The future of HIV services in England: Working across London s local authorities to deliver prevention PROUDLY SUPPORTED BY ALL LONDON BOROUGHS

Transcription

1 The future of HIV services in England: Working across London s local authorities to deliver prevention PROUDLY SUPPORTED BY ALL LONDON BOROUGHS

2 What is the LHPP? London-wide programme of HIV prevention activities and interventions, funded by all 32 London boroughs and City of London ( )* 2.4m over two years ( ); 2.1m ( ) Delivers needs-led, evidence-based interventions where there a rationale for city-wide approach Main elements:- Campaigns/communications on HIV (all groups) Condom distribution scheme for MSM Targeted outreach (venues & online) A review of condom distribution schemes targeting black African communities in London Central focus for policy & delivery around HIV prevention in the capital Evaluation & evidence building (independent of LHPP)

3 Cartogram of HIV diagnosed prevalence. The former NHS regions are sized by the prevalence rate of diagnosed HIV (SOPHID data). Darker colours represent higher rates.

4 London - Commissioning Context on HIV History of collaboration on HIV prevention by London PCTs Transition of public health to local government, including responsibility for HIV prevention Limited information or evidence from the previous programme ( ) on which to make a case/set out future options LAs keen to demonstrate getting a grip of their new PH responsibilities, esp HIV : Leaders of all London Councils agreed to London wide needs assessment to inform future & agreed a new coordinated approach

5 Strong governance & management ADPH> Chief Executives> Leaders decision Commissioned and managed by Lambeth Council on behalf of all boroughs Annual borough contributions proportionate based on SOPHID data MoU between Lambeth and each borough Governance via LHPP Steering Group Lambeth procurement/decision making operational autonomy is key for London not on borough basis Thorough and robust commissioning, procurement and delivery (5 new contracts), forensic monitoring/oversight In house direction of marketing/advertising/pr

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9 Phase 1: soft launch (May 2015) Strategic role was to introduce the brand, so that it is more familiar when more engaging formats launch in late June 238 phone kiosks London wide Generic HIV testing message Traffic to Supported by digital & social (e.g. Facebook) and very positive press coverage Collaboration with borough comms & PH teams to amplify impact using local channels

10 Phase 2: Summer 2015 Media pack pull up banner stands, A3 posters, artwork, digital brand guidelines Wide coverage through OOH, print & digital media Outreach & CDS in venues across city Press & comms plan opportunities in every borough (though not maximised in all) Monthly ADPH London briefings Regular campaign briefings

11 Phase 3: Winter 2015/16 campaign

12 Phase 4: Summer Testing

13 Phase 5: Winter 2016/17 STIs

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15 By working together, London boroughs have done impressive work to improve sexual health and increase HIV testing through the London HIV Prevention Programme s Do It campaign. It s important that we continue to work together to build on the campaign s success, so I would urge Londoners to find out more and get tested for HIV

16 CTR Exit Link Out ( signpost or button ) CTR 2015 CTR 2016 Average CTR 5.39 % 3.58 % 4.10 % 1.03 % 1.85 % 1.69 % 1.98 % 0.92 % 1.20 %

17 Independent market research evaluation: Campaign impact all respondents (Feb 2016) I am more likely to practice safe sex (e.g. use condoms) in the future 60% 27% 13% I will visit the Do it London website to find out more 41% 39% 20% I plan to get tested for HIV 40% 46% 15% I plan to get tested for STIs 39% 48% 13% Yes No unsure

18 Proportion of people diagnosed with HIV at a late stage of infection in London and outside London: United Kingdom, Presentation title - edit in Header and Footer Late stage of HIV infection: CD4 <350 cells/mm 3 within three months of diagnosis. Crown copyright 2016

19 Indicative shift in HIV incidence 2016

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21 The anxiety that elected officials are often not public health experts: you might get a very enlightened council, who understood the needs of the disenfranchised and prioritised them; or you might get a bunch of puffed-up moralists who spent their syphilis budget on a new aqua aerobics provision for the overweight. In practical terms, the problem immediately identified was that people don t have sex within only one borough; in some cases, this forced local authorities to cooperate; in other cases, it left some councils picking up the tab for their neighbours. It is a near-perfect example of why balkanisation is more expensive than collectivism, creating both waste and under-provision. Zoe Williams, 21 September 2015

22 Challenges LOCAL v REGIONAL: LHPP complementary to, rather than replacement for, localised intervention 33 LAs: Communication, reporting and engagement BUDGETS: benefit of pooling budgets & making the case for a London approach PROOF: Evaluation v market research BUSINESS CASE: Securing future all-borough commitment

23 Paul Steinberg Lead Commissioner & Programme Manager