HIV treatment and care
Our service is the largest of three dedicated HIV services offered by NHS hospital trusts in north east London and it also provides a referral service for patients who may have more complicated health problems. Patients are referred to us by sexual health clinics, other hospital departments or GPs once they are diagnosed with HIV infection. Patients can also make contact with us directly without a referral from any other medical service or those newly diagnosed. We provide a free and confidential treatment for people living with HIV.
Hepatitis C and HIV testing in the Emergency Department
From Monday 15th April, all adults attending the Emergency Department at the Royal London Hospital, will be offered routine opt-out tests for HIV and Hepatitis C (HCV) if they are already having bloods done.
We are doing this because HIV and Hepatitis C are preventable diseases which are now easily treatable. People living with HIV who are diagnosed and treated early can expect to live a normal life with a near normal life expectancy. Once on treatment, they also cannot pass the virus on to others. Directly-acting antiviral treatments for HCV are short, oral treatments with few side effects which successfully cure more than 95% of patients. Deaths due to HIV have decreased, and HCV related deaths and liver cancers are falling due to better treatments. However nearly 40% of people with HIV and 50% with HCV are diagnosed late, which can result in significant ill health and mortality.
If you have had a test in ED you will be contacted within 2 weeks if there is a positive result. If you would like to talk to someone further, please contact us on 07715812663.
If you feel you are at risk of HIV
If you feel you are at risk of HIV infection please visits your local sexual health centre and ask for a test.
Information for patients
Transferring your care to Grahame Hayton Unit
Patients can contact us directly using our contact numbers or visit the clinic in person.
- a list of all the medications your taking
- letters/reports from your referring doctor (if applicable)
- your GP details
Your first visit can take up to 1 hour with the nurse. The nurse will take additional health information and explain how our service works. He or she may take with your consent some more blood samples and help you to arrange your next appointment(s) with your new doctor.
You can now book, change or cancel your appointments via email. If you would like to do so, please email GHUappointments@bartshealth.nhs.uk with your request and our reception team will reply to you as soon as possible. Alternatively you can call us and change your appointment.
Urgent clinic (SOS) and out of hours care
We are able to provide urgent clinic reviews for our patients within 24 to 48 hours except weekends and bank holidays if a patient is unwell at home with symptoms related to HIV. Please contact us.
If you experience an urgent and HIV related problem outside of clinic opening times, contact your GP. If this is not possible, call the HIV ward on 020 35942906. Either will be able to advise you what to do. In an emergency you should go (or be taken) directly to the nearest A&E department.
Patients are advised to have regular blood tests done 2 weeks before their routine doctor's appointments so that their results will be available when they see the doctor. To get bloods done, patients should come to the clinic during opening times (no appointment needed).
GHU Pharmacy, Home delivery of ARV and Emergency prescriptions
There is a standard process of safety checking, labelling and counselling before prescribed drugs can be released to the patient. The checks ensure the prescription dosage/amount is correct, that the patient is not allergic to the drugs, or that the patient is not taking other drugs that could potentially interact with the prescribed agents. This process takes time but is ultimately there to protect and inform the patient.
GHU Pharmacy opening hours:
- Monday, Tuesday and Thursday: 9:20am to 5:30pm
- Wednesday: 1pm to 5:30pm
- Friday: 9:20 am to 5pm
Please note: prescription requests received before 1pm will be processed within two working days (excludes bank holidays).
Emergency prescription service is currently only available to patients living with HIV who attend the Grahame Hayton Unit at The Royal London Hospital. Only one month emergency prescription can be given, and supplies longer than this will normally be issued after a regular follow-up appointment and blood tests.
You must attend the Grahame Hayton Unit to collect your prescription. Lloyds Pharmacy located on the Ground Floor of the main hospital building is where medication will then be dispensed from with your prescription.
The home delivery service is a registered primary care pharmacy which dispenses a patient's prescriptions and sends them via registered post to a nominated address in an unmarked package. The VAT savings cover the cost of the posting and also help to save the NHS money. Home delivery is not appropriate for everyone but does offer another way for patients to receive their medication. If you are stable on antiretroviral/anti-HIV treatment with an undetectable viral load this is an option for you – ask your regular doctor or HIV pharmacist.
Sexual health screening for HIV positive patients
Asymptomatic sexual health screening is offered to all our patients as part of our routine blood tests. For any symptomatic patients we send them to our sexual health clinic on the ground floor above our clinic.
We offer vaccination after discussion with your clinician for:
- Hep A
- Hep B
HIV co-infection clinics
HIV and viral hepatitis co-infection clinics
We work in a multidisciplinary team and in close collaboration with our Hepatology colleagues to provide the following services for HIV-positive individuals:
- Hepatitis B and C testing.
- Partner notification and access to testing and vaccination of partners if indicated.
- Health advisors and psychology support.
- Access to an onsite fibroscan machine if required.
- Monitoring, treatment and care for those with HIV and hepatitis B co-infection.
- Monitoring, treatment and care for those with HIV and hepatitis C co-infection. We refer patients to the North East London Operational Delivery Network to access new hepatitis C antiviral therapy.
