HIV Money for Councils

posted: 21/12/2010

The Government have now said how much each council will receive for HIV social care in the next two years. This used to be paid as 'AIDS Support Grant'.  

Increased Grant

Remarkably the funding identified for ‘AIDS Support’ is increased from £25.5 million this year (2010/11) and will rise to £36.2 million by 2014/15.

HIV community organisations worked hard to keep the amount for HIV listed within the overall grant to councils. This will mean people can ask what this HIV funding is really being spent on.

psending Ring-Fence Gone

The bad news is that this HIV money is no longer 'ring-fenced'. This means the council could spend the HIV money on anything. We need local people to help be our eyes and ears and put pressure on councils to spend the cash on HIV and nothing else.
 

MPs welcome increase

“This is a huge achievement.” said Simon Kirby MP, Vice Chair of the All Party Parliamentary Group for HIV and AIDS, who pushed for this increase. “With many councils having to make savings of up to 10% this year, there is no doubt that there will be pressure on all services including HIV services. But if councils receive a specific named ‘AIDS Support Grant’ people living with HIV have a good case to argue that the money should be spent on them.”
The All Party Parliamentary Group policy adviser, Veronica Oakeshott, says that HIV campaigners will still have a fight on their hands to ensure the grant “does what it says on the tin.”
 

Cuts presssure

Because of the cuts to council spending the government announced last week (the maximum 8.9% cut hits Manchester and other councils) there are great financial pressures on local authorities. Councils will be tempted to spend this HIV money on other, more popular services.

We encourage people to tell their local authority to spend all its 'HIV/AIDS Support' allocation on social care for people with HIV.

Tell your councillors what they should be spending on HIV 

You can find details of your local councillors using your email address and then send an email at WriteToThem

NW England table showing HIV funding (April 2009 to April 2013) from central government to councils that provide social care services

HIV money for each council for the year April 2011 - April 2012
HIV money for each council for the year April 2012 - April 2013

More information on HIV social care on NAT's website 

Manchester Pride Raises £115,000

posted: 26/10/2010

Manchester Pride 2010 raised £115,000 for charity, bringing the total since 2003 to £895,000. This year’s total is rather less than the most Pride ever raised, which was last year: £135,000.
The £115,000 will be used to support the Lesbian and Gay Foundation’s ‘Free Condom and Lube’ scheme, the George House Trust HIV Welfare Fund, and in grants over the coming months to various lesbian, gay, bisexual and transgender (LGBT) groups and projects across Greater Manchester.

HIV Welfare Fund 

The £115,000 will be split like this:
25% to the LGF Condom & Lube Scheme (£28,750), providing free condoms across Greater Manchester
25% to the George House Trust Welfare Fund (£28,750), supporting those living with or affected by HIV suffering financial hardship - apply here
50% to these three funds (£57,500 in total)

• Community Fast Track Fund
• Community Events Fund
• Development Fund

Jackie Crozier, festival director of Manchester Pride, said: “This is a fantastic achievement and we’re absolutely delighted with the figure. It’s a wonderful feeling to know that everyone who supported Manchester Pride 2010 has made a positive contribution to the future of the LGBT community in Greater Manchester.”

“Manchester Pride is a team effort and it wouldn’t be possible for us to stage the event we do without the help and support of so many organisations and individuals from across the city. I would like to take this opportunity to express my sincere gratitude to each and every person who helped us along the way.”
 

Applying for Community and Development Fund grants

For more information on how to apply for any of the community grants available, visit Pride

Image George House Trust volunteers collecting in St Anns Square: Graeme Vaughan www.photogas.com graeme@photogas.com

THT Hardship Fund Open

posted: 13/10/2010

The Terrence Higgins Trust (THT) Hardship Fund has now opened. People with HIV who need fnancial support can now apply for up to £100. In mid June Crusaid's Hardship Fund merged with Terrence Higgins Trust and the hardship fund closed temporarily. 

The replacement Hardship Fund service from Terrence Higgiins Trust will be fully working from April 2011. In the meantime George House Trust, which is the only approved referring agency in North West England, can apply to the THT hardship fund for grants of up to a maximum of £100 per person. People can't apply direct - they either need to apply through us, or use the Terrence Higgins Direct phone service: THT Direct on 0845 1221 200

If you live in NW England please speak to one of our service advisers for more details - 0161 274 4499. We can help in various ways, including through our own welfare fund, and with benefits and money advice.

