NHS under fire for ‘misdiagnosis’
pharmafile | October 5, 2012 | News story | Sales and Marketing | BHIVA, HIV, NHS
Patients with HIV infections are going unnoticed by the NHS while those with rare diseases are often being misdiagnosed.
These are the findings of two separate reports, from the British HIV Association (BHIVA), which represents professionals in HIV care, and the think tank 2020Health.
BHIVA’s latest audit of HIV testing and diagnosis in the UK looked at the records of more than 1,000 patients attending HIV treatment centres, and suggests one in four could have had their condition diagnosed earlier.
The delay increases the risk of HIV-related illness and of the disease being passed on, and pushes up the cost of treatment, the group says.
Describing it as a ‘wake-up call’, BHIVA is calling for the government to introduce a proactive and widespread-targeted testing programme.
In particular it wants increased testing for HIV by GPs and in acute medical settings in areas of high risk – the group’s research shows the number of people diagnosed with HIV in non-traditional settings, such as A&E wards, has increased by 14.4% since a 2003 audit.
It highlights in particular a 6.4% increase since then in the number of people diagnosed with HIV by GPs.
Figures in this year’s audit showed 52.2% of patients were diagnosed HIV positive only after they had already presented with evidence of a damaged immune system.
Many displayed physical symptoms such as weight loss or chronic diarrhoea, and BHIVA says 25% of patients overall were not offered an HIV test – despite being seen by the NHS prior to their diagnosis.
The number of people living with HIV in the UK is expected to exceed 100,000 this year, and the Health Protection Agency says people whose infection is noticed in its early stages are ten times less likely to die in the first year, than those who are diagnosed at a more advanced stage.
“Late diagnosis is the single biggest cause of death from HIV in the UK,” says BHIVA chair Professor Jane Anderson.
“HIV is treatable, and if diagnosed in time, people with HIV can expect to have long and healthy lives,” she added. “Sadly, opportunities for longer life expectancy for people with HIV are being thrown away by late diagnosis.”
Meanwhile, a report by 2020Health found that GPs are missing or misdiagnosing rarer diseases, such as ankylosing spondylitis (AS), a potentially crippling disease which causes back pain.
Twice as many people in the UK suffer from AS as from multiple sclerosis – yet the average time between the onset of AS and correct diagnosis is eight and a half years.
The report ‘Forgotten Conditions: misdiagnosed and unsupported, how patients are being let down’, suggests doctors concentrate on a handful of major illnesses rather than diagnosing and treating rarer ones.
Wrong or late diagnosis increases the cost to the NHS and impacts negatively on patients quality of life, the report points out.
One in 17 people will be affected by a rare condition in their lifetime and this number is expected to rise: there are already more than 5,000 designated rare diseases, and around five new ones are listed in medical journals each week.
The UK offers screening for five childhood diseases at birth, which compares unfavourably to 30 in the US and 20 in many European countries, 2020Health says.
Since 80% of rare conditions have a genetic element, this is an area of diagnosis which needs to improve, the report adds.
2020Health chief executive Julia Manning suggested that the technology and expertise already exists to aid diagnosis.
“There is still too much variation in care across the NHS, too little information on rare disease and not enough down to empower patients to look after themselves,” she said. “At present there are too many inequalities in treatments offered to patients around the UK.”
The think tank will communicate its findings to the Department of Health, whose consultation on the UK plan for rare diseases is due to be published by the end of 2013.
The 2020Health report came out of a roundtable bringing together health policymakers, GPs, politicians and senior academics.
Adam Hill
Related Content
A community-first future: which pathways will get us there?
In the final Gateway to Local Adoption article of 2025, Visions4Health caught up with Julian …
The Pharma Files: with Dr Ewen Cameron, Chief Executive of West Suffolk NHS Foundation Trust
Pharmafile chats with Dr Ewen Cameron, Chief Executive of West Suffolk NHS Foundation Trust, about …
Is this an Oppenheimer moment for the life sciences industry?
By Sabina Syed, Managing Director at Visions4Health In the history of science, few initiatives demonstrate …
