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My GP

My GP



Should I tell my GP about my HIV?

It’s a good idea to tell your GP about your HIV (or register with a GP if you don’t have one).  While your HIV clinic will monitor your HIV and prescribe the HIV medication you need, your GP is still the best place for other health issues (e.g. flu, minor infections, elevated blood pressure). 

If your GP knows your HIV status and what medication you are on, they can be sure not to prescribe anything that will interact badly with it. It will also help them to recommend services which may be helpful to you. For example, people living with HIV can have a free flu vaccine1  and women living with HIV are recommended to have an annual cervical smear2 

However, there is no obligation to tell your GP about your HIV. (For more information see Confidentiality and Disclosure).

And because HIV clinics are open access, you will not need to be referred by a GP to get HIV treatment.

For more practical advice on GPs and HIV try NAM's resource, HIV, GPs and other primary care.



What can a GP do that my HIV doctor can’t?

Your HIV doctor is the expert in HIV, but GPs have a lot of experience with a wide range of everyday health issues and long term conditions.  Many people living with HIV have other, more common, conditions such as high blood pressure, diabetes or depression, which GPs deal with every day.  They prescribe the medication you need for these conditions and refer you to specialist doctors when needed.   Some GP surgeries also run special ‘clinics’ for people who  want help and advice on health-related issues such as diet and quitting smoking.  

GPs are also very experienced in the care of older people, so are increasingly important in providing care as people living with HIV age.  They can also help manage common side-effects of treatment, such as gastro-intestinal problems.   

It will normally be easier and quicker to get an appointment with a GP to deal with these sorts of problems as they happen, rather than wait for your next appointment with the HIV clinic.  Increasingly, GP practices have longer opening hours to make getting an appointment easier. 



How do I register with a GP?

You can register with any GP practice in your local area, provided they have space on their list.1 

Contact the practice you would like to go to and ask to register. They will ask you to fill in a form called the GMS1. They may also ask for proof of identity (such as a passport or driving license) or proof of where you live (such as a bill sent to you at your home address).

The GP practice may ask you for your NHS medical card or your NHS number, but you don’t need either of these to register with a GP or to get NHS treatment.2 



Do I have to go to a GP near my home?

GP practices must accept registrations from people who live in the local area (called a ‘catchment’ area), unless they have run out of space on their patient list.

GP practices now also have the option of registering people who don’t live in the catchment area – for example, people who work nearby.  This is voluntary – GP practice don’t have to register people from outside the area – but if they refuse your request, they should give a reason.1

[1] NHS Choices http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/patient-choice-GP-practices.aspx 



Are there any residency restrictions on registering with a GP?

Overseas visitors are able to register with a GP, even if they are not entitled to free hospital care.1   Charging rules which apply to hospital services do not apply to GP services, which are free at the point of use.  You do not have to have been resident in the UK for any minimum time to be allowed to register.1  

Some GP surgeries will ask to see a passport for proof of identity but immigration documents are not a requirement of registering for primary care.1    If the surgery you are trying to register insists on this sort of documentation, try another one or talk to your local HIV support organisation who might be able to help you register. 

[1] NHS England. https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2015/11/pat-reg-sop-pmc-gp.pdf 



What can I do if a GP practice won’t register me?

Anyone living in the area served by the GP practice should be able to register, unless the GP practice list is full. A GP practice cannot refuse to register you because of your HIV status, race, gender, sexual orientation, age or religion.1   If a GP practice will not register you, you can ask them to provide you a reason for the refusal in writing. 



How long will I have to wait for an appointment?

GP practices have different ways of managing demand for appointments.  So you may find you need to ask for an ‘emergency’ appointment, call or arrive early on the day to be sure of seeing a doctor urgently. You could also try an NHS walk-in centre , which can help with things like infections, minor injuries, stomach upsets and emergency contraception.  Walk-in Centres are normally nurse-led.



Can I see the same GP every time?

You can ask to see a specific GP every time you need to see a doctor and your GP practice should try to make this happen.1   This can help build up a good relationship with your GP and stop you having to explain everything multiple times.  However, you may have to wait longer for an appointment – waiting time targets do not apply to named GPs.

You can also specify if you would like to see a male or female GP, although again you may have to wait a little longer to see your preferred doctor.1 



Do I have to tell the receptionist why I need to see the GP?

Some receptionists will ask why you need to see the GP when you ask for an appointment. This is normally to check whether your health problem or question could be dealt with by another healthcare professional, such as a practice nurse. However, you don’t have to give any details if you don’t want to. You may want to tell the receptionist that your GP is helping you manage your long-term health condition, and leave it at that. 

