National Aids Trust issues warning over future of HIV services

Many authorities could reduce their social care spending on people with HIV/Aids if the Department of Health (DH) removes ring-fencing from a grant targeted at the client group, the National Aids Trust revealed today.

Almost a third of 106 local authorities that responded to an NAT review of the Aids Support Grant (ASG) would cut funding if the DH removed the ring-fence.

A quarter did not know what they would do, while 35% said they would continue to provide funding at their current level and 4% said they would no longer fund services.

Lack of voluntary sector confidence

Only 8% of the 30 voluntary sector respondents to the survey felt services would be funded at the same level if the grant was not protected, while half thought services would continue at a reduced level.

Although the ring-fence is in place until at least 2010/11, the NAT pointed out that there had been a “clear move away” from specific ring-fenced grants by government.

The ASG is worth £21.8m in 2009/10 and the DH said it would allocate a “similar amount” in 2010/11.

Four out of five authorities were happy with the formula used to allocate the grant – 70% of which is based on the number of people living with HIV in an area, and 30% according to the number of women and children.

Additional costs to fund services for black Africans

However, one London borough said there were additional costs associated with providing services for black Africans because they were “hard to engage with”, and councils should receive more money if many people from these communities lived in their area.

In addition, 14% of authorities had not spent their entire allocation, and one had not used the grant because it had no commissioner in post.

The NAT called for all authorities to carry out assessments of needs in their area before planning and commissioning social care services for those with HIV, after finding that almost half of those surveyed had not done this.

HIV-specific social work roles at risk

The report found almost three in five local authorities used the grant to fund HIV-specific social workers, but anecdotal evidence suggested these roles were “disappearing as services are mainstreamed”.

Among other findings, the NAT found that:-

• 82% of authorities had evaluated services funded by the ASG
• 43% had a public monitoring or scrutiny process in place
• 24% were using direct payments for the client group
• 32% said the social care needs of people living with HIV were included in their local area agreements
• 45% asked people with HIV to go through a fair access to care assessment, using standard eligibility criteria, while 55% used different eligibility thresholds to FACS for ASG-funded services
• In some cases where standard eligibility criteria were used for statutory services, voluntary sector services funded by the ASG were open to everyone with an HIV diagnosis

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