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Charities should be central to NHS decision-making and delivery, says new government-backed report

Charities and social enterprises should be deeply involved at every level of the health and care system, according to a new report backed by Alistair Burt, Simon Stevens and Duncan Selbie.

The report, based on the largest ever review of the voluntary sector's involvement in statutory health and social care, urges local hospitals, clinical commissioning groups and councils to do more to involve expert charities in the design and delivery of services of all kinds.

While there are many good examples of local partnerships between statutory and voluntary health providers, overly complex commissioning processes mean that the expertise of many charities is excluded from design and delivery of health services. The report recommends a 'simplest by default' approach to procurement practice, in an attempt to put an end to unduly complex and cumbersome contracting arrangements which are barriers to the involvement of smaller charities and social enterprises in particular.

The report argues that the future of the health and care system in England requires a greater focus on promoting wellbeing and helping people live well at home. To do this, the NHS and local authorities need to harness the contributions of families and communities and work more closely with charities and social enterprises rooted within them.

Analysis of 300+ responses to a written consultation along with face-to-face and online consultation events showed that despite this potential, many charities and social enterprises experienced barriers to working with the NHS and councils. These included limited opportunities for engagement, declining funding for some community groups, and complex contractual arrangements to deliver services.

Other recommendations in the report include:

  • funding for voluntary organisations should be transparent, long term and have a greater emphasis on social value
  • local strategic plans should be based on thorough engagement with local communities and VCSE organisations
  • statutory guidance for CCGs should be revised to emphasise the need for them to work with charities and social enterprises in order to meet duties under the Health and Social Care Act
  • future NHS transformation programmes should only be approved if they include plans to involve charities and social enterprises in strategic decision making and service delivery.

The review was commissioned by the Department of Health, NHS England and Public Health England to identify barriers to voluntary sector involvement in health services. It was chaired by Alex Fox, chief executive of the social care charity Shared Lives Plus, which helps local charities that support older and disabled people to stay in their homes rather than hospital. The review's secretariat was provided by the National Council for Voluntary Organisations, which represents charities, social enterprises and community groups.

Alistair Burt MP, minister of state for community and social care said:

I welcome this report, which confirms the vital role the voluntary sector plays in the health and care system.

We know there is more work needed to promote and foster these valuable relationships and we will work with the sector and partners to consider how best to realise the aims of the report.

Simon Stevens, chief executive of NHS England said:

Community groups, charities and social enterprises play an important role in tackling health inequalities, often reaching people who don't access mainstream health and social care services in traditional ways.

This report sets out a strong vision for health and care systems to work with their local voluntary organisations in designing and delivering services, with practical suggestions on how to form transformational partnerships and invest effectively.

Duncan Selbie, chief executive of Public Health England said:

This report hits the button and makes the obvious point that the voluntary, community and social enterprise sector are an inseparable part of the health and care system.

It is time that we on the statutory side better recognise this and the recommendations set out how we should go about making this a reality.

Alex Fox, chair of the review said:

There's consensus that we need charities, social enterprises and community groups to be at the centre of local health and care systems if they are to reach excluded people earlier.

Effective health and care services will increasingly be those that are designed by the people who use them. Voluntary organisations are essential in ensuring patients' perspectives are heard, particularly if they are from disadvantaged groups.

We need a fundamental change in how voluntary organisations are seen. Rather than peripheral players, they are an integral part of the health and care system, and must be treated as equal partners in the strategic planning and delivery of services.

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