Getting to Zero collaborative

The ‘Getting to zero’ collaborative is a key part of the Fast-Track Cities London work plan for 2023-26. Launched in April 2024, the voluntary sector and NHS partnerships are delivering support initiatives across London to meet the strategic aims of the Fast-Track Cities London programme and the national HIV Action Plan.

The ‘Getting to Zero’ collaborative builds on our previously successful quality improvement approach of creating an improvement community within the HIV sector. This approach allows us to pilot new and innovative ways of partnering and strengthening referral pathways.

The Programme delivers two linked workstreams to address the unmet non-medical needs of people living with HIV, to improve quality of life and wellbeing so that they have the best opportunity to maintain engagement in HIV care and treatment. One workstream is integrating peer support workers employed by the HIV voluntary sector in every London HIV clinic, and the other provides a range of linked voluntary sector support services to address people’s unmet non-medical needs.

The in-clinic peer support work is led by Positive East in North East London, Metro in South East and South West London, and Positively UK (in partnership with Plushealth, Sophia Forum and NAZ Project) in North West and North Central London.

The partners are working with the clinics to discover how best to implement effective referral pathways, opt-out support for people who are newly diagnosed and use of a standardised wellbeing and needs assessment to better offer support for any unmet non-clinical needs, which might otherwise negatively impact on their ability to manage their HIV and remain in care. The key to addressing not only these needs, but any internalised stigma around the HIV diagnosis and the potential for people to become isolated, is the lived experience which these workers can share with those they support.

Where needs or problems are identified, the partnership is developing clear and simple referral pathways to the wrap-around support provided by the second workstream, which includes:

• Psychological support, including counselling, hypnotherapy and coaching, delivered by Living Well
• Welfare benefits, housing and immigration advice, delivered by Positively UK
• Housing and benefits advice, delivered by Positive East and The Food Chain
• Re-engagement in care, chemsex support, nutritional advice, support for women and African communities, delivered by Terrence Higgins Trust, 4M Network, The Food Chain and Africa Advocacy Foundation
• Courses for people who are newly diagnosed or having difficulty adjusting to their diagnosis, delivered by Terrence Higgins Trust, METRO Charity, Positively UK and Positive East

The Programme has already improved referral pathways and partnership work between the participating voluntary sector organisations. Pathways to non-clinical support have also been strengthened by having in-clinic peer support workers, with 26 of London’s 27 HIV clinics now having a dedicated worker.

Later this year The Tavistock Institute will be running an independent evaluation of the programme and its processes. Our aim is to build the case that this model of in-clinic peer support, linked to wraparound advice and support services not only keeps people in care and on treatment, but improves their quality of life and wellbeing. We hope that this approach can be used as a national model for advancing person-centred care in HIV, and potentially other long-term health conditions.

The 2020-2023 HIV improvement community

You can read the case studies of the previous HIV improvement community in our highlight report here.

You can read a case study about the improvement community approach to tackling city wide challenges here.

If you would like any further information then please email us at rf-tr.londonftci@nhs.net