- Access to clinical trials for the treatment of viral hepatitis where available.
- Assessment, treatment and care of non-viral liver disease.
We have joint clinics within the GHU. For every clinic we have one of our HIV consultants seeing patients with consultants from the other services that have interest in HIV care:
- HIV and Renal joint clinic
- HIV and Cardiovascular joint clinic
- HIV and Tuberculosis (TB) joint clinic
- HIV and Kaposi Sarcoma Joint clinic
- HIV and Lymphoma joint clinic
- HIV and Liver joint clinic
- HIV and Neurology joint clinic
Social Worker service
Social work support is available to all patients who need help to cope with any worries related to HIV, manage difficulties and adjust to changes in their situation.
The social worker can provide information and advice around a number of issues, offer practical and emotional support to patients, family, friends and carers and refer on to other specialist services as required.
Social work clinics are held on Tuesdays and Fridays. Appointments can be booked via reception.
The Virtual Review
The Virtual Review Service is for patients who are taking HIV medications and have had an undetectable viral load for approximately one year.
Booking a Virtual Review Slot
After seeing your regular clinician, you should book both a Virtual Review Slot for 6 months later and a further appointment with your clinician for 1 year later.
2-weeks before you virtual review slot
You should attend for you blood tests approximately 2 weeks prior to you Virtual Review Slot, you should receive a text message approximately 1 month before we are due to virtually review your bloods to remind you.
On the day of your virtual review
On the date of your virtual review you will receive either a text message or email (depending upon your chosen follow up option) informing you of your results
If you collect you medications: we will write a prescription when we review the blood results. This will be collectable from the day after your virtual review date.
If you have your medications delivered: we will write a prescription when we review the blood results. If patient have not heard from the Home Care Delivery company within 2 weeks of your virtual review date you should call them on:
Emergency supplies of Medicines.
It’s important that there’s no interruption to your HIV medicines. We can’t arrange urgent medication deliveries.
If you know you will be running out of drugs before your next routine prescription will be ready, you can arrange to collect a month’s supply from pharmacy. Please call your clinic and state that you need a repeat prescription. You will need the following information when calling:
- Your name and hospital number or date of birth
- Your next appointment date
- The names of the medications you require
We require 24 hours’ notice. The prescription will be for 1 month, it is therefore important that you have your bloods taken and a virtual review before this prescription is due to run out.
If you need to see a doctor.
You can still book in to your current regular clinic doctor to discuss any concerns you may have.
If you feel you need to be seen urgently, but cannot obtain an appointment, call the clinic in the morning (except Wednesday mornings when we open at 12MD) on 020 7377 7616 and ask to speak to a nurse. The nurse will triage you and advise whether you should be seen in the SOS clinic or by another person (possibly your GP, walk in centre or A&E). If you need an SOS appointment that can usually be arranged within 48hrs.
In an emergency, outside of normal clinic hours, please phone ward 13F at the Royal London Hospital on 02035942906, or call 020 7377 7000 and ask for 13F ward, your call will be directed to a nurse in charge experienced in the care of HIV and they will be able to advise you further.
Routine bloods tests
If you have blood investigation labels already then you can attend any Barts Health Hospital to have your blood taken within the outpatient phlebotomy services. If you do not then it is advisable to attend your regular clinic. To view your clinics opening times then please refer to you appointment card or look on the Barts health website.
If you have opted for email as choice of contact:
Before we can start sending you results to an email address, we need you to first complete you registration by emailing: Efirstname.lastname@example.org.
We will only send results or reply to emails sent from the address you’ve given us. To check the address is correct, we will ask you to email us with your clinic number and date of birth before we use it for the first time.
In the subject line you should add your name, date of birth and hospital number (found on you appointment card). You should try to do this as soon as you book your first appointment. If you forget we will send reminder text messages. If you have not registered within one month then we will transfer your appointment to be seen by a senior nurse.
If you have any questions, please feel free to email the E-clinic on the above address. The e-clinic inbox will be checked certain days (excluding weekends)
Please note that we cannot deal with urgent enquiries via the E-clinic as this email address is only checked on certain days.
If you have non-urgent enquiries then please follow the following rules when emailing us:
- Put your hospital number in the subject box.
- If you are emailing a particular person, then also include their name in the subject box.
Example: subject: - 1234567, Dr/Nurse XXX
We will endeavour to reply to you email within 2 working days.
Who will I see?
Clinical nurse specialist (community services)
The HIV clinics at Newham University hospital, the Royal London hospital and Whipps Cross hospital are providing care for over 4,000 HIV patients.
The department employs two HIV community clinical nurse specialists who are able to visit patients at home if they live in Newham, Tower Hamlets or Waltham Forest. Patients who live further afield can be referred to a local HIV community CNS.
A home visit, or regular home visits, might be necessary if a patient is unable to attend their regular clinic for physical or psychological reasons. Our CNSs are able to assess patients at home, take bloods, prescribe medications and arrange home delivery of medications.
The community HIV nurses do not replace district nurse or GP services but add to the existing community ones. They are able to help communicate between specialist and generic healthcare providers.
