What is the activity?
Policy change is often the outcome of dedicated interventions that aim to inﬂuence people who make decisions that affect the lives of others, at local, regional, national and international levels. In this context Making it Count has 18 over-arching policy aims that constituted the strategic priorities of the CHAPS partnership.
Whether we work in the statutory or voluntary sectors, part of our mandate is to be involved in the policy development processes that our democratic society affords, functioning as advocates for those whose interests we serve. That means becoming active within the policy environment that provides the context for our work.
Policies that help to reduce HIV prevention need among gay men and other MSM in England can cover a vast number of areas, including health, education, social care, housing, equality, criminal justice, welfare beneﬁts, immigration and employment. Policies that foster well-being, attend to human rights, and ensure appropriate access to services from the voluntary and statutory sectors will contribute to an environment where HIV prevention needs are better met.
The form that policy interventions take is inﬂuenced by existing structures for input. For instance, many signiﬁcant policy changes instituted by central government or local government are subject to a formal consultation, based on written responses to a draft document. Knowing about such consultations, and having the capacity to respond to them requires capacity within organisations, and supporting infrastructure between them. Informal policy development involves becoming familiar with the core documents that help to form a particular policy landscape, attending and introducing oneself at planning meetings or public events, exchanging emails, collating and sharing case studies, making phone calls, or preparing press releases.
Whether policy interventions are local, regional or national, success requires a strategic and proactive approach. It is not possible to inﬂuence all policy and all organisations should prioritise the issues they want to focus upon, devise a plan of action, identify and build partnerships, and review progress on a regular basis.
Partnership-working on policy issues can be particularly powerful, as evidence can be collated across agencies, and innovative approaches to exercising inﬂuence can be strategically applied by different actors, with a diverse range of targets. These might include, but are not limited to those listed in structural targets and aims.
Whatever the activity or the audience, success will hinge not only on the persuasiveness of the argument, but also on the use of evidence. This means it is essential to be well-prepared with data and examples that help to support the change you wish to see occur.
Strengths and limitations
Policy interventions can result in change that dramatically alters the conditions of life for men likely to be involved in HIV transmission. Their strength should not be underestimated, given that it has been widely argued that key players in policy have the greatest inﬂuence on and greatest responsibility for HIV incidence (UNAIDS 2002, Barnett & Whiteside 2002).
Involvement in policy interventions requires understanding of connections between the HIV and gay men's health sectors, statutory agencies, local government and central government. These connections offer opportunities to identify and establish partnerships that traditionally fall outside an organisation’s immediate contact base, thus helping to further develop the sector.
Intervening in the policy ﬁeld can require signiﬁcant effort for little immediate reward, making it difﬁcult to secure discrete funding to support policy activities. Also, those in direct contact services will sometimes be forced to choose between the pressing needs of individual service users, or following up on the complex documentation that policy interventions can involve. In the face of such pressures, it is useful to remember that achieving policy change improves outcomes for whole populations, not just individuals.
Those with little experience of participation in policy interventions may ﬁnd such activities daunting. With appropriate support and guidance, those who are enabled to deliver a petition to a CEO of a NHS Trust, attend council meetings, write a letter to the editor of a newspaper, or make a visit to the Houses of Parliament will ultimately ﬁnd that familiarity with the ‘rules of engagement’ for each of these different activities improves their capacity to provoke change.
Issues to consider
Within the HIV sector policy work is signiﬁcantly under-valued, making it difﬁcult to prioritise it. The best means of circumventing this problem is to identify what core issues are most relevant to a particular agency’s work, and to begin devising a policy action plan with a few key targets in mind.
National agencies (such as Terrence Higgins Trust, National AIDS Trust and Positively UK) cannot prioritise, collect evidence for, execute and evaluate their policy interventions in isolation. The success of larger-scale policy interventions are reliant on information collated on the ground and shared. This is easier when there is at least one nominated individual within agencies who acts as a liaison on policy issues, and who can maintain ongoing contact with the policy ofﬁcers in national organsations. As a part of this infrastructure, agencies also need to consider devising ways for front-line staff to communicate their experiences and feedback into an policy intervention plan.
In the same way that there is a need for information to ﬂow downwards with regards to campaigning strategies and support, there is also a need for a signiﬁcant ﬂow of information upwards. The documentation and sharing of information about policy interventions will increase success through sharing of best practice. This also helps to feed a dynamic process whereby those working on HIV policy issues at national level get to hear about the impact of their work, while those delivering services are better able to inform future policy interventions.
Given the range of individuals and organisations that can be targets of policy interventions, it is also important to have a means of identifying local and national partners to collaborate with. This often means looking for potential partnerships outside of the HIV sector and collaborating with other gay, LGBT, migrant, disability and equality interest groups.
Aims and outcomes
Outcomes relating to policy interventions will be linked very speciﬁcally to the policy area that is targeted (see policy aims). Examples of policy outcomes may include:
- Local policies and national policies which facilitate social equality for all MSM and / or all people with diagnosed HIV (see Policy aim 9 and Policy aims 14-17, for example).
- Local policies and national policies which increase the priority attached to HIV prevention with MSM (see Policy aim 1 and Policy aim 3, for example).
- Local policies and national policies which increase investment in HIV prevention with MSM, or more realistically at present, do not further reduce investment in HIV prevention (see Policy aim 1, Policy aims 4-5, for example).
- Educational settings play a greater role in equiping young men to explore and learn about their diverse options, risks and precautions in relation to sex and relationships (see Policy aim 10 and Policy aim 18, for example).
The following activities may help agencies unfamiliar with this type of work to begin to engage with local and national policy developments.
- Develop and maintain an up-to-date contact list of: local MP’s constituency ofﬁce and surgery times, key local councillors, PCT sexual health and HIV commissioning leads, Local Authority contacts regarding social services and housing policy, and contacts in the local or gay press.
- Maintain records of involvement in local and national policy consultations and their results, and share these with National AIDS Trust.
- Document participation in devising any local and regional sexual health and / or HIV strategies.
Monitoring and evaluation
Evaluation and monitoring of the delivery of (or involvement in) policy interventions is not a substantial priority for many agencies or individuals in the HIV sector.
Evaluation of policy interventions can take on a number of forms. At the most basic level it requires keeping an up-to-date record of current and past activity, and the outcomes of those interventions.
In addition. document analysis can be undertaken with a discrete number of policy and other related documents (such as newspaper coverage, minutes of public meetings, or Hansard reports, for instance) covering a speciﬁed period of time. The purpose is to assess changes in the approaches or narratives used to address a particular issue before, during and following a speciﬁc policy intervention.
Data can also be collected from those who commission, support, and deliver interventions in order to assess reasons for, and impacts of, shifts in particular policy areas.
Finally, ongoing process evaluation undertaken throughout the life of a policy intervention can help those involved to determine the extent to which the intervention is worth continuing, what opportunities might have been missed, and to amend the intervention’s design and targets if necessary.
Page last updated: 5 July 2013
Policy network consultation updates
Knowing about policy consultations in plenty of time is key to preparing a thoughtful response, a need which can be met by the National AIDS Trust (NAT) policy network. Relevant government consultations and opportunities for the submission of joint responses are shared by email with the network members (who represent more than 80 agencies). NAT also circulates information about the outcomes of consultations so that members are able to see the impact of their participation. To become a member of NAT’s policy network, send them an email.