It was 28 years ago that Nick Partridge became the first employee of the Terrence Higgins Trust, a little-known HIV and sexual health charity. It had been founded three years earlier, in 1982, after the death of Terry Higgins, one of the first people in the UK to die of Aids. Until Partridge's arrival, the trust had been staffed entirely by volunteers.
"When I first joined, we had two tiny offices in central London, rented by the week," he says. "Our neighbours were tattooists and motorbike couriers, and in the basement of one of the offices there was a page three photographer."
After almost 30 years - 22 of them as chief executive - Partridge is calling time on his career at the trust. Knighted for services to healthcare in 2009, he is leaving behind a charity very different from the one he joined. Last year it had an income of more than £20m, employed 270 full-time equivalent staff and had more than 10,000 members, about 4,000 of whom have HIV.
Partridge says he has stayed with the charity for so long because of the speed with which the HIV/Aids epidemic has changed and the way the charity has adapted to meet the needs of its service users. "What we saw in the early 1980s was an unknown illness becoming a fatal transmissible illness that shook everybody," he says.
"But by the mid-1990s we'd had the discovery of highly effective drugs, and suddenly people were surviving. This was both hugely important and challenging for Aids charities, because the needs of people with HIV and Aids completely changed. We had to redesign our services while continuing to deliver them - but without the necessary investment capital."
Partridge's time at the trust has included many mergers. Until the late 1990s, most regions had their own HIV charities, but it became increasingly clear that what was needed was one national charity. "One of the things I'm proudest of is how we negotiated the merger of eight charities into a new THT in 1998," he says. "It gave us a real national reach. Since then, we've negotiated about 30 mergers."
The economic downturn has hit many charities hard, but the trust's income has remained fairly static at between £18m and £21m a year for the past five years. About 75 per cent of its income comes from NHS contracts, the rest from grants and other fundraising activities. Partridge says the trust has continued to win contracts by offering "new and different ways of doing things that are clearly good value".
He credits the trust's fundraising team and members with helping to grow its charitable income, but adds: "HIV is still not the easiest cause to fundraise for. We're unlikely to win charity of the year partnerships in major employee ballots. We get close, but rarely win."
But the fact that THT's work spans sexual health education, HIV prevention and support has enabled it to attract money from a variety of funders. "We have something that we can offer to trusts operating in health, education and social care," he says.
On the political front, Partridge has worked with 14 health secretaries under Conservative, Labour and coalition administrations. He believes the economy has determined the level of government support as much as the party in power. "Times have been hardest when the economy has not being doing well," he says. "We might look back at the 2000s as a golden age for the third sector. It was a period of growth and a Labour administration that valued partnership and the sector."
He describes the approach of the coalition government as "less collaborative". "The way it does consultation is less engaging than under previous Labour or Tory administrations," he says. "It's a tough time for the third sector."
Reforms to the NHS are also throwing up problems: commissioning for sexual health services will be moved to local government and the role of HIV prevention will be shared between local government and Public Health England. Partridge believes this creates a risk of fragmentation.
He is equally wary of increased competition from the private sector. He says that competing with the private sector will require charities to become more entrepreneurial, which he says isn't necessarily a bad thing. But he adds: "We have some difficult decisions to make about how far we go if there's a race to the bottom on cost and quality. At what point do we say 'this service is not going to be good enough' and walk away?"
Now aged 58, Partridge plans to keep working in health and social care. Earlier this year, he became interim chairman of the UK Clinical Research Collaboration, set up to make the UK a world leader in clinical research, and became a non-executive director of the Health and Social Care Information Centre. He says he wants to help develop ways in which people with HIV and Aids can manage their conditions better at home.
1991: Chief executive, Terrence Higgins Trust
1988: Communications manager, Terrence Higgins Trust
1987: Press and liaison officer, Terrence Higgins Trust
1985: Office manager, Terrence Higgins Trust
1980: Pricing manager, Rank Xerox
1978: Marketing officer, Thorn-EMI