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RESOLVED to:
1. 
Prevention and Promotion: Authorise Hackney Council to
be included in the new North East London framework for community
and voluntary organisations working in sexual health, HIV
prevention and support. This will be commissioned and managed by
London Borough of Newham for all North East London local
authorities commencing in 2025. The value of services to be
procured by Hackney Council via the four
year framework would be a maximum of £875k ex
VAT.
2. 
Prevention and Promotion: Authorise Hackney Council to
be included in the London HIV Prevention Programme commissioned by
Lambeth LA for a further 4 years. Hackney Council’s
contribution for this period will be a maximum of £200k ex
VAT.
3. 
Additional funding option: Across City, Hackney, London
and nationally the need for sexual and reproductive health services
is significantly increasing with rising rates of unwanted
pregnancies, increasing number of terminations and increased rates
of STIs. Significant cost savings have taken place across sexual
health services and a number of leading agencies including the All
Parliamentary Women’s and Equality Group, Local Government
Association and Association of Directors of Public Health have been
advocating for increased national funding for sexual health
services.
4. 
To enable rapid deployment of any additional (national
government grant) funding that may be provided to local
authorities, permission to include an option to increase the value
of contracts by further sums allocated to the Council, currently
estimated to be approximately a further 40%, as part of the
procurement options. Any such option to increase contract values
would be taken in line with internal governance to allow suitable
oversight of the option but also rapid deployment in the event that
additional funding is provided.

Reasons For Decision
 
Prevention and
promotion:
1. 
Preventing sexual and reproductive ill health by increasing sexual
health literacy is a key strategic priority contained within the
SRH strategy.
2. 
Alongside work being undertaken by Young Hackney in schools and the
youth hubs the voluntary sector has a key role in Increasing
information on prevention methods such as condoms, PrEP, contraception, testing, treatment and partner
notification.
3. 
The recent needs assessment confirmed that significant sexual and
reproductive health inequalities exist, with high levels of
need 
including for young people, gay and bisexual men and amongst
specific global majority communities.
4. 
City and Hackney has been party to an existing NEL framework for
community and voluntary organisations working in prevention and
support. This framework finishes in 2025.
5. 
The London Borough of Newham, on behalf of all North East London
local authorities, plans to recommission the framework in 2025.
 
The existing
contracts to be procured under the framework are:
 
6. 
Condom distribution to targeted communities - The service provides
free condoms and lubricant, and information, to Hackney and City of
London residents aged 18+ from black ethnic groups, as well as
other ethnic minority groups, through targeted outreach and
engagement
7. 
HIV Preventative Services for adults (Lot 1) and HIV Preventative
Services - families and children (Lot 2): The service provides
people living with HIV, particularly newly diagnosed cases with a
timely, personalised, time-focused package of support which
promotes independence as well as emotional, physical and social
wellbeing. It also includes community outreach and testing
services.
8. 
Project Community (Community Sexual Health Promotions service) -
The aim is to prevent and improve poor sexual and reproductive
health outcomes for individuals from high-risk communities
9. 
Continuing to be a party to the framework provides City and Hackney
with a number of benefits including:
a) Making it easier
for local C&H voluntary sector providers to be commissioned
across NEL
b) Increased
efficiency by aligning the approach to contract and performance
management
c) Providing for
economies of scale across NEL whilst retaining the focus on local
areas.
10.In addition to the NEL
framework, City and Hackney has been a long - standing member of
the London HIV Prevention Partnership (LHPP), commissioned by
Lambeth Council and provided by a wide range of voluntary partners,
including East London based organisations, across
London. 
11.LHPP is a London wide
partnership that aims to reduce HIV transmission and promote
regular HIV testing as well as PrEP
uptake across both gay and bisexual men and also heterosexual
communities especially from global majority communities.
12.By taking a London wide approach
the LHPP benefits from economies of scale especially in relation to
social media based health promotions, outreach to venues (including
those based in City and Hackney) that serve residents from across
London, the UK and worldwide.
13.The contracts commissioned by
Lambeth will need to be recommissioned in 2025/26 and permission is
sought to confirm that City and Hackney will remain as a
partnership member.
14.The overall outcomes for the
prevention and promotion services will be:
15.Increase uptake of long-acting
reversible contraception (LARC), including for disadvantaged or
under-served communities
16.Increase the uptake of HIV
testing, reduce late HIV diagnoses and preventing new
infections
17.Ensure timely results and
follow-up for all STIs and improve immunisation, to help to reduce
the risk of onward infections
18.Ensure screening/identification
and interventions for health and social risks such as domestic
violence, child sexual exploitation, Female Genital Mutilation
(FGM), and child and adult safeguarding, as part of local
arrangements for pathways of care and support
19.Improve sexual health promotion,
HIV prevention and uptake of sexual health interventions including
LARC in key and vulnerable groups through targeted interventions
and promotion, encouraging innovation
20.Monitor and improve the quality
and experience of services for all users, including annual service
user engagement plans.
 
 
Alternatives
Considered and Rejected
 
Option 1 - End the services at
the currently scheduled end date of and do not recommission
services
1. 
This option considers the implications of ceasing the delivery of
prevention and promotion services.
2. 
Under the Public Health ring-fenced grant conditions, sexual and
reproductive health promotion services are not prescribed, but they
are listed under the non prescribed
(and, therefore, expected functions) and play a key role in
reducing health inequalities, reducing the direct costs of
providing for prescribed services e.g. testing and treatment of
STIs. Not recommissioning services would lead to increased health
inequalities, mortality and morbidity.
 
Option 2 - Not join the NEL
Framework
3. 
This option considers directly re-procuring the existing contracts
directly rather than continuing to do so via a new framework
4. 
A framework for HIV support across NEL was established in 2017 and
has been effectively used to procure services for HIV support and
prevention from local organisations
5. 
City and Hackney has played an active role in establishing the new
framework to ensure it meets local needs and will facilitate local,
smaller organisations being commissioned more efficiently by a
wider range of organisations e.g. NHS partners but also
neighbouring authorities
6. 
Not joining the NEL framework will put our local community
organisations at a disadvantage and increases their administrative
burdens when applying for contracts
7. 
In the event that the framework does not deliver what is required
for City and Hackney purposes we are not compelled to use it and at
any point can choose to procure services directly
 
Option 3  - Do not continue with London
HIV Prevention Partnership
8. 
This option considers not continuing with London HIV Prevention
Partnership (LHPP)
9. 
This would be contrary to the Labour Party Manifesto which
specifically includes a commitment to continue with this
partnership arrangement
10.The partnership provides for
significant economies of scale of working on HIV prevention at
scale across London for both our gay, bisexual communities and also
global majority communities.
11.Not continuing with the LHPP
would lead to a reduction in the scale and reach of the London wide
programme programme and be contrary to
the key decision AHI S299.
 
Option 4  - Join the NEL framework and
continue to be part of the London HIV Prevention Partnership
12.This option allows us to
continue to realise the benefits of local providers whilst also
realising economies of scale
13.This also provides for more
efficient procurement of services by using a framework
14.Local providers and other
specialist providers on the framework will allow Hackney to quickly
and efficiently commission providers to meet existing and future
needs for sexual health promotions
 
Option 5 - insourcing
15.These health promotion services
are provided by community and voluntary sector organisations who
are an integral part of local communities and provide value for
money for the Council. Insourcing would potentially destabilise
voluntary sector organisations by removing funding and staff which
are central to their functions.
16.Many of the communities with the
highest inequalities have long standing trusted relationships with
local community organisations. It would be difficult, if not
impossible, to replicate this if services were insourced.