Source: UK Health Security Agency published on this website Wednesday 29 October 2025 by Jill Powell
The UK Health Security Agency has today published its evaluation report of the groundbreaking NHS emergency department (ED) opt-out testing programme – an integrated bloodborne virus (BBV) testing programme for HIV, hepatitis B and hepatitis C.
The evaluation findings show the programme has identified thousands of people living unknowingly with bloodborne viruses, with many now being offered life-saving treatment for the first time.
As part of blood tests taken during emergency care in 34 EDs in areas with the highest HIV prevalence, people are automatically tested for HIV, hepatitis B, and hepatitis C unless they opt out. Those who receive a diagnosis are then offered treatment and support.
The results demonstrate the programme’s significant impact. Over 33 months, it conducted over 7 million BBV tests, representing around 50% of all BBV testing done in these areas during this period. It achieved a high test uptake rate of around 70% among eligible people, demonstrating the effectiveness of the opt-out approach.
A large number of new diagnoses were identified:
- 3,667 new hepatitis B (HBV) diagnoses
- 831 new hepatitis C (HCV) diagnoses
- 719 new HIV diagnoses
One in 240 people tested was found to have hepatitis B, highlighting the large number of people who are living with undiagnosed hepatitis B and the benefit of combined opt-out testing for BBVs in EDs. Similarly, one in 1,276 people tested was found to have with HCV and one in 1916 for HIV. Further benefits included care re-engagement including 291 people previously diagnosed with HIV who were subsequently re-linked to HIV care during the programme.
The report, commissioned by NHS England, evaluates the first 33 months of the programme from April 2022 to 1 January 2025.
Dr Sema Mandal, Consultant Epidemiologist and Deputy Director of the Blood Safety, Hepatitis, STI and HIV Division at UKHSA, said:
“The pioneering NHS opt-out testing programme in emergency departments is helping us reach thousands of people who did not know they were living with HIV, hepatitis B or hepatitis C. Many of these individuals might never have been tested otherwise – missing the chance to access life-saving treatment.
“What we’re seeing is a clear and urgent need to do more to tackle these serious infections. The high number of new diagnoses across all three conditions – particularly the consistently high hepatitis B numbers – shows just how many people are living with undiagnosed bloodborne viruses. We must improve awareness, expand testing and diagnosis and ensure people are supported into care and treatment. Early diagnosis can help prevent years of ill health and save thousands of lives.”
Over 60% of people tested had no record of previous BBV testing, indicating the programme successfully reached populations who may not have been diagnosed in other healthcare settings.
