorganisation and financial strain within the NHS has caused uncertainty which has led to a downturn in referrals.

“As the reforms to the NHS begin to take shape, the effects are being felt across the healthcare sector. With services like ours this impacts on very vulnerable people.”

She added that the clinic saves a “substantial” amount of taxpayers’ money – up to £30,000 for one patient in a year.

As many as one in five patients with HIV have some degree of HIV-related neurocognitive impairment. This can lead to problems with speaking, walking and basic self-care. Mildmay Clinic helps patients regain some skills for more independence.

Dr Simon Rackstraw, medical director at Mildmay, said: “Doctors and nurses with patients living with HIV know our service is there and that there is a need for it.

“As a result of our specialist rehabilitation programme almost half of our patients are able to return to independent living, many of the others return to a good quality of life.

“Without Mildmay, many of these patients would remain in residential care for the rest of their lives. This is particularly significant given the extended life expectancy of people living with HIV.”

A Department of Health spokesperson said it was up to primary care trusts how HIV patients with complex needs should be treated and did not say whether the Mildmay clinic would remain open.

A statement given to Gaydar Radio said: “Effective treatment has transformed for the good the outlook for people diagnosed with HIV. HIV remains a complex illness and there will be a small minority who require more specialised or hospital in-patient treatment. It is for primary care trusts to decide how they meet these complex needs either by referral to specialist NHS providers or voluntary sector providers like Mildmay.”