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Challenges remain for voluntary organisations’ input into health and social care services

All future health and care plans should be produced in collaboration with the voluntary sector, review urges

Recognition of the voluntary, community and social enterprise sector’s potential in health and social care is vital but still limited, a new report finds. While there are examples of positive local partnerships, the difference that these organisations can make is not consistently understood.

The report calls for health and social care commissioners to focus on co-design of services and says that guidance available from the NHS should be re-worked to reflect this.

The report is a one-year update from an NHS-backed review which found that people in England face significant health inequalities which voluntary organisations help address in often innovative ways. The VCSE Health Review was the largest ever review of the voluntary sector’s involvement in statutory health, wellbeing and care outcomes.

But the contribution of voluntary organisations in health and social care is too often seen as non-essential, the chair of the review’s implementation group warned today.

The report raised concerns that most Sustainability and Transformation Plans (STPs) – plans drawn up by NHS organisations and local councils to improve the provision of health and care in entire areas – are not being produced in cooperation with local voluntary organisations. But a greater focus on designing health and care plans with these organisations would ensure that services are shaped by the people who use them, as well as resulting in more local support and better value for money.

More positively, the review acknowledges some significant progress in the year since the report. A new partnership programme, the Health and Wellbeing Alliance, has been formed between the Department of Health, NHS England and Public Health England and the voluntary sector to focus on health inequalities. Later this year, a new grant-giving programme is expected to be launched as part of this work. The government has also acknowledged the challenges of helping smaller charities contribute to public services.

In order to harness the voluntary sector’s transformative potential, the report recommends that the government, health services and the voluntary sector should take further action in a number of areas, including to:

  • ensure that the new health and care services are co-designed, by resourcing and engaging with the community groups who are closest to people who use them
  • further support local councils to commission more voluntary sector interventions, including through the active promotion of the principles of the Social Value Act
  • continue to embed and adequately fund social prescribing, which allows GPs and other primary care professionals to refer patients to non-clinical resources in their local community.

The VCSE health review was produced in collaboration between the Department of Health, NHS England, Public Health England and representatives from the voluntary sector, and managed by the National Council for Voluntary Organisations, which represents charities.

The final report, published in 2016, listed 28 recommendations to help the stakeholders involved design and co-deliver more sustainable and cost-effective interventions, in closer partnership with citizens, families and communities.

Alex Fox OBE, chair of the implementation group and chief executive of the charity Shared Lives Plus, said:

It is incumbent upon all public services to invest time and resources in building relationships with local people, through the charities, community groups and social enterprises who are often best at reaching them. Health and care services should involve people who use those services in redesigning them. This creates services which more people can use and which are more cost-effective. People want services which intervene earlier and which feel more human, even when delivering complex care.

The best voluntary, community and social enterprise services excel at all of these skills. Our health and care systems need them more than ever, but continue too often to see them as non-essential when budgets are cut.

Our recommendations were designed with input from both government and the voluntary sector. When we published them, the feedback from the voluntary sector was that the recommendations were strong, and that the test would be whether they became reality. This update shows that government and the voluntary sector are, through working together, making progress on some important shared goals, and also that there is much further to go in sharing resources and power, as well as responsibility, between the state and the communities they exist to serve.

Karl Wilding, director of public policy and volunteering at NCVO, said:

It has been very encouraging to see the progress that has already been made since the publication of the report. However, the update published this week has also shown that there is still some way to go if we want to make sure that health and social care services benefit from the full potential of the voluntary sector to improve health and wellbeing outcomes.

There are so many examples of charities and volunteers delivering better outcomes for service users so I hope that all the relevant stakeholders will continue to work together to make it easier for them to get involved in health and social care, and public services more broadly.

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