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Take a look at a selection of our recent media coverage:

New report calls for priority investment in NHS staff mental health and wellbeing

11th December 2023

A new report from the British Psychological Society (BPS) is urging the Government to commit to further long-term funding for NHS staff mental health and wellbeing services, calling it ‘fundamental‘ for workforce retention, the delivery of the NHS Long Term Workforce Plan, and protecting patient care.

The BPS ‘Learning from the NHS Staff Mental Health and Wellbeing Hubs‘ report highlights the need for standards for staff mental health provision, amid concerns that staff struggling with their mental health could face a postcode lottery to access the support they need from a dwindling number of NHS Staff Mental Health and Wellbeing Hubs.

Set up in February 2021 to provide health and social care staff with rapid access to mental health support, ring-fenced Government funding for NHS Staff Mental Health and Wellbeing Hubs ended in March 2023, with integrated care systems (ICSs) either identifying short-term interim funding for their Hub for a defined period of time, or closing them.

The report highlights a data analysis from the Nuffield Trust showing six million sick days recorded for NHS staff due to anxiety, stress, depression and other psychiatric illnesses in 2022, with sickness absence associated with a higher likelihood of staff leaving the NHS.

And the same Nuffield analysis revealed that a consultant missing three days of work for mental health reasons is 58% more likely to leave three months later.

Further figures outlined in the BPS report showed demand for NHS Staff Mental Health and Wellbeing services is increasing.

Data from one hub recorded 404 people registering for one-to-one support between July 2023 and September 2023 – a 65% increase on the same period in the previous year during which 245 referrals were made – with one in five of those accessing one-to-one support identified as senior leaders.

BPS says its report aims to support health and care leaders make ‘crucial decisions‘ about future investment in local mental health and wellbeing services for their teams.

It cites evidence of the cost benefits for investment in mental health and wellbeing that shows an investment of £80 per member of staff in mental health support can achieve net gains of £855 a year through savings from absenteeism and presenteeism.

Noting ‘more than 121,000 unfilled jobs across the NHS in England today‘, Saffron Cordery, deputy chief executive of NHS Providers, said: ‘Heavy workloads and huge pressure on stretched services are leading to lots of staff feeling worn out. The effects of financial pressures on trusts and the cost of living crisis on staff amid the longest period of industrial action in the history of the NHS’ history have compounded problems of high staff turnover.‘

As a result, the report makes a series of recommendations, including that:

  • ICSs provide long-term, ring-fenced funding for evidence-based, psychologically-led staff mental health and wellbeing services, complemented by further ring-fenced funding from the Department of Health and Social Care
  • NHS England develop national service standards for psychologically informed staff mental health wellbeing provision, including impact and evaluation measures
  • ICSs evolve and build upon existing NHS Staff Mental Health and Wellbeing Hubs infrastructure to support system-wide priorities and requirements.

Dr Roman Raczka, president-elect of the BPS, said: ‘The ambitious measures set out in the NHS Long Term Workforce Plan are not a quick fix.

‘Existing and future staff members deserve to work in an environment that gives them the support they need, to provide the safe, high-quality care they as health and care professionals are proud to give.

‘Put simply, NHS and social care employers cannot afford to ignore the mental health needs of their workforce, if they wish to create a system that’s fit for the future.‘

UK Government to lay legislation on physician and anaesthesia associates this week

The UK Government will lay legislation this week to allow the General Medical Council (GMC) to begin the process of regulating physician associates (PAs) and anaesthesia associates (AAs).

The legislation will be laid before Parliament via affirmative statutory instruments on Wednesday and the regulations are expected to come into force at the end of 2024.

The GMC will set standards of practice, education and training, and operate fitness to practice procedures, ensuring that PAs and AAs ‘have the same levels of regulatory oversight and accountability as doctors and other regulated healthcare professionals’, the Government said.

The legislation follows a consultation which had also suggested PAs could get prescribing rights in order to relieve pressure on doctors and services.

