An overview of our work for

1. “It is more than food; it is like an invisible family (my invisible family) who is taking care of me in tough times” An overview of our work for

2. What we do • Since 1988, TFC have provided tailored food and nutritional support to people living with HIV (PLHIV) and their families in London, to help improve their health and quality of life. • We have identified four major barriers that prevent PLHIV in London from accessing good nutrition: • Ill health • Poverty • Isolation (a reduced motivation) and • Limited nutrition knowledge. • Our new Personalised Nutrition Care Plans are designed by a dietitian to help overcome these barriers. • We use a network of over 700 skilled volunteers who deliver all services, supported by a staff team of just 8. • In 2011, we delivered over 30,000 meals (500,000 since 1988), 2,000 weekly household food hampers and taught over 300 people practical food skills. Most people we support have complex needs, so require a combination of support services.

3. Poverty In 2009, 25% of those accessing our food services had a household food budget of less than £20pw We have seen a 550% surge in demand for our emergency hampers over the past four years 56% of people receiving our emergency hampers in 2010 had NO INCOME £0 The average weekly income for applicants to the Crusaid hardship fund fell from £99pw in 1999 to £63pw in 2008 (£22.78pw for an applicant with residency issues) 18% of applicants to the CWAC hardship fund are unable to provide their children with 3 meals a day We estimate that 15% of PLHIV in London (4,400 people) and their families are living in extreme poverty, and aim to reach 3,200 of them within 3 years. For families living in poverty, the food budget is often the most flexible household expense.

4. Ill-Health 7,000 people in the UK are newly diagnosed with HIV each year - half of these in London. One in three are diagnosed late when they are already unwell. We expect 20% of our new referrals to come from HIV clinics and healthcare professionals, looking to support patients following immediate discharge from hospital. The assurance that appropriate nutrition will be available to patients at home frees up hospital beds, and saves the state thousands of pounds annually in avoidable care costs. We estimate 1,167 PLHIV receive a late diagnosis in London each year, and aim to reach 800 of the most vulnerable within 3 years.

5. Limited knowledge Eating Positively cookery and nutrition classes allow us to share over 20 years of nutrition expertise face-to-face with service users. The classes offer practical skills and advice in a kitchen setting where we can discuss topics including food labels, budgeting or understanding ingredients. Tailored classes are run to support people with specific knowledge needs e.g. adapting diets to help manage diabetes or heart health. This knowledge adds a longer term benefits to the immediate food we deliver and allows people living with HIV to make better food choices in the future. The classes aim to reach 400 people in 2012-12 and are complimented by factsheets, recipes and bespoke dietetic advice where appropriate.

6. Isolation Eating Together will bring isolated PLHIV around a table to eat together and offer peer support. Living and eating alone diminishes appetite, food consumption and dietary quality. In many cases this isolation and deprivation can contribute towards worsening health. New arrivals in the UK can face additional barriers that contribute towards social isolation including language and cultural differences. The population of PLHIV is ageing and older people are more likely to be isolated. Nearly one in three people living with HIV in London has experienced discrimination as a result of HIV – often leading to social isolation where a persons condition is likely to deteriorate.

7. Strategy and Challenges • Ambitious 4 year strategy to help us meet demand for services and deliver appropriate support more efficiently: • Demand for crisis support is up 550% in 4 years. There are 3 x more PLHIV in the UK today as in 2001. • Soaring food prices (18% yr on yr) mean many families struggle to afford to eat healthy with around 1 in 5 unable to give their children 3 meals a day. • Nutrition is essential for PLHIV – to rebuild the immune system, ensure effectiveness of medication and maintain a healthy weight. • A recent appeal has allowed us to acquire our own kitchen, combine the office and work more closely with other HIV support charities. This move is vital in allowing us to expand our work and offer more efficient and appropriate services. • Exceptional buy-in proven by recent kitchen appeal and £1m EJAF supportallowing us to feed 4,000 people in need 2011-13.

8. Synergies • Why it makes sense for us to work together: • Food, health and nutrition focus • Opportunity to share expertise and proven systems and teach efficiencies • Access to hundreds of food-focused London professionals who volunteer and work in catering • Staff engagement / volunteer opportunities • High profile London project - accessible location – visible sharing of expertise in charity sector • Branding recognition for support on site and annual review, publicity and case studies for CSR reporting • Retail learning opportunities for the charity

9. Support us to develop our new home • How NACC members could support our work: • Wish list of kitchen equipment / installation (new or used) and ongoing servicing • Access to ‘expertise’ and support systems - menu planning, HACCP, kitchen management, etc • Purchasing power and sourcing – access to suppliers and contract prices • 3 month secondment to assist setting up robust procedures followed by ongoing volunteer opportunities for compass staff • Retail expertise and support as we investigate / pilot ways to generate income • Access to FH training for volunteers or service users looking to gain skills / employability

10. How we help Barriers to good nutrition Intervention (Food Chain) Expected outcomes Poverty as a result of unemployment, inability to work, debt, asylum issues Improved nutrition, short term alleviation of poverty, improved health, exit strategy An appropriate package of food (meals & groceries) provided to PLHIV and their children/ carers/ dependents Ill-health as a result of late diagnosis, or other short / long term complications Improved nutrition, improved health, stronger immune system, exit strategy Isolation as a result of discrimination, mental health, cultural barriers Develop ‘Eating Together’ service Regular contact opportunities to eat, learn, socialise and discuss problems Information and skills taught at nutrition and cookery classes supported by appropriate fact sheets Limited knowledge Lack of information / skills to make informed choices Ability to maximise benefits of nutrition to self manage health long term

11. Many central London boroughs experience high levels of deprivation and HIV infection Over 1,000 PLHIV accessing care Over 500 PLHIV accessing care Over 300 PLHIV accessing care Focus area for Food Chain Services Source: SOPHID 2006

12. Plots • Gardens • Allotment National and local policies • Agriculture • Trade • Housing • Employment • Retailing • Health • Planning • Welfare Barriers to healthy eating Institutional food • School, canteen, day centre, hospital, home Choice • Taste, preferences • Family acceptability • Social/cultural norms • Nutritional knowledge • Motivation • Influence of promotions and advertising Eating patterns Food preparation Practices • Cooking skills • Ability and confidence to prepare healthier foods • Cooking facilities Access • Foods prices • Relative costs of healthier food • Money for food • Shopping capacity: time, transport, physical care • Food storage capacity Foods households can buy Foods households and individuals choose to buy Availability • Foods stocked in shops used range, quality • Location of shops Information • Foods labelling • Advertising and marketing • Leaflets, contact with health professionals, schools Food consumed by individual nutrients absorbed Eating/ meal patterns Intra-household distribution • Family food hierarchy Frame work of the barriers to healthy eating - The Manual of Dietetic Practice (4th edition)

13. Our direct interventions (green) National and local policies Evidence shared with advocacy organisations to influence policy Interventions to help PLHIV Institutional food Pilot meal programme at Mildmay Choice Tailored. culturally appropriate meals and groceries Eating patterns Food preparation Practices Practical cookery classes Access Food packages home delivered for those in ill - health Foods households can buy Foods households and individuals choose to buy Availability Food packages provided for those in poverty Information Nutrition classes, fact sheets and pathways to other care services Food consumed by individual nutrients absorbed Eating/ meal patterns Intra-household distribution Sufficient food for entire family Where our work influences decisions (yellow)

14. Contact Please do not hesitate to contact me if you have any questions: Andrew Davies, General Manager www.foodchain.org.uk andrew.davies@foodchain.org.uk DL 020 7288 9000 / Mob 07949 559989 Registered charity No. 1003014