Ban On Nhs Staff With Hiv To Be Lifted.

[anotheoldgit]

Is this lifting on the ban on NHS staff with HIV, more to do with protecting their jobs, than protecting their patients?

/// However, for some professionals a positive HIV diagnosis can end careers in areas that require frequent exposure-prone procedures. ///

[Old_Geezer]

I guess those who made the decision have looked at the stats and calculated it to be an acceptable risk, but I have to say it sounds one not worth taking to my layman ears. Is it really so awful that some folk don't get involved in procedures that could cause an infection ? It's a pretty awful disease to be given you by the medical industry after all, especially when you know they could have prevented it.

[woofgang]

then I agree with slaney, you'd be crazy to not report it. In fact when i was working in an area much less risky that surgery, ANY blood to blood contact had to be reported.

[LazyGun]

It was a sensible precaution to take back in the 1980s, when HIV infection was essentially viewed as a death sentence.

Things have moved on since then, because of the massive advances in anti-retroviral drug therapy. Those self-same anti-retroviral drugs work by reducing the viral load, making HIV a manageable disease rather than a death sentence which in turn further reduces the already slight risk that an HIV healthworker represented to a patient.

In those circumstances, given the numbers of known HIV healthworkers in the UK, given the number of instances of Healthworker to Patient HIV transmission globally - 4 documented, and none in the last decade, it seems reasonable enough to relax the rules somewhat.

And the benefit of relaxing the rules might be that the fear of losing your vocation is ended, so healthworkers that suspect they might have or are at risk of HIV might be less reluctant to actually come forward for testing.

[LazyGun]

And I would agree with Slaney and Woofgang. I cannot imagine a surgeon not reporting an incident where there was even a suspicion of blood to blood transmission.

[woofgang]

Slaney, is the prophylactic treatment still horrible?

[Sqad]

LazyGun

\\\\\In those circumstances, given the numbers of known HIV healthworkers in the UK, given the number of instances of Healthworker to Patient HIV transmission globally - 4 documented, and none in the last decade, it seems reasonable enough to relax the rules somewhat.\\\\

Yes, but one would expect that.............because they was a ban, one wouldn't expect the number of cases to rise.BUT, what if that ban was lifted, as it has been?

\\\\I cannot imagine a surgeon not reporting an incident where there was even a suspicion of blood to blood transmission.\\\

?????

In my experience this is more common than one might think and minor incidents are not reported.

[LazyGun]

@ Sqad = Not sure we would "expect that". Globally speaking, all those millions, maybe even billions of procedures on all those people by all those healthworkers over decades, and only 4 cases of AIDS documented? Thats an exceptionally powerful argument for relaxing the rules somewhat.

And I cannot comment directly on Surgeons reporting rates if they nick themselves during a procedure, but certainly my own anecdotal evidence is that they would, simply because you would want any prophylaxis as early as possible, and because it is part of that whole system. Nor are they usually in isolation in the OT - any nick is likely to be observed by any one of the number of colleagues also present. The only reason I can think of where it might go unreported is someone thinking "it is too much fuss", but even then the whole procedures and paperwork and reporting means it would likely get recorded somewhere- at least in hospital systems within the developed world.

There probably are some stats and surveys kicking around somewhere :)

[Sqad]

LG

\\\\There probably are some stats and surveys kicking around somewhere :)\\

LOL

\\\\@ Sqad = Not sure we would "expect that"\\\

OK...in simple terms....NHS workers 20 yrs ago who are HIV+ are banned from surgical procedures and invasive patient treatment......SO.....one would EXPECT no increase in the number of cases. Agreed?

Now, one is assuming that in lifting that ban, there would be no cases of clinical transfer of infection.

A big "IF" in my opinion.

[LazyGun]

@Sqad Ahh i see where you are coming from, and yes in that sense it would be expected.

I disagree with you that lifting the restriction represents a big "if" though. Its a relative risk calculation. How many Health Workers are HIV positive and not registered or are not receiving anti-retrovirals? How many times and in what circumstances do you get blood to blood transmission from healthworker to patient? And then what is the risk of the patient going on to develop HIV as a direct consequence of that blood to blood transmission, given the fact that it is a one-off exposure, that the quantitities of blood transmitted are going to be very small, and, if the healthworker is taking the anti- retrovira drugs, the viral load is going to be extremely low.

Taking all those factors into account, it does not surprise me that the CMO compared the risk to being struck by lightning :)

[Sqad]

LG...you know that i would follow you(and your reasoning) to the end of the earth.....;-)

[LazyGun]

Mind you, I would worry if the Doctors nickname was "The Butcher", they paraded around in bloodstained scrubs and whose digits were covered in plasters :)

I might just start requesting another consultant at that point :)

[sunny-dave]

Nah - as long as he has those nice bright blue plasters, what could possibly go wromg ... :)

[sunny-dave]

But with my 'sensible' head on, I tend to agree with LG - whilst just retaining a wee smidgeon of the worry that the estimable sqad has.

Take a deep breath and monitor the situation ...

[Sqad]

dave...LOL