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Charity plans legal action against NHS England over HIV treatment decision

An Aids charity is planning legal action against NHS England over the availability of PrEP, an HIV prevention treatment.

According to the National Aids Trust (NAT), PrEP is effective in stopping HIV transmission. The charity is looking to raise £10,000 so it can seek a judicial review of a decision by the Specialised Services Commissioning Committee of NHS England that it does not have the legal power to commission PrEP provision.

The committee took that decision after receiving external advice from law firm DAC Beachcroft, which considered the legal position under the National Health Service Act 2006, the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013 and the NHS public health functions agreement 2016-17.

NAT chief executive Deborah Gold said: “In a shocking U-turn, NHS England has pulled the plug on over 18 months of hard work which demonstrated the need, efficacy and cost-effectiveness of PrEP.”

She said the £2m allocated instead to the 500 gay men judged most at risk was a decision “not informed by any due process; the amount of money is arbitrary; the claim that more ‘testing’ of PrEP is needed is disingenuous”. 

Gold added: “Faced with one of the most exciting prevention options to emerge since the HIV epidemic began, and which offers the prospect of real success in combatting this virus, the NHS has failed miserably to deliver."

An NHS England statement said local authorities were the responsible commissioners for HIV prevention services.

It explained: “Including PrEP for consideration in competition with specialised commissioning treatments as part of the annual Clinical Priorities Advisory Group prioritisation process could present risk of legal challenge from proponents of other ‘candidate’ treatments and interventions that could be displaced by PrEP if NHS England were to commission it.”

The Specialised Services Commissioning Committee said it would work with Public Health England to run early implementer tests to research how PrEP could be commissioned in the most clinically and cost effective way.

It added that even if the legal position were different “there is no guarantee that the annual prioritisation round would result in a decision to invest millions of pounds in PrEP over new treatments and interventions in other service areas which are also competing for funding”.

NHS England's decision has been described as "hugely disappointing" by the Local Government Association.

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