Most patients would rather know than not know

Mike Stone

Whether or not a patient is informed will depend on the level of risk of exposure.

This may mean that in some instances there is no patient notification exercise, or it is limited in scope.

Until now all patients have been notified regardless of their level of risk.

The guidance is based on advice from the Expert Advisory Group on Aids and the UK Advisory Panel on Health Care Workers Infected with Blood Borne Viruses.

No UK cases

There has never been a detected case of transmission of HIV from an infected health worker in the UK.

Mike Stone criticised the guidance

The Department of Health has carried out 22 studies on the issue involving thousands of patients.

In a statement, the department said the policy change had been taken in an effort to avoid unnecessary anxiety to patients.

It will now be more in line with that of the rest of the world.

The department is currently working with health professionals and patients to draw up specific guidance to quantify the level of risk associated with clinical procedures that are classified as exposure prone.

Approaching the issue on a case by case basis is likely to minimise unnecessary distress

John Godwin

Under the new guidance, all patients that are notified will be offered pre-test discussion and an HIV antibody test.

Mike Stone, director of the Patients Association, said the NHS should be as transparent as possible, and that patients should be fully informed of all the circumstances surrounding their treatment.

He told BBC News Online: "Most patients would rather know than not know, and it should be up to them to make up their own minds about how they want to proceed."

However, the National Aids Trust welcomed the change in policy.

Unnecessary distress

John Godwin, Head of Policy and Advocacy, said: "Approaching the issue on a case by case basis is likely to minimise unnecessary distress and also enables the limited funds available for health care to be used for improving services.

"We know a lot more about HIV transmission risks in occupational settings now than we did even five years ago, and the new guidelines allow practice to reflect this."

Lisa Power, head of policy at Terrence Higgins Trust, said: "We endorse the approach taken in this new policy from the Department of Health.

"We hope it will ensure that healthcare workers are treated fairly and without prejudice, and that patients are given full support whilst not being unnecessarily alarmed by needless notification exercises.

"There will still be patient notification when needed, but the assessment will avoid needless panic and scare mongering, and protect all parties involved."

Theoretical risk

There is a theoretical risk of HIV transmission during invasive procedures when a health worker's gloved hands may be in contact with sharp instruments, needle tips or sharp tissues inside a patient's open body cavity or wound.

There have only been two reported incidents world-wide.

In a well publicised case of a dentist in Florida HIV was transmitted to six patients, however the exact route of transmission has never been established.

More recently transmission of HIV from an infected orthopaedic surgeon to a patient was reported in France.

An HIV-infected NHS specialist has begun legal proceedings to stop his former patients being told he has the potentially fatal disease.