Decision Maker: Cabinet

Outcome: Decision approved

Is Key Decision?: Yes

Is Callable In?: Yes

Date of Decision: October 1, 2024

Purpose: In 2020, Cabinet agreed that Newham Council could establish a Framework on behalf of Local Authorities across north east London (NEL) for the provision of services to support residents with HIV (e.g. practical, emotional and social support) alongside targeted prevention activity (i.e. screening, outreach, engagement and communications). This Framework and associated contracts are due to expire in May 2025.   The existing services deliver positive outcomes and offer good value for money .   A new Framework is therefore required and Newham Council, as the lead of the Sexual Health Shared Commissioning Service, is the logical choice to lead this procurement exercise on behalf of Local Authorities and health partners across NEL.   Decisions required:   1.  Establish and maintain an Open Access Framework for HIV Prevention & Support Services for up to eight years on behalf of all Local Authorities and Health Partners across London.  2.  Commence the registration process for providers to join the Framework. 3.  Delegate authority to the Corporate Director for Adults, Health and Communities to approve the registration of suitably qualified providers onto the Framework.

Content: Decision   For the reasons set out in the report and its appendices Cabinet RESOLVED to Agree:   i)  To establish and maintain a Framework for HIV Prevention & Support Services for up to eight years on behalf of all Local Authorities and Health Partners across London. (The intention is for the Framework to be accessible to all Local Authorities, Integrated Care Partnerships (ICPs), Integrated Care Boards (ICBs), Integrated Care Systems (ICSs) and NHS Trusts across the whole of London (or future equivalent bodies in the event of re-structures). ii)  Commence the registration process for providers to join the Framework. iii)  Delegate authority to the Corporate Director for Adults, Health and Communities to approve the registration of suitably qualified providers onto the Framework.   Alternatives Considered   a)  Commissioners are acutely aware of the financial pressures currently faced by the Council and the need to seek efficiencies. As such, an Options Appraisal was conducted that sought to understand and summarise the implications for Newham Council of reduced funding or no funding within this service area. This work will be used to inform the upcoming Spending Control Review. b)  Commissioners have also considered whether a specific Framework for HIV Prevention & Support was necessary – i.e. could the health inequalities associated with rising cases of HIV (and especially late diagnosis) be mitigated through existing ‘mainstream’ services? Commissioners concluded 8 that (separate to the issue of funding) there was a valid case for specific HIV Prevention & Support services, for the following reasons: 1.  Many PLWHIV have experienced stigma when dealing with mainstream ‘support’ services (e.g. advocacy, debt advice, counselling) and may therefore be less likely to engage with them in the future. 2.   HIV is a complex illness and there is value attached to the specialised nature of knowledge among staff in this sector. For example, adherence to anti-retroviral therapy (ART) can prove challenging for many people (especially non-English speakers) for various reasons, but it is vital as a way of reducing the risk of onward transmission. This point overlaps with; 3.  Staff mix: the CVFS staff in this sector often have lived experience of HIV, which means that they literally and figuratively speak the same language as residents LWHIV. Mainstream services could not offer this. 4.  There are no mainstream services that could achieve the level of access achieved by established specialist providers in this area when it comes to preventing HIV through targeted outreach and screening programmes in locations such as saunas, sex work venues and hostels (among others).