However, the BMA raised concerns about the legislation saying it thinks this ‘will add further, dangerous confusion’ with patients being left under the impression that they have seen a doctor when they haven’t.

‘The blurring of this distinction between doctors and non-medically qualified professionals can, and has, led to fatal consequences,’ the BMA added.

The union asked doctors to write to their MP ahead of Wednesday‘s Parliament session, so that MPs are ‘aware of this issue, oppose the legislation in Parliament and force the Government to abandon its plans’.

Health and social care secretary Victoria Atkins said: ‘Physician associates and anaesthesia associates are already making a great contribution to the NHS, supporting doctors to provide faster high quality care for patients.

‘This new legislation paves the way for these professionals to be held to the same strict standards as doctors, boosting patient safety.

‘This is part of our Long Term Workforce Plan to reform the NHS to ensure it has a workforce fit for the future.’

GMC chief executive Charlie Massey said: ‘This is a welcome and significant milestone towards bringing physician associates and anaesthesia associates into regulation.

‘We’re pleased to support the development of these valuable professionals recognising the important role they play in the medical workforce. Regulation will help increase the contribution PAs and AAs can make to UK healthcare while keeping patients safe.

‘We are working hard to design and deliver detailed regulatory processes for registration, education, standards and fitness to practise for both professions.’

Most statutory instruments (SIs) subject to the affirmative procedure are laid in the form of a draft SI and are considered by the Joint Committee on Statutory Instruments (JCSI).

Next, the SI will be automatically referred to a Delegated Legislation Committee (DLC). These committees have 16-18 members. Any MP can attend and speak but only members of the DLC can vote.

A DLC considers an SI but does not have the power to stop it. In some rare cases, the SI is not referred to a committee, but is debated in the Commons Chamber if it is of particular interest.

Once the SI has been debated by a committee, it needs final approval by the Commons before being ‘made’ (signed by the minister) and becoming law.

Health Education England (HEE) and NHS England recently warned the BMA that its stance on medical associate professionals (MAPs) is impacting NHS relationships and patient confidence.

HEE has published an open letter to the BMA in response to the union’s call to halt recruitment of MAPs until regulation is in place.

At its recent Symposium, the GMC also called on doctors to show ‘multi-disciplinary respect’ towards healthcare professional colleagues who are not doctors.

A version of this article was originally published by our sister publication Pulse.

Undertreatment of women with heart disease increases risk of serious preventable outcomes

Women who are diagnosed with heart issues are consistently undertreated, leading to preventable heart attacks, strokes and death, according to a new study.

Researchers found that although men had a higher chance of developing heart disease over their lifetime, when heart disease was detected in either sex, women were up to 50% less likely to be treated with preventative medicine compared to men.

The study examined the heart health of approximately 24,000 people over a 25-year period to identify patterns in long-term health outcomes and how they differ between the sexes.

The findings are published in the European Journal of Preventive Cardiology and provide evidence of the need for sex-specific cardiovascular prevention strategies.

Cardiovascular disease is one of the leading causes of death and disability in the UK, Europe and worldwide, and accounts for significant healthcare spending.

Understanding how heart disease affects different populations, including different sexes, is essential in tailoring effective preventative care for individual patients.

Using data from The European Prospective Investigation into Cancer (EPIC)-Norfolk study, the researchers analysed a large population cohort over a very long follow-up period of over 25 years.

The EPIC-Norfolk study also records cardiovascular events, including myocardial infarction, stroke, peripheral artery disease, atrial fibrillation, heart failure and valve disease.

The analysis showed that men had a 49% greater risk of developing heart disease than women over their lifetime and a 43% higher risk of dying from a heart condition compared to women.

The age at which heart disease presented itself was found to be lower in men, with males typically presenting with a heart attack in their 50s. For women, cardiovascular disease would most likely present in their 60s in the form of a stroke or atrial fibrillation.