Sir Nick Partridge, chief executive of THT, said:

“For years the Hardship Fund has been an important resource, making a real difference to the lives of people with HIV, and THT is fully committed to preserving its legacy. We are working hard to get the national fund fully operational by next spring, and in the meantime we hope our interim fund will continue to help those who need it most.”
 

A report released this week by THT and the National AIDS Trust said that one in six people diagnosed with HIV make use of the fund, and that the majority of beneficiaries are living in “extreme” poverty, on just 20 per cent of the average weekly income. Read more about this here
 

Social Care - Feast To Famine

posted: 08/10/2010

Feast to Famine? HIV Social Care and the AIDS Support Grant is a report on social care for HIV in England, by Andrew Pearmain, HIV Consultant Practitioner, Essex County Council. As part of this investigation he spent time at George House Trust.

What is the future for HIV social care with the end of the ring-fence protecting the AIDS Support Grant? This report looks at the current provision of local authority HIV social care, recent changes, how people find and receive HIV social care services,  how HIV social care is organised, and the community sector’s contribution. Here's the executive summary; you can download the full report by clicking here or on the image of the report cover.

1. Introduction
• Around 86 HIV-specialist social workers are supporting around 9000 people with HIV/AIDS in England; most HIV social workers have an ‘open’ caseload of around 30, including between 5 and 10 ‘active’ at any one time, and around 70 more who have recently had or will soon need support.
• The ‘de-ring-fencing’ of the AIDS Support Grant poses a major threat to HIV statutory and voluntary social care.
• HIV social work has been steadily declining, partly because of the reassertion of the ‘medical model’, but also because social services have rarely embraced it. As “good old-fashioned social work”, protected by the ASG from service plans, eligibility criteria and funding constraints, it has remained separate and untypical. For most people with HIV/AIDS receiving statutory social care, HIV social work is the service.
• This report is based on visits to sixteen local authorities in England, chosen to represent different regions, social and demographic characteristics, models of service delivery and levels of HIV infection. Research included interviews with HIV social workers, their managers and commissioners, and HIV voluntary workers, observations of visits to service-users, and related background reading.
• The most notable feature of HIV-specialist social care across England, twenty one years after the inception of the AIDS Support Grant, is its extraordinary diversity.

2. HIV Social Care: A Brief History
• HIV social care developed, towards its mid-1990s heyday, in the absence of effective medical treatments for HIV infection. The voluntary sector led the way, with a heavy emphasis on self-help and mutual support, and this shaped the statutory response.
• Gay men were disproportionately affected by HIV/AIDS, and service responses were heavily influenced by gay politics, cultures and values. The state only acted when HIV infection threatened to ‘cross over’ into the ‘general population’, but it was surprisingly ‘liberal’ in its confidential, non-judgmental support and universal alarm.
• The 1987 AIDS Control Act set the legislative framework; the AIDS Support Grant was established in 1989 to promote HIV ‘community care’ and ‘joint working’ with the NHS and the voluntary sector.
• HIV social work grew and spread steadily, with a strong sense of ‘trailblazing’ radical mission; this included pioneering and highly effective programmes of ‘AIDS Awareness Raising’ across social and other public services.
• The introduction of ‘care management’ in the 1990s created sharpening and debilitating tensions between generic and specialist social services. At around the same time, the experience of living with HIV/AIDS was being transformed for many people by effective anti-retroviral drugs, which revived ‘the medical model’.
• Changes in the HIV population since, specifically the growth in black Africans, have revived HIV stigma in new forms, challenged all HIV social care services and further complicated HIV social work.
• New Labour substantially increased the AIDS Support Grant, but just as steadily downgraded the importance of HIV by subsuming it within health strategies for ‘blood-borne viruses’ and ‘broader sexual health’.
• The historical basis for HIV-specialist social care, specifically the prejudice and discrimination and consequent stigma and shame experienced by people with HIV/AIDS, remains as much of a factor in many of their lives.

3. HIV Social Care Now
• HIV/AIDS ‘awareness’ and services are still clustered in places with substantial and influential gay populations, even with the emergence of ‘new client groups’. The AIDS Support Grant has failed to ‘nationalise’ provision.
• The service response to the needs of black Africans with HIV has generally been limited, temporary and grudging.
• There is a “massive divide” between statutory and voluntary HIV social care, with frequent mistrust and misunderstanding on both sides; but where efforts are made to define roles and boundaries, and to maintain good communication, services for people with HIV/AIDS markedly improve.
• For all the constraints and pressures, there are still examples of high-quality, effective and appreciated HIV social work; it constitutes a viable, necessary and highly professional specialism within HIV social care.

