The Directorate of Infection at Birmingham Heartlands hospital have been managing HIV inpatients since the 1980s. They are jointly managed by HIV and Infectious disease consultants to ensure that a high quality of care is provided. The nursing and multidisciplinary team includes therapists, dietitians, and pharmacists who work in both outpatients and inpatients ensuring continuity of care. Furthermore, the nursing team have accumulated a great deal of experience from working on a general infectious disease unit dealing with a range of infections.
Our established care pathway into inpatient treatment offers peace of mind to patients whose HIV complications require admission into hospital. We provide rapid, responsive care monitored by a consultant-led multi-disciplinary team [MDT] which is matched to the often complex and life-threatening complications of HIV. Our HIV-specialist nurses, pharmacists and consultants are all part of this care, as are our colleagues from all other relevant disciplines.
The ward itself is well-catered for, with a high proportion of side rooms including negative pressure rooms where patients with drug resistant tuberculosis can be managed safely. 24-hour on-call support is available for all doctors seeing HIV inpatients acutely via Infectious disease on call registrars and consultants. Daily review occurs from a Consultant specialising in HIV or Infectious diseases. There is 24-hour availability of pharmacy services and access to specialist HIV pharmacist advice. There are on-site ITU services which allow appropriate escalation of care to HDU and ITU when indicated.
Our inpatient treatment is geared towards very close management of these all HIV-associated opportunistic infections, cancers, and other related conditions. We also provide the same social, psychological and peer support enjoyed by our outpatients.
The pattern of HIV-related illness has shifted in the last decade as the result of the huge improvements in ARV therapies. We maintain a nationwide network of relevant specialists, acute medical and A&E colleagues to ensure we can provide precisely the inpatient care necessary to each complication. We focus on integrated care and optimum outcomes, and provide 24/7 consultant cover within an MDT framework for all inpatients.
Likewise, our assessment and diagnosis of HIV-related malignancies is widely respected, and our relationships with relevant clinicians for onward referral excellent. Indeed, we benefit from fully established integrated care pathways for a wide range of conditions requiring specialist input, including end-organ liver and renal disease, lymphoma and Castleman’s disease. At all stages we operate full infection control procedures.assessment, diagnosis and management of complications of ARVs which require inpatient care, including immune reconstitution syndrome (IRS).Equally, advanced immunodeficiency can still present, and we have huge experience in the Initiation of ARVs in these kinds of case. We are also experts in the assessment, diagnosis and management of complications of ARVs which require inpatient care, including immune reconstitution syndrome (IRS).
In short, our inpatient services are complete and comprehensive, and offer the fullest possible range of protections against the co-morbidities and cross-infections which can be part of HIV management. High standards of confidentiality, privacy and dignity in line with the law, GMC guidance and national standards are maintained. In addition, inpatient activity is audited annually to ensure excellent standards are maintained.
