Stakeholder Engagement Report - London Councils

• Skills and competencies training made available for all clinic staff that
wish to ‘skill up’ and offer more individual tailored support. This is seen
as a priority as it could target those known to be at risk, vulnerable or
those who report behaviour, which puts them and others at risk. (It was
noted that within the clinics there is no specific tariff for this specialised
intervention. Given that to be beneficial, sessions should be a minimum of
30 - 40 minutes, the impact on a clinic, which actively seeks to minimise
harm for both, its HIV positive and negative patients can be significant).
• Third sector organisations with the necessary skills to be commissioned to support
clinics and encourage robust referral pathways. Some third sector organisations
felt ‘pushed out’ by some GUM clinics especially where health advisor roles are
deemed to be doing the broader support role. Given the increased recognition that
a ‘combination prevention’ approach is the way forward, there were also concerns
raised that there are too few health adviser roles in clinics, and that access to
more specialised psychology or psychiatry services may be more appropriate
but there is limited access for sexual health HIV patients and service users.
• HIV testing of new registrants in primary care, with HIV testing being part
of routine practice. Stakeholders welcome the broader implementation
of peer led sexual health Sexual Health in Practice (SHIP) training across
London to increase capacity skills and competence within primary
care, in particular GPs in high prevalence areas. The (SHIP) scheme is a
hugely successful training and educational programme, developed in
Birmingham and successfully piloted in north London, and welcomed as an
innovative and meaningful way in which to engage GPs at local level.
• A defined or ideal configuration of targeted HIV
prevention service models and activity agreed
• Partner notification and contact tracing to be explicitly commissioned
as part of a GUM service with monitored data on numbers
and evidence of attendance and treatment uptake.
“These are not LOCAL services - they are about communicable disease control for all.
They shouldn’t be used as a pawn in a political boundaries game. They are open access,
and with that goes confusion for those who keep wanting to talk about localism!”
VFM and Funding
What is seen as value for money (VfM) was reported as being inconsistent by
stakeholders; with concerns about the level of understanding of how an investment in
HIV prevention now may not yield a return for many years to come. There were very
serious concerns expressed as to how Local Authorities would collaborate effectively in
such a contentious area as HIV, both due to the population groups it effects and the fact
the majority of transmission occurs through sex, which is not a topic many people are
comfortable talking about within a politically charged environment.
Stakeholders felt that the high cost of late diagnosis of HIV treatment and subsequent
social care costs should encourage Local Authorities to form alliances in order to
concentrate on effective commissioning for HIV Prevention.
Some felt that rather than asking “what can HIV prevention funding do to meet the
diverse health needs of those at risk of HIV exposure?’ the question might be turned
around to ask ‘what can HIV prevention funding do to realign other services so they
better meet the diverse health needs of those at risk of HIV exposure?”
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