October 2020 update from Mildmay’s Chief Executive

Dear Mildmay Supporters,

I am writing to bring you up to date on what has been happening at Mildmay Hospital this year, at a time of pivotal change for our Charity. The key drivers for this change have been the advances made in both HIV prevention and treatment, with some reports suggesting that onward transmission of HIV in the UK could fall to practically zero by 2030. Our current HIV services will still be called on for some time to come, but we are taking steps now towards the time when Mildmay Hospital will no longer be needed in the fight against HIV/AIDS – something that has always been our goal.


Recognising our “outstanding” specialist services for people with HIV and our ability to adapt and respond to new, often complex, and rapidly changing needs, NHS England/Healthy London Partnership commissioned Mildmay Hospital to immediately start admitting fast-track, step-down patients from NHS hospitals that were clearing beds to make way for COVID-19 patients.

We were also asked to admit homeless patients over the course of the spring and summer, who would also be stepped down to Mildmay prior to discharge. We agreed to both requests and patients quickly began to arrive. We worked with NHS England and the Healthy London Partnership to create our new homeless patient pathway in an extremely short timeframe and our relationship with them has never been better. This contract was subsequently extended to March 2021 with the hope that longer-term funding will be agreed after that. Alongside HIV, this will form the bedrock of Mildmay’s work in the future.


One of the biggest challenges Mildmay still faces is the supply of PPE. At one point, we came within two hours of running out of masks. We sought new suppliers to ensure we had enough supplies during the height of the Lockdown period. Once we got past this watershed, we put systems in place to ensure that we will never be faced with this situation again.


Earlier in the year, the UK Government made great strides in moving rough sleepers from the streets, realising both their vulnerability in catching and transmitting COVID-19, as well as their general poorer underlying health. By July, with the London COVID-Care Centre at London City Airport being decommissioned and an alternative, with fewer beds needed, Mildmay was asked to take in homeless COVID-19 patients who were being isolated and tested. This worked well and there has been a steady stream of these patients since July.

Mildmay’s extensive rehabilitation expertise is relevant for post-COVID recovery and we are now designated as London’s primary facility for homeless COVID-19 patients not requiring intensive care. We provide rapid-testing, accommodation in which to self-isolate, and medical care and recovery for those with confirmed COVID-19 infection. At the time of writing, COVID-19 transmission is rising again, so we expect to see further demand for our services in the months to come.


The number of HIV patients we treat fell this year as the number of HIV patients being treated in the NHS has also gone down. As we go into autumn, numbers are increasing again and there is a strong feeling that they will continue to rise as we head into winter. The commissioning of these patients is still on a CCG by CCG basis and most do not have a contract with Mildmay. A Pan-London contract for HIV patients would be the most practical way forward, but London CCGs are reticent to commit funding to this, despite the exceptionality of the specialised neurorehabilitation services that Mildmay has always provided.

The story over the course of the spring and summer has been one of success. Whilst there have been operational challenges, the hospital has stepped up and delivered. Longer-term funding for the homeless pathway isn’t yet certain and some core costs of running the organisation aren’t covered. The move from HIV/AIDS to a new primary focus brings with it a ‘change’ cost as we adapt our staffing model as services are rolled out to meet these new demands. It is our hope and our appeal that, having proved that we can rapidly adapt to deliver new services, Mildmay can provide HIV - and the much-needed homeless services, beyond the pandemic, and well into the future.

With Mildmay being founded just over 150 years ago to serve people in London’s poorest slums, the charity is once again refocussing to meet the needs of those from across the capital, who have the least. It is the beginning of the next phase of Mildmay Mission Hospital, and one aimed at bringing a new beginning for every person we serve.

Geoff Coleman MIHM, DMS, MA, MBA
Chief Executive Officer 

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