Thank you for sight of your proposals in relation to the allocation of the
AIDS Support Grant (ASG) and the HIV Capital Grant (HCG). You have raised a
number of wide ranging issues on grant allocation and the future which I
will respond to in the order in which you listed them.
 
1.    You are correct that there is weighting towards HIV+ women and
children in the ASG allocation formula, but this comprises only 30% of the
formula itself. The bulk however (70%) is still based on the overall HIV
caseload in a local authority area of residence. The decision to implement
a revised allocation formula was taken after a review of the continuing
effectiveness of the grant in 2002. The review involved key stakeholders in
the local authority and voluntary and community sector, as well as service
users, and agreed that from 2003/04 the ASG allocation formula would be as
outlined above.  This revised formula has the benefit of recognising the
increasing pressure on HIV affected children and families services in local
authorities and incorporating it into the allocation mechanism. In addition
basing 70% of the allocation on HIV, as opposed to strictly AIDS, caseload
recognises that with combination therapy people are not progressing as
quickly to a full blown AIDS diagnosis and therefore have distinct social
care needs that should be taken into account by the grant.
 
The formula has proved popular with local authorities. In a report to be
published later this month by the National AIDS Trust on the ASG,  a survey
of English local authorities indicated that 80% of those who responded (106
out of 150 authorities - 71%) felt the formula was an equitable means of
allocating the grant. Given the overwhelming feedback that the formula is
continuing to delver the effective distribution of the grant in an
equitable and effective manner, there are no current plans to review the
allocation of the ASG.
 
2.    In terms of using a ratio of funding approach, part of the rationale
in moving away from a strict sum per person approach as we used to adopt in
terms of AIDS diagnoses prior to the introduction of the revised formula,
was to be able to respond to the wider pressures and increasing costs of
HIV children and families services that weren't being captured in an
allocation process based strictly on headcount. Our experience has been
that revised ASG formula has been extremely useful in directing money to
the pressure points where they have been needed, and as in our response to
your first point there are no plans to revert back to sum per case
allocation process.
 
3.    The level and future of the ASG and HCG after 2010/11 will be
considered by the government's next Comprehensive Spending Review, which
will decide on the direction on overall government spending for the three
years from 2011/12 onwards. Our current understanding is that next review
will not take place until 2010, therefore we are yet not in a position to
be able to discuss the proposals that will inform the review itself or
speculate on possible outcomes.
 
4.    Although English local authorities are aware that the ASG is a
contribution towards their overall level of HIV social care, it is a matter
for the authorities on the ground taking into account their finances and
other pressures, to take decisions on how much extra funding beyond the ASG
they allocate to this area. The Department have no authority to insist on
any type of match funding arrangements on the part of local authorities.
 
5/6   Given that HIV caseload can and does fluctuate between individual
(and often neighbouring) local authorities on an annual basis, our view is
that to announce a minimal level of funding in advance for every local
authority over a three year period, would not reflect the demand created by
the most recently available pattern of HIV caseload distribution across the
country, and therefore divert resources from where they are most needed and
where costs are greater due to pressure points. As mentioned in the
responses to points 1 and 2, our position is that the formula. especially
with its HIV+ women and children weighting is a more effective tool in
allocating funding to where the costs of HIV social care services are
greater, rather than a sum per person approach. in addition, as you are
well aware, thanks to the effectiveness and success of ARVs, the levels of
HIV related social care will vary from authority to authority.
 
7.    The HIV Capital Grant is available for all local authorities to apply
for if they so wish, and details of the HCG scheme and bidding process are
included as part of the annual ASG Local Authority Circular. Applications
are assessed on a merit basis. Partnership working with housing
associations and local authority fronted bids to purchase capital or IT
equipment for/refurbishment of voluntary sector premises have often
featured in previous HCG bids.
 
8.    It is your prerogative as a service user to disseminate your
proposals for discussion amongst LINks, commissioning networks.etc and we
would be very interested to see the feedback you receive. But it is not for
us to formally as a Department to circulate proposals for consultation, as
these are your individual views, rather than an agreed government position
in response to widespread and obvious pressure for change in the ASG/HCG
allocation process.  We have not received any requests for the current ASG
allocation formula to be reviewed since it's inception in 2003/04, and as I
indicated above, the vast majority of authorities surveyed are content with
it's operation.
 
9.    Historically, the ASG has been disbursed to the all the boroughs,
unitary and county authorities in England. The important point to note here
however, is that although district councils are not directly awarded a
separate ASG allocation, the counties in which they are situated receive
their ASG allocation based on the HIV caseload in those district councils,
and are responsible for coordinating HIV social care for all the service
users within their county boundaries. Therefore, the grant is calculated
on, and used to provide services to every local authority in England, even
though formally just 150 authorities receive payment.
 
Following on from our previous discussions, I attach a table indicating the
breakdown of HIV Capital Grant allocations in 2008/09, and details of the
projects the HCG supported, demonstrating that the grant was indeed fully
utilised in that financial year.
 
I hope you find our comments and the HCG information useful.
 
regards