Despite women presenting later than men, the death rate from cardiovascular disease for women rose to the same level as men. Women were found to have diminishing sex advantage in survival once they developed heart disease.

The researchers believe that the rise in the mortality rate in women is explained by the different preventative treatments that men and women receive.

Dr Tiberiu Pana, honorary clinical research fellow at the University of Aberdeen, said: ‘This is the first study to delineate sex differences from the same population, over very long follow-up while controlling for factors such as lifestyle, socioeconomic status and history of cardiovascular disease.

‘Our analysis found that women were 30-50% less likely to be treated with preventative medicine compared to men.’

Dr Pana said the consistent undertreatment of women with heart or circulatory disorders is ‘worrying’.

She added: ‘Our findings highlight how it is important to consider how future prevention campaigns should focus differently on men and women.’

It is also possible that the menopause may influence outcomes for women, with hormonal changes eroding the early advantage that women have.

Dr Pana suggests that targeted preventative measures around the time of menopause in women may help prevent heart disease.

She said: ‘Everyone should consider minimising their risk factors for heart disease as early as possible in life, such as regularly monitoring their blood pressure, keeping a healthy weight and being physically active.

‘However, it is even more important that people be aware of the need to take preventative medicines after suffering a heart or circulatory disorder to minimise their risk of recurrence or death.’

A version of this article was originally published by our sister publication Nursing in Practice.

Extended provision of ‘highly effective’ PrEP for HIV backed by researchers

8th December 2023

HIV pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition but greater provision is needed to meet the ‘large unmet need’ and maximise the potential of a national programme, say researchers who led a large trial of its use in England.

Results from the largest real-world study of PrEP provided through 157 sexual health clinics across the country found the treatment reduced the chances of getting HIV by 86%.

Reporting the findings from more than 24,000 participants in the journal The Lancet HIV, the researchers said provision of PrEP considerably reduced HIV acquisition across several years of use.

The PrEP Impact Trial was led by the UK Health Security Agency (UKHSA) and Chelsea and Westminster Hospital NHS Foundation Trust and funded by NHS England in order to inform routine commissioning of the drug, which has been in place since October 2020.

Evidence from the trial now confirms its effectiveness in the ‘real world’ but concluded there would now need to be a ‘substantial expansion’ in access, beyond the level given in the trial, the researchers said

‘Urgent work is required to ensure equity of access for all who might benefit,’ they concluded.

The paper comes as the UK Government is looking at making PrEP available in settings other than specialist sexual health services, including GP practices, in order to meet the target of zero HIV transmissions by 2030.

A road map on measures to ensure equitable access is expected from the HIV Action Plan Implementation Steering Group by the end of this year.

Dr John Saunders, UKHSA deputy head of programme delivery and service improvement for STI and HIV Division, said: ‘This trial has further demonstrated the effectiveness of PrEP in preventing HIV transmission and has, for the first time, shown the protective effect reported by earlier trials, but at scale and delivered through routine sexual health services in England.

‘Now we know just how effective PrEP is in real-world settings, substantially reducing the chance of acquiring HIV. It’s vital that all those who can benefit from PrEP can access it. HIV testing and PrEP is available for free from sexual health services.’

John Stewart, national director for specialised commissioning at NHS England and co-chair of the PrEP Impact Trial Oversight Board, said: ‘Not only did the trial directly prevent many cases of HIV, help normalise the use of PrEP, remove stigma and pave the way for a routinely commissioned clinically and cost-effective PrEP service; but it also made a very real contribution towards our goal of ending new cases of HIV by 2030.’

Professor Kevin Fenton, the Government’s chief advisor on HIV and chair of HIV Action Plan Implementation Steering Group, said PrEP was a ‘powerful tool that reduces the risk of acquiring HIV’.

He added: ‘Expanding access to, and the uptake of, PrEP is key to our ambition to end HIV transmission in England by 2030, and a public health priority.’