4. How People Get HIV Social Work
• There is some tension between the ‘medical’ and ‘social’ models in HIV care, and considerable variation in relationships between ‘frontline’ HIV services.
• ‘Single Access Points’ into statutory social care are not generally receptive to people with HIV/AIDS; the HIV-specialist ‘back door’ is wherever possible being retained.
• HIV social care assessments are generally rigorous and comprehensive, especially when compared to generic assessments.
• Less than 10 per cent of HIV social care cases meet the ‘critical or substantial’ FACS eligibility criteria for services. In some places, the availability of HIV-specialist services has been used to justify withholding necessary and ‘eligible’ generic social care.
• The level and quality of ‘cross-referrals’ between statutory social care and the HIV voluntary sector vary widely across the country, depending on the level of ongoing practical collaboration between them.
• ‘Self-Directed Support’ offers a chance to restore ‘good old-fashioned social work’, with the service-user in control and a healthily preventative approach, but it may prove difficult to sustain under spending cuts and ‘institutional inertia’.

5. Organisational Issues for HIV Social Work
• There is an obvious and serious tension between HIV specialist and generic social work, which can be eased by good management. Where HIV and generic social work are combined in single posts or teams, the HIV element tends to get squeezed out.
• Good HIV social work supports people throughout their HIV infection, prevents crises and keeps them well, promotes life planning and HIV treatment adherence, enables challenge to other professionals’ decisions and access to suitable generic services, and as such is demonstrably ‘cost-effective’.
• Hospital settings for HIV social work can be isolating and dominated by ‘the medical model’; for similar reasons, HIV social work does not easily fit into Drug and Alcohol teams. The most congenial setting is Physical/Sensory Impairment; the least of all is generic Adult Social Care dominated by services for older people.
• Close working relationships with NHS-based HIV services are crucial, but HIV social workers must retain some independence.
• Under ‘personalization’ or ‘transformation’ agendas, ‘outsourcing’ to other settings is being considered for HIV social work; the biggest but not insurmountable problem is preserving links back into the local authority.
• HIV infection is either recorded in code on local authority databases or on separate ‘protected’ records, or not recorded at all. This can conflict with local authority obligations to monitor and account for their social work, and with leave-cover arrangements.
• In fact there have been very few serious breaches of confidentiality in Adult Social Care – they tend to occur in other agencies - and in general people trust the security of local authority databases.

6. The HIV Voluntary Sector
• The HIV voluntary sector is diverse, complex and occasionally fractious. There are particular tensions between national, regional and local organisations.
• There needs to be a revival of HIV voluntarism and self-help, and clearer recognition of new client groups.
• The expectations of funders and commissioners can be either too vague or misguided, with limited monitoring and contracting.
• The NHS and ‘the medical model’ still dominate HIV care. Working relations between (and within) the NHS, the voluntary and statutory sectors are complex and ‘political’.
• There are opportunities as well as threats in a future without the ASG, especially in ‘Self-Directed Support’ and NHS reconfiguration, including comprehensive and coherent, integrated HIV statutory and voluntary social care, which might even be purchased by non-HIV service-users’ ‘individual budgets’.

Copies of this executive summary, and of the full ‘Feast to Famine?’ report, and presentation, consultancy and training based upon it, are available from Andrew Pearmain by e-mail or phone 07505 083 864
 

AIDS Support Grant Changes

posted: 12/08/2010

The Department of Health wants people’s views about changes it plans in how it works out the amount of AIDS Support Grant (ASG) paid to each council. The deadline for comments is Wednesday 6 October.

Instead of working out the ASG amounts each year, The Department of Health wants to decide and tell councils now what they will get in the following four years. However they don’t guarantee anything about the future of ASG, because of the Autumn Spending Review, which will be announced in late October.
 

Two Options

They suggest two options. The first, which they prefer, is based on the current formula which would be frozen. This would mean using the most recent HIV data (on the numbers of people with HIV and of children with HIV in each district) to decide the grant for each year of the Spending Review. The second option uses another formula - the younger adults social care relative needs formula. This produces very strange results.

Impact in NW England

We have produced a table showing the amounts of ASG paid to NW councils this year and last year, and the amounts using the two formulas, that would be paid for the next four years. 

The consultation proposals and response form are here
 

The deadline for replies is Wednesday 6 October.