We're the UK’s leading HIV and sexual health charity, founded in 1982 at the beginning of the global HIV and AIDS epidemic. In 2020, we've had to respond to the challenges arising from the COVID-19 pandemic and adapt our strategy and plans accordingly. Our operating models, funding streams and our organisational resilience have been tested by the crisis, and our medium-term plans need to reflect this new reality.
In early 2020 after extensive consultation, we were ready to approve a new and ambitious three-year strategy, with a 10-year view. As a direct result of the COVID-19 crisis, we've paused the implementation of this new strategy and instead will work towards meeting seven key strategic priorities between now and March 2022.
While needing to focus on our core service offer, we're also creating an environment where new opportunities can be grasped and innovation is encouraged and can be accelerated.
1. We'll work towards ending HIV transmission in the UK by 2030.
In the next 10 years we have the chance to end new HIV transmissions in the UK for good. As the UK’s leading HIV and sexual health charity, we’ve been fighting for this opportunity for nearly four decades. Together with the National AIDS Trust and the Elton John AIDS Foundation we have established the independent HIV Commission which will identify what needs to be done to reach zero new HIV transmissions by 2030 – a process that has been endorsed by the UK Government.
The outcomes of the Commission’s work – due later in 2020 – will frame our prevention activities in the months and years ahead. However, we already know some elements that will assist us in meeting this ambitious target.
- Enable access to HIV tests that are either free or cost-effective to purchase.
- Ensure that PrEP is available free on the NHS throughout the UK and access is promoted to all at-risk groups.
- Raise awareness of the effectiveness of HIV treatment, PrEP and condoms to stop HIV transmissions in the general population and those most at risk.
- Develop specific strategic interventions for people from trans communities, women, black African men and gay and bisexual men.
- Drive forward the relevant recommendations of the independent HIV Commission.
2. We'll support people to live well with HIV and manage the impact that COVID-19 has on them.
People living with HIV need to be informing the delivery of our programmes designed to provide them with support. This is going to be even more important due to the impact of COVID-19, as we see limitations on how activities can be delivered and the impact on the emotional and mental health of our service users.
Our services will focus on facilitating individuals’ mental and emotional well-being, self-care, advice, skills development and access to peer support. The majority of our support activities will be delivered using online platforms.
- Expand and further develop the newly created Terrence Higgins Trust At Home service as the main focal point for supporting people from diverse communities living with HIV, including those from BAME communities and those growing older with HIV.
- Launch a new online HIV peer support forum.
- Widen our psychological and therapeutic support services.
- Support people with haemophilia who are living with HIV.
- Use THT Direct as the main gateway for support services.
- Expand the digital aspect of our employment and skills programme.
- Provide specific support for those shielding and in need of practical and emotional support.
- Maintain a reasonable level of resource for the Hardship Fund to support people in crisis.
- Co-produce our services with those who use these services.
3. We will ensure that HIV and sexual health are not forgotten by key decision-makers.
Prior to the COVID-19 emergency, great progress was being made in HIV with diagnoses falling, a new national commitment to end HIV transmissions by 2030, and a commitment from the UK Government to draft a National HIV Action Plan for England to meet this target. At the same time, rates of STIs were increasing and sexual health services were unable to cope with demand. We worked with partners to get a commitment on a National Sexual Health and Reproductive Health Strategy for England and brought together evidence of the STI crisis in our State of the Nation report with the British Association for Sexual Health and HIV (BASHH).
COVID-19 has threatened all of this progress. Current and future access to sexual health services is a concern, and no recent progress has been made on the national strategy and action plan. The routine commissioning of PrEP is up in the air, and there are questions about whether compulsory Relationships and Sex Education in England will commence on time. There is a real fear that sexual health and HIV has fallen off the Government’s agenda.
By working collaboratively with experts and partners in the sector, our key supporters, and social media influencers, we will effectively lobby national governments, local authorities and health organisations to ensure that HIV and sexual health are not forgotten.
- Work to reverse the current lack of focus and ensure that sexual health and HIV are a priority for Government.
- Use our strengths in policy and public affairs, and work with partners to ensure that barriers preventing progress on HIV and tackling STIs are overcome and Government at the national and local level steps up to its commitments in these areas.
- Work to ensure that sufficient resources are provided to continue to deliver HIV and sexual health services during this period.
4. We'll challenge the stigma associated with HIV and poor sexual health.
We want HIV stigma to be a thing of the past. We want to end the discrimination experienced by people living with HIV across their lives so that they can thrive and enjoy fulfilling lives that aren’t limited by their HIV status.
- Deliver stigma-busting awareness campaigns, mainly through social media channels.
- Enable people with HIV to tell their stories in order to tackle stigma.
- Deliver online training for organisations and healthcare professionals.
5. We'll deliver high quality HIV and sexual health services in local communities across the UK.
Across the UK we provide a range of HIV and sexual health services, delivered on behalf of Local Authorities, Health Boards and other statutory partners. These services are often targeted at the most-at-risk groups including BAME communities, women, trans people, young people and men who have sex with men.
Activities include increasing awareness of HIV and other sexually transmitted infections, outreach, testing, condom distribution, reproductive health services and Relationships and Sex Education.
- Provide high quality services meeting the needs of local communities in order to tackle health inequalities and reduce the prevalence of HIV, blood-borne viruses (BBVs) and sexually transmitted infections as well as improve access to reproductive health services.
- Work collaboratively with local commissioners in order to meet their requirements as well as to innovate with them.
- Ensure that services are financially sound and meet their budgets.
- Work in partnership with a range of statutory and non-statutory organisations to deliver good quality services.
- Ensure that services are delivered based upon up-to-date risk assessments and following guidance from public health authorities.
- Maintain a commitment to developing our work in both Scotland and Wales and consider the emerging needs in Northern Ireland.
6. We'll ensure that the charity remains financially resilient.
The financial impact of COVID-19 is not yet fully known but the UK economy will be severely impacted with a significant reduction in GDP and a significant recession. It's anticipated that the financial consequences of COVID-19 will be experienced for at least 18 months. Our income generation potential will be severely impacted and we'll need to be far more creative in raising funds that we need to deliver our work.
We're fortunate in that we have a healthy level of cash and reserves but we also have significant long-term obligations including a closed pension scheme that is currently in deficit.
- Limit the loss in 2020/21 to no more that £1.5 million.
- Maintain tight control of expenditure throughout the remainder of the financial year 2020/21.
- Ensure that the budget framework for 2021/22 limits the use of reserves with the focus of moving towards an operational net nil position.
- Review the income generation strategy with realistic targets of income generation potential for 2020-2022.
- Manage our cash flow to ensure that we have at least three months of readily available cash at any one time.
7. We will support our staff and volunteers to work more flexibly.
The COVID-19 pandemic has had a seismic impact on where and how our staff and volunteers are able to work for the charity. While some face-to-face activities will not be possible for some time to come, the shifts toward greater homeworking, equity of participation in meetings and events have had positive benefits.
- Ensure that we look at all the safe, socially distanced, ways that staff and volunteers can fulfil their roles in a range of settings.
- Continue to be flexible in the times and ways that staff and volunteers work for us.
- Continue to move more services and offerings to digital platforms to enable staff to contribute to achieving the aims of these strategic priorities.
- Work with the Staff Forum to ensure we understand what is working – and not working – for staff and amending organisational approaches as a result.
- Work with the User Involvement team to ensure that changes to staff and volunteers are not negatively impacting service delivery.
- Consider the overall shape of the charity as it evolves with changes in ways of operating.