Dr Ann Sullivan, chief investigator for the PrEP Impact Trial and consultant physician in infectious diseases and HIV at Chelsea and Westminster Hospital NHS Foundation Trust, said: ‘The PrEP Impact Trial has further demonstrated the effectiveness of PrEP in preventing HIV transmission and has provided key insights, including identifying subgroups where more work is needed to increase access to PrEP and prevent HIV transmissions.

‘It is reassuring that this research has further confirmed the protective effect of PrEP reported by earlier trials, when taken correctly and delivered through routine clinical services, which will continue to shape the delivery of HIV prevention across England.‘

Earlier this month, the UK’s Department of Health and Social Care announced it would expand a successful opt-out testing programme for HIV and other bloodborne viruses in emergency departments in England.

A version of this article was originally published by our sister publication Pulse.

Lower oxygen targets show benefit for critically ill children in intensive care

Reducing oxygen levels in critically ill children on mechanical ventilators in intensive care could save 50 lives each year, according to a new study by Great Ormond Street Hospital (GOSH) and University College London.

The Oxy-PICU study, published in The Lancet, is the largest randomised controlled trial ever conducted in paediatric intensive care units (PICUs).

The researchers recruited 2,040 children from 15 NHS PICUs across England and Scotland. Each of the children required a mechanical ventilator and extra oxygen on admission to the PICU.

The children, who ranged from newborn up to 16 years, were randomly allocated to one of two groups: they received oxygen to the standard target level of oxygen (saturation “SpO2” >94%), or a reduced oxygen target (SpO2 88-92%).

The researchers found that the children who received the lower level of oxygen were 6% more likely to have a better outcome, either in terms of survival or the number of days spent on machines supporting their organs.

In the UK, around 20,000 children are admitted to intensive care each year and roughly 75% will receive additional oxygen through a ventilator.

If the study were to be scaled up, the researchers anticipate that this approach could save 50 lives, free up 6,000 ICU bed days and save £20m annually in the UK alone.

Professor Mark Peters, consultant paediatric intensivist at GOSH, professor of paediatric intensive care at UCL Great Ormond St Institute of Child Health, and lead author on the study, said: ‘Giving the minimum safe dose of anything in intensive care appears to generate the best outcomes, so we wanted to test this approach with oxygen.

‘We found a small benefit of lower oxygen targets that is unlikely to have been due to chance. But because so many children are treated with oxygen, this has the potential to improve outcomes and reduce healthcare costs in the UK and around the world.

‘This could have particular implications in countries where oxygen is a scarce resource, or in situations as we have seen in recent years, where health needs change, and oxygen demand quickly peaks.’

Lauran O’Neill, senior critical care research nurse at GOSH, said: ‘This is a major milestone study, which was nurse-led, with research taking place at the bedside as part of normal clinical care. It’s a great example of a research-hospital vision as every child admitted to ICU was screened for inclusion into the study.

‘Although GOSH teams were managing the study and a major recruiter, undertaking the research process was part of the standard of care for many emergency teams across the country – so training and education was the focus. We had to work well together across all collaborating hospitals to deliver this huge success for our patients.’

The Oxy-PICU study also includes researchers from the Intensive Care National Audit & Research Centre and the Paediatric Critical Care Society Study Group.

It is funded by the National Institute for Health and Care Research (NIHR)’s Health Technology Assessment programme and supported by the NIHR’s Biomedical Research Centres at GOSH and UCLH.

Innovative ‘blood product powder’ may help prevent bleeds in complex cardiac operations

A new type of ‘blood product powder’ that can help the blood to clot naturally in patients who are at higher risk of bleeding during complex cardiac operations is the subject of a new clinical trial.

If successful, it could significantly cut the need for blood products, improve outcomes and remove the need for blood to be cross-matched between donor and recipient.

The powder – a type of fibrinogen concentrate – is created from waste products in donated blood, which are separated, dried and stored in small vials at room temperature.

Therefore, as well as having a potential clinical benefit, the powder takes up less storage space and has a much longer shelf-life – around two years compared to two months.

