HIV SERVICES DURING COVID: THE EXPERIENCE OF TWO TEAMS

The Community Specialist Service

This service delivers care to the most vulnerable and complex HIV patients here in Brighton & Hove and West Sussex. These are a group who often struggle to engage with services, and have many psychological and sociological issues to deal with.

When Covid first hit hard and during the first lockdown, 75% of the nursing workforce was redeployed, leaving a depleted team, forcing those left behind to work in a different way. Prioritising workload became crucial and significantly reducing face-to-face visits and increasing virtual working was introduced.

Over the past year the team has built back its capacity, ensuring highquality care is delivered to this complex and vulnerable group of patients in their homes. Covid has taken its toll and staff are tired and exhausted.

This last year has also left its mark on our patients and we have seen an increase in mental health issues, drug and alcohol problems and deterioration in physical health.

In terms of future approaches when dealing with patients with complex issues, virtual working cannot replace face-to-face visits, and the benefits and advantages of seeing our patients cannot be overstated. We gain so much more from a face-to-face visit as opposed to a phone call. Often our patients are isolated and lonely and we cannot underestimate the importance of human contact. Patients have described their community HIV specialist nurses as ‘lifelines’ throughout the pandemic.

The Lawson Unit

In March 2020, the majority of staff in the Lawson Unit were redeployed to inpatient areas to support the Covid response at Brighton and Sussex University Hospitals. We were able to keep a core team in the Lawson Unit to deliver essential care to people living with HIV.

We had two main goals during the initial and subsequent lockdowns – first, to ensure people with HIV had uninterrupted access to antiretroviral therapy and second, to be available for patients who needed urgent blood tests or who had pressing HIV medical problems. This meant that many face-to-face visits were replaced with telephone appointments and all joint/specialist clinics were postponed.

We were concerned by the mixed messages that people with HIV were receiving about shielding and worked with national organisations to ensure the correct information was communicated where this was possible.

Feedback from patients who contacted the clinic for advice on Covid was very positive. As a clinical team, we worked closely with our local NHS and voluntary sector partners to provide additional support for patients who were particularly vulnerable during Covid.

The whole experience has taught us how quickly we can adapt services in a crisis. It has equally reinforced the need for the clinic to provide a menu of services, including face-to-face appointments alongside virtual options such as telephone, email and apps to respond to patients’ individual needs.