An MP has blamed 'NHS silos' for 'holding back access' to HIV-prevention drug Pre-Exposure Prophylaxis (PrEP) in primary care, including in community pharmacies.

During a debate last week (27 November), Labour MP for Uxbridge and South Ruislip Danny Beales said it was 'unacceptable that the drug was not being accessed by everyone who could benefit'.

And he called for access to the medicine to be expanded beyond its current provision through specialist sexual health services.

Patients waiting three months to access PrEP

Speaking to parliament, Mr Beale highlighted reports of people having acquired HIV while waiting to access the drug, which he said has an average waiting list of 12 weeks.

And he described the 'life-changing' effects of the drug 'in removing the fear and stigma of HIV' and in delivering a 'massive public health benefit'.

'It has driven the significant falls in new transmissions [of HIV], particularly among gay men, who have largely been the people who have accessed the drug to date,' Mr Beales said.

The government has committed to publishing a new HIV Action Plan by summer 2025.

Mr Beale said he hoped the new plan would address the 'significant failure' of long wait times, 'as well as turbocharging access outside sexual health services', which are currently the only place where PrEP can be accessed.

'It is entirely wrong that NHS silos are holding back access to PrEP in primary care, including in pharmacy and other settings,' he said in the debate, held ahead of World Aids Day, which was on 1 December.

In response, a spokesperson for NHS England (NHSE) told The Pharmacist: 'We know that PrEP is crucial in stopping the development of HIV as well as eliminating its spread through sexual transmission, which is why anyone eligible can access the medicine from any NHS sexual health clinic.

'The NHS is committed to working with the government to virtually eliminate HIV by 2030, and local NHS organisations are supporting this ambition through tailored plans that meet the needs of their communities.'

'Not on track' to reach no new cases of HIV by 2030

In a report also published ahead of World Aids Day, sexual health charity the Terrence Higgins Trust (THT), also called for expanded access to PrEP, as it warned England was 'not on track' to reach its goal of ending new cases of HIV by 2030. 

In particular, the report calls for a national PrEP Expansion Plan that includes the development of an online PrEP access portal.

The THT highlighted analysis by the Elton John AIDS Foundation published earlier this year that recommended 'a fully integrated online portal that delivers PrEP direct-to-the door... or [to a] local pharmacy'.

And it said that the plan 'should diversify the places where people can have a conversation about their HIV risk and be given PrEP, for example antenatal care, women’s health hubs, contraception services, and prisons, among others'.

It added: 'Pharmacies must be able to dispense the PrEP that is prescribed by these services.

'These avenues provide a rare opportunity to address PrEP awareness and initiation, with ongoing care and support delivered in adapted sexual health services.'

In response to the report, the government told The Pharmacist that it was 'exploring opportunities to deliver PrEP in settings outside sexual health services [SHSs] to improve access', including potentially through community pharmacies and online.

A spokesperson for the Department of Health and Social Care added: 'More widely, this government is committed to shifting the focus of healthcare from hospitals to the community. This includes expanding the role of pharmacies by better utilising the skills of pharmacists, pharmacy technicians and making prescribing part of the services delivered by community pharmacists.'

Last year, the government said it was looking at making PrEP available in settings including GP practices and pharmacies.

But its PrEP roadmap published in February this year said ‘more evidence’ was needed ‘on the effectiveness of providing PrEP outside SHSs’.