Professor Andrew Klein, consultant anaesthetist and the study lead at Royal Papworth Hospital, said: ‘If a patient bleeds at the end of their operation, we would normally give them donated blood, such as cryoprecipitate which helps the blood to clot, and red blood cells and plasma to replace their lost blood.

‘This new type of “powder“ is infused into patients before bleeding occurs, with the hope it prevents bleeding in the first place.’

If this can be achieved, ‘the impact could be significant’, he said, adding that ‘people who do not need transfusions typically have better outcomes, fewer complications, a shorter length of stay in hospital and quicker recovery’.

The double-blind study is being conducted at 13 hospitals across five European countries, with the first patient recently recruited at Royal Papworth Hospital NHS Foundation Trust in Cambridge, UK.

In total, it is hoped that 620 participants will be recruited to the study across Europe. They will all have blood that is less likely to clot and therefore be more likely to experience a bleed during or after surgery. Some patients will receive the drug while others will receive a placebo.

The study is supported in the UK by the National Institute for Health and Care Research.

According to Professor Klein, around 12,000 patients require a blood transfusion during or after surgery in the UK each year – almost a third of the total number of patients undergoing heart surgery.

New trial aims to redefine post-myocardial infarction treatment and prevent sudden death

The first clinical trial to challenge the routine use of implantable cardioverter defibrillators (ICDs) in myocardial infarction survivors with heart failure has enrolled its first patient.

With modern drug treatments demonstrating the ability to lower the risk of sudden death in these patients, there is potentially less of a need for life-saving ICD shocks.

The PROFID EHRA trial will therefore test whether in post-myocardial infarction patients with symptomatic heart failure and reduced left ventricular ejection fraction (35% or less) drug treatment alone is not inferior to drug treatment plus an ICD for preventing sudden death.

Dr Nikolaos Dagres, chief investigator of the trial, said: ‘The PROFID EHRA trial is set to influence clinical practice around the world by closing a huge evidence gap that has existed for the past 20 years.

‘The trial is re-evaluating the role of ICD implantation in post-myocardial infarction patients in the context of contemporary medical treatment and will provide vital new information to optimally guide therapy and address this serious health issue.’

Over the next 30 months, the trial will recruit some 3,595 patients from 180 hospitals in 13 countries: Austria, Belgium, Czechia, Denmark, France, Germany, Hungary, Israel, Poland, Spain, Sweden, the Netherlands and the UK.

The first patient was enrolled from the Heart Centre Segeberger Kliniken in Germany.

Participants will be randomly allocated to either optimal medical therapy alone or optimal medical therapy plus ICD implantation. Participants will be followed up for around 2.5 years for the primary outcome of all-cause death.

The investigators will also examine the impact of the two treatment strategies on death from cardiovascular causes, sudden cardiac death, hospital readmissions for cardiovascular causes, length of stay in hospital, quality of life and cost effectiveness.

The study is due to last for approximately 49 months, with results expected in early 2027.

Professor Gerhard Hindricks, chief investigator of the trial, said: ‘PROFID EHRA is a ground-breaking study that could change the prevention of sudden cardiac death in clinical practice.

‘Currently, many patients who receive an ICD never need one, while some who could benefit miss out.

‘This trial will provide novel, randomised evidence on which patients should receive a defibrillator, and which patients can be spared an unnecessary procedure, which typically requires an overnight stay in hospital and may lead to complications or unintended shocks from the device.’

The PROFID EHRA trial is part of the PROFID project, which aims to personalise the prevention of sudden cardiac death after myocardial infarction.

The project involves a consortium of 21 multidisciplinary partners, including the European Society of Cardiology, and has received funding from the European Union’s Horizon 2020 research and innovation programme.

MHRA urges forward planning ahead of January valproate prescribing changes

7th December 2023

New regulatory measures tightening the rules around valproate prescribing are set to come into force from January 2024, and the Medicines and Healthcare products Regulatory Agency (MHRA) is urging healthcare organisations to adequately prepare.

