The UK Health Security Agency (UKHSA) has published a landmark evaluation of the NHS opt-out bloodborne virus testing programme, revealing that thousands of people unknowingly living with HIV, hepatitis B, and hepatitis C have now been diagnosed and offered life-saving treatment. The programme, which automatically tests emergency department (ED) patients unless they choose to opt out, has been hailed as a breakthrough in early virus detection and public health protection.
Launched in April 2022 across 34 emergency departments in England’s highest HIV prevalence areas, the NHS opt-out testing scheme has carried out more than 7 million bloodborne virus (BBV) tests over 33 months—accounting for nearly half of all BBV testing in these regions. Around 70% of eligible patients accepted the test, proving the effectiveness of the opt-out model.
The programme identified 3,667 new hepatitis B cases, 831 new hepatitis C cases, and 719 new HIV cases, with an additional 291 people re-engaged in HIV care after previously dropping out of treatment. The findings reveal one in 240 people tested positive for hepatitis B, underscoring the scale of undiagnosed infections in the UK.
Early Detection Saves Lives
Dr Sema Mandal, Deputy Director at the UKHSA’s Blood Safety, Hepatitis, STI and HIV Division, said the results confirm that “thousands of people who would otherwise remain undiagnosed are now receiving life-saving care.” She called for continued efforts to expand awareness, testing, and treatment: “We must improve diagnosis and ensure people are supported into care. Early detection prevents years of ill health and saves thousands of lives.”
The evaluation also highlighted the programme’s strong reach among under-tested populations. More than 60% of those tested had no record of prior BBV screening. Uptake was particularly high among older adults—72% among those aged 80 and above—and among minority communities, with 73% participation among Black Caribbean and nearly 69% among Asian Other attendees.
A Step Toward Ending HIV Transmission by 2030
Public Health Minister Ashley Dalton praised the initiative as “a huge success” that aligns with the UK’s commitment to end new HIV transmissions by 2030. “By making testing a routine part of emergency care, we’re helping patients get treatment earlier and protecting the wider community,” Dalton said.
The minister added that nearly 300 people previously diagnosed with HIV but not in care have now reconnected with NHS treatment services thanks to the programme.
NHS Hails the Programme as a ‘Gamechanger’
Dr Claire Fuller, NHS England’s National Medical Director, described the rollout as a “gamechanger for early detection,” ensuring thousands more people access life-saving care while reducing virus transmission. “This shows the NHS making every patient contact count,” she said.
The NHS plans to expand the initiative further as part of its broader public health strategy, which also includes community testing and GP-led screening.
Background: Tackling the UK’s Hidden Epidemic
The UK government’s 10-year HIV Action Plan aims to eliminate new HIV transmissions by 2030, focusing on testing, early intervention, and stigma reduction. Hepatitis B and C remain major global health challenges, with the World Health Organization estimating that millions worldwide are undiagnosed. In the UK, health experts warn that undetected infections continue to contribute to preventable deaths and long-term liver disease.