If a patient requires rehabilitation, either from an acute centre or home, the HIV community nurses are able to arrange or instigate admission to Mildmay hospital UK, and oversee the admission and discharge back into the community.
Referrals are accepted from patients, health, or social care professionals, or non-profit organisations.
Contact the team
- For Tower Hamlets residents: 020 7377 7616
- For Newham residents: 020 7363 8146 or 8939
- For Waltham Forest residents: 020 8535 6535
Clinical nurse specialist (women’s health)
The women’s health service in the Grahame Hayton unit is run by a clinical nurse specialist who has experience in women’s health and HIV nursing.
The service offers cervical cytology tests, contraception, sexual health screening and advice on related health issues. This includes advice on fertility and planning a pregnancy. We can also provide advice to women whose partners attend the unit.
We also run a HIV antenatal clinic with dedicated specialist midwife and doctor.
Health adviser; partner notification and family testing
Health advisers are more common within sexual health clinics where the role is often about avoiding exposure to or reducing the risks of getting a sexually transmitted infection, it also involves supporting those who do get diagnosed with an infection and helping with partner notification.
At the Grahame Hayton unit, our health advisors provide help and support around disclosure and assisting with getting partners and children tested for HIV. This specialist role was created in recognition of the difficulties disclosure can still cause for many people living with HIV.
Despite advances in both testing and treatment, we have still encountered cases where young adults have been diagnosed with late HIV infection where it is believed that the transmission has been vertical i.e. from mother to child. This may have happened for a number of reasons:
- The young person was born outside of the UK and joined their parents during childhood and is therefore untested
- A mother has been diagnosed after their children were born and not offered to have their children tested
- A small number of women may not have been tested during pregnancy and therefore precautions to reduce mother to child transmission has not be possible or
- Parents have been fearful of discussing the issue of testing their children and assumed that because they were well they did not need testing.
Talking to our children and young people about testing and sexual health matters is never easy, whether we are living with HIV or not. Sometimes parents are comfortable with talking to their children and sometimes young people find it easier to talk to someone who is not their parents because it is less embarrassing.
If you have any issues relating to your diagnosis; disclosing to partners, thinking about having a family, wanting to test your existing children or wanting to have safer sex with new partners, please make an appointment to meet with me. You can contact our health advisors via reception - they are available in the Grahame Hayton unit on Mondays, Tuesdays and Fridays.
Clinical psychology is part of the multidisciplinary team which offers services to patients, partners and their carers. We provide a range of psychological therapies to help people cope with a range of health and emotional problems, such as adjustment to a diagnosis, co-morbid mood problems, disclosure and issues regarding sexual wellbeing or risk.
What is clinical psychology?
Clinical psychologists work with people in a variety of settings, most commonly in health centres, clinics and hospitals. They have academic and specialist professional training in the application of principles of psychology to health and emotional problems. They are not medical doctors and therefore do not prescribe drugs. Clinical psychologists use their psychological knowledge and understanding of behaviour, emotions, thoughts and experiences to help people with health-related problems, relationship and emotional difficulties.
What kinds of problems can clinical psychologists help with?
Clinical psychologists see individuals and their partners or families with many difficulties related to health problems. These may include problems such as:
- adjustment to a diagnosis
- anxiety or panic
- depression or low mood
- pain management
- grief and loss
- adherence to treatment
- sexual problems or managing risk and sex
- relationship difficulties related to your illness
How do I get to see a clinical psychologist?
If you are interested in meeting with a clinical psychologist, please speak to any member of the service about being referred.
What do clinical psychologists do?
After you and the clinical psychologist have assessed your current situation and problems you may decide to have a series of appointments with a member of the clinical psychology team to examine ways of addressing your difficulties. Clinical psychologists offer a range of psychological therapies and work with individuals, couples and groups. The length and frequency of therapy is negotiated to suit individual needs.
Clinical psychology and you
Clinical psychology aims to provide a service to a client that is respectful of individual lifestyles, and sensitive to family, social and cultural issues.
If you are interested in finding out more about the clinical psychology service please feel free to talk to any member of the GHU staff.
Clinical research unit at Grahame Hayton unit
The clinical research unit within the Grahame Hayton unit undertakes, leads and manages clinical trials within the rapidly changing areas of HIV, sexual health and all liver diseases. Our dedicated team of research health care providers offer a very high standard of care to patients from all backgrounds and ethnicities. These studies enable our patients to access cutting edge treatments through clinical trials that are not yet available through the NHS. Within a clinical drug trial, patients are monitored and investigated more rigorously than in a general clinic. We also manage smaller academic studies which help us to understand how the various diseases manifest and how we can then treat or prevent them.
The clinical trials unit within the GHU is among the top five recruiting centres within Barts Health NHS Trust and is a leading research and clinical trials unit for HIV and liver disease therapies.
All clinical trials undergo a rigorous approvals process and are all approved by independent ethics committees.
If you would be interested in a research study in the areas of HIV, sexual health or liver disease, please contact our team on 020 7377 7457 and we would be happy to discuss which study would be suitable for you and also discuss which studies are currently recruiting.