From the new year, the first phase of the new measures will curb the use of valproate in new male or female patients under 55 years of age unless two specialists independently find there is no other effective or tolerated treatment, or that there are ‘compelling reasons that the reproductive risks do not apply’.

The measures aim to reduce the significant risk of serious harm to babies if sodium valproate, valproic acid or valproate semisodium are taken during pregnancy, as well as the risk of impaired fertility in males associated with the drug’s use.

These regulatory changes have been recommended by the Commission on Human Medicines to increase scrutiny of valproate prescribing and ensure that valproate is only used when the benefits outweigh the risk.

In addition to limiting new valproate prescribing, the measures include using a revised valproate Annual Risk Acknowledgement Form at the next annual specialist review of all women who could become pregnant and girls who are currently taking valproate.

This review will include the need for a second opinion’s signature if the patient is to continue with valproate. 

A similar system will be introduced later in 2024 for male patients currently taking valproate.

The MHRA is urging healthcare organisations to adequately prepare for the changes, including designating a new or existing group to co-ordinate their implementation.

It is also encouraging patients to attend any offered appointments to discuss their treatment plan and to talk to a healthcare professional if they are concerned.

Dr Alison Cave, MHRA chief safety officer, said: ‘To better protect patients from [harm], we are taking robust regulatory action to ensure greater scrutiny of valproate prescribing. Valproate should only be used when no other treatment is effective.’

She added: ‘No one should stop taking valproate without advice from their specialist.’

Dr Henrietta Hughes, the Government’s independent patient safety commissioner for England, said: ‘We must dramatically reduce the number of babies exposed to teratogens which can cause physical and learning disabilities in children. To do this, all organisations must ensure they bring in new measures from January 2024.’

Professor Munir Pirmohamed, chair of the Commission on Human Medicines, added: ‘I am pleased to see the recommendations of the independent Commission on Human Medicines being prepared to be put into practice.

‘Valproate is a highly teratogenic medicine that also carries known risks to male fertility – it is therefore vital valproate is only used when there is no other effective or tolerated treatment option.

‘We have consulted with patients and healthcare professionals with experience of valproate to inform our recommendations and to ensure that they are introduced in a way that does not disrupt ongoing patient care.’

According to the MHRA, it is estimated that one in nine babies exposed to valproate during pregnancy will be born with major birth defects and as many as four in 10 born with a neurological disorder, ranging from poor educational attainment to autism spectrum disorder.

In spring 2018, the MHRA banned the use of valproate for epilepsy during pregnancy without a pregnancy prevention programme.

In May 2023, NHS England launched a valproate decision support tool to help maintain patient safety and curb inappropriate prescribing of valproate during pregnancy.

And in September, new measures recommending the avoidance of all medicines containing topiramate during pregnancy were published by the European Medicines Agency‘s Pharmacovigilance Risk Assessment Committee.

Junior doctors confirm dates for strike action after failed talks with new health secretary

Junior doctors in England have voted for further strike action over the Christmas period and in the new year after rejecting the Government’s new pay offer.

This follows five weeks of ‘intense negotiations’ between the British Medical Association (BMA)’s junior doctors committee and the Department of Health and Social Care. 

The Government has offered an additional 3%, on top of the average 8.8% increase already awarded this year.

But the committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said this increase ‘would still amount to pay cuts for many doctors’.

Last month, former health secretary Steve Barclay was replaced by Victoria Atkins, and the BMA has said her approach to pay negotiations has been ‘more constructive’. 

The new strike action will take place for three days from 20 December and six days from 3 January – the January strike will be the longest of the industrial action so far.

Strikes have been put on hold over the last five weeks, but the BMA said the ‘deadline’ has now passed and the Government has been unable to put forward a ‘credible offer’ for junior doctors.