Likewise, if you have gone to your GP for a test which is recommended for people living with HIV or to access the seasonal flu vaccine (which is free to people living with HIV), it should be enough to tell the receptionist that you meet the eligibility criteria for the test or vaccine - and that you will discuss the details with the GP or practice nurses if necessary. 

If you have told your GP about your HIV, this will normally be recorded somewhere on your patient record, reception staff may sometimes see this. However, only those who need to know will access this information and only on a need to know basis.

All NHS workers are bound by a duty of confidence, not just clinical staff. Receptionists and other administrative staff are contractually obliged to show regard to the NHS Code of Practice on Confidentiality and could face dismissal if they were to breach the confidentiality of a patient.


Will my GP be involved in my HIV care?

Good communication between your GP and your HIV doctor is very important. For example, your GP will want to know what medication you are taking, so they don’t prescribe you anything that would react badly with you or interact with your HIV medication. When you visit your GP, they may ask you about your key monitoring information, like your CD4 count and your viral load. They may also help you with any side effects of treatment you are taking. But the major aspects of your HIV care, including treatment decisions, will remain with your HIV doctor.1  If you have any concerns about how the care provided by your GP fits in with your HIV specialist care, ask your HIV doctor to talk to your GP.  If you have disclosed your status to your GP, your HIV doctor should already be in touch with them at least once a year to make sure both doctors are up to date with your treatment and care.1 

[1] BHIVA Standards of Care – Standard 3 - Provision of outpatient treatment and care for HIV,and access to care for complex comorbidity.  http://www.bhiva.org/standards-of-care-2012.aspx



What do I do if my GP says they can’t treat me because of my HIV?

Not all GPs are always confident treating people living with HIV. However, they should be able to manage your non-HIV care and should not send you back to your HIV doctor for routine health problems, ‘just in case’.  When you are first diagnosed with HIV or first disclose your HIV status to your GP, they should speak to your HIV doctor about your treatment and care and anything they should be aware of. You can also ask your HIV doctor to telephone your GP. 

One of your GP’s concerns may be around prescribing other medications which may interact with your HIV medication. This can lead either to medication not working properly, or to side-effects. For example, some cholesterol drugs interact badly with common HIV medication and some types of the hormonal contraceptive pill (The Pill) will not be as effective when taken alongside some HIV medication (see also Can I get contraception from my GP?).

However, your GP can access free guides which explain what they should and shouldn’t prescribe, depending on your HIV treatment.  They should also be in contact with your HIV doctor or the pharmacists at your HIV clinic about the medication you are taking and any current issues with your HIV care. 

There are also guides and training available for GPs to help them provide good treatment and care for people living with HIV. You could ask your HIV doctor to recommend these to your GP, or bring a copy yourself. 

If your GP still keeps sending you back to your HIV clinic for routine health problems, you can ask your HIV doctor to speak to them.  You might also want to find another GP who is more confident with your care – fellow patients at your clinic or your local HIV organisation might be able to recommend a GP. 



Will my GP tell anyone else about my HIV status?

GPs normally assume that there is implied patient consent to share relevant medical information with other parts of the NHS, when referring you for other care (e.g. hospital services).  As HIV is considered relevant to almost all aspects of your care, your GP will routinely share this information unless you ask them not to.  

Your GP is not to tell anyone outside of the NHS about your HIV status without your consent.1   This includes an employer, your children and insurance companies.

If you do consent to have information shared (e.g. to apply for insurance) the GP should only provide information that is relevant to the request.  Only rarely will it be necessary to send the whole of your patient record, this is the case for certain benefits requests and for some solicitors' requests.   Ask your GP if you have any concerns about how much detail they are sharing, and if this is necessary.  You have a right to see a copy of the information that is shared.

(For more on confidentiality see Confidentiality and Disclosure).

[1] Handbook to NHS Constitution, March 2013. http://www.nhs.uk/choiceintheNHS/Rightsandpledges/NHSConstitution/Pages/Overview.aspx

 

This resource was proposed by an advisory board, attended by an expert panel of voluntary sector/patient organisations. The writing of the resource was undertaken by NAT (National AIDS Trust). Merck Sharp & Dohme Limited (MSD) funded and attended the advisory board, and had the opportunity to check the resource for accuracy and balance. Final editorial control was held by NAT, taking account of input from the advisory board members and other experts.

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