Authors: Neil Stanworth
Location: United Kingdom
The Commissioning Better Outcomes (CBO) Fund is a social impact bond (SIB) programme funded by The National Lottery Community Fund, which aims to support the development of more SIBs and other outcomes-based commissioning (OBC) models in England.
The National Lottery Community Fund has commissioned Ecorys and ATQ Consultants to evaluate the programme. A key element of the CBO evaluation is nine in-depth reviews, and this review of the Zero HIV SIB is one of these.
The Zero HIV SIB was driven by the Elton John AIDS Foundation (EJAF) which designed, implemented, managed and part-funded the project. It drew on extensive research and pilot projects by EJAF into the barriers to people living with HIV being successfully tested and diagnosed, and thus entering treatment. If people are diagnosed and treated early it has huge social benefits to their health and financial benefits to the NHS in reduced and avoided treatment costs. The aim of the project was to deploy a SIB structure to fund the delivery of HIV testing and associated support to people in the South London Boroughs (LBs) of Lambeth, Southwark and Lewisham (LSL). It was targeted at people who were either living with HIV and had not been diagnosed, or had been previously diagnosed but were not in care and had become what is technically known as ‘lost to follow up’ (LTFU).
This is the final review of this project and aims to draw overall conclusions about the success of the Zero HIV project, its value for money, and the lessons that we think can be learned from it for other projects. The main aim of the in-depth reviews, and of the evaluation as a whole, is to assess whether there is a ‘SIB effect’ – that is whether the key elements of the project that are unique to or have greater emphasis in a SIB model – notably the use of payment by results (PbR), capital from social investors, and enhanced performance management – had an effect on the way that the project was designed and implemented, and the impact that it achieved.