Dr Laurenson and Dr Trivedi said: ‘Without enough progress by the deadline, we have no choice but to take action that demonstrates doctors are as determined as ever in reversing their pay cuts. 

‘However, we can still avoid the need for these strikes. We will be ready and willing any time the Government wants to talk. If a credible offer can be presented the day before, or even during any action, these strikes can be cancelled.’

Health secretary Ms Atkins said: ‘The new strikes will result in more disruption for patients and extra pressure on NHS services and staff as we enter a busy winter period, risking patient safety.’

Last week, the Government and the BMA reached an agreement in principle on an offer that could end consultant strikes.

The offer also saw the Government committing to an overhaul of the workings of the Review Body on Doctors and Dentists Remuneration. 

In October, NHS formally warned the BMA over the ‘cumulative’ impact of consultant and junior doctor strikes which it said are causing ‘significant disruption and risk to patients’. 

At the time, consultants and junior doctors were jointly striking for three full days.

A version of this article was originally published by our sister publication Pulse.

HIV given ‘testing turbo boost’ with expanded opt-out programme in emergency departments

1st December 2023

An opt-out testing programme for bloodborne viruses in emergency departments in England is to be expanded after the success of schemes in extremely high prevalence areas of HIV, the Department of Health and Social Care has announced.

Almost 4,000 people have been identified as having HIV and hepatitis B and C through the opt-out testing programme that was launched in April 2022 at 34 emergency departments in areas with the highest prevalence of HIV.

The new testing programmes will be launched in 46 further emergency departments across 32 high-prevalence areas of England.

Backed by £20 million in funding from the National Institute for Health and Care Research, the expanded initiative is expected to save, and improve the quality of, thousands of lives, particularly from groups less likely to come forward for routine testing.

It is part of the Government’s ambition to reduce new HIV transmissions in England by 80% in 2025 and end new transmissions of HIV by 2030, all while getting people into the right care.

Richard Angell, chief executive of the Terrence Higgins Trust, referred to the announcement as a ‘testing turbo boost that’s needed if we are to end new HIV cases by 2030’.

‘It’s hugely significant that an additional two million HIV tests will be carried out in A&Es over the next year thanks to a temporary but wholesale expansion of opt-out HIV testing to 46 additional hospitals,’ he said.

‘The evidence is crystal clear: testing everyone having a blood test in emergency departments for HIV works. It helps diagnose people who wouldn’t have been reached via any other testing route and who have often been missed before.

‘It also saves the NHS millions, relieves pressure on the health service and helps to address inequalities with those diagnosed in A&E more likely to be of black ethnicity, women and older people.’

Also commenting on the announcement, health and social care secretary, Victoria Atkins, said: ‘As well as promoting prevention for all, the more people we can diagnose, the more chance we have of ending new transmissions of the virus and the stigma wrongly attached to it.

‘This programme, which improves people’s health and wellbeing, saves lives and money.’

The existing bloodborne virus opt-out testing programme provides joined-up care so previously undiagnosed patients, or those disengaged from their care, gain access to medication and a treatment and care pathway. 

During the first 18 months of the programme, 33 emergency departments conducted 1,401,866 tests for HIV, 960,328 for hepatitis C and 730,137 for hepatitis B.

It identified 934 people unknowingly living with HIV or disengaged with their care. A further 2,206 people were identified as having hepatitis B and 388 were disengaged from hepatitis B care. And 867 people were found to be living with hepatitis C and 186 were identified as being disengaged from care.

Professor Kevin Fenton, the Government’s chief advisor on HIV and chair of the HIV Action Plan Implementation Steering Group, said: ‘We know HIV is most commonly unknowingly spread by people who don’t know their status. Knowledge is power in preventing HIV transmission and accessing life-saving care.’

He added: ‘The opt-out testing programme will boost our progress to identify the estimated 4,500 people who could be living with undiagnosed HIV and help us ensure we meet our 2030 ambition, with the possibility to save thousands of lives in the process.’