Initial thoughts at the launch of the review

Alex Fox, Shared Lives Plus (originally posted January 2015)

Having been asked to chair this review of the voluntary, community and social enterprise sector, I’ve been thinking more than normal about what kind of VCSE sector we want and what kinds of relationships national and local health and care bodies should have with it. For me personally (and in this blog you’re going to find the personal views of advisory group members, not any ‘official’ lines), the real question here is what kind of health and care system do we want in this country?

New challenges

If we want the same kind of health and care system we’ve always had, then we need a VCSE sector which gets better at delivering on public service contracts, and provides a steady supply of volunteers to help out alongside professionals. Nothing wrong with those goals, but actually I think we need a very different kind of health and care system, and the national health and care strategies all read as visions for something very different, not just a more efficient version of what we’ve always aimed at. This means a different view of what charities, community groups and social enterprises are there for, and how their contribution should be supported and valued.

If the challenges of 1948 were our major challenges now, the health system would be well able to meet them. But our key challenge now is that health and care is not used by only a relatively small number of people for a relatively short time. A quarter of the population now lives with a long term condition and many of those with several long term conditions. Living well with a long term condition, avoiding health and other crises, is not something even a great service and the most expert professionals can do for us, it is something which is only achievable when people with long term conditions, family carers, communities and professionals work together, each making their own kind of contribution, sharing information and expertise, and backing each other up when things get tough. Living well requires joined-up health, care and housing interventions, but also services which can join up with informal action and arrange themselves around our real, messy lives.

Unique strengths

Charities, community groups and social enterprises can do many things well, from delivering huge public service contracts to running campaigns which change the national conversation, but for me, this collaborative approach to living well and overcoming health and care challenges is one of the sector’s unique strengths. VCSE organisations often have the opportunity to form deep relationships with people touched by the health and care system; they can think whole-person, whole-family and whole-community, and they can take a long-term view. When the VCSE sector achieves that sense of shared responsibility and genuine collaboration, it can mobilise astonishing community action, even in communities which other sectors overlook or label ‘hard to reach’.

Upcoming work

My colleagues in the advisory group will I’m sure focus on other areas of the VCSE sector’s work in their blogs over the next few weeks and you are welcome to submit a blog of your own. The ambition for this review is quite broad and our timescale and resources tight (familiar VCSE territory!), so we will be thinking aloud, changing our minds and having as open and iterative a conversation as we can.

Before the world shuts down ahead of the general election we want to have drawn up a vision for what the three bodies’ central government grant programme could look like and how it could role-model an approach to investing in the sector which is outcomes-focused, fair, open and co-designed with the VCSE sector. But we also want to put that relatively small (£25m) programme in the context of the larger cross-government spend on VCSE health and care work, and also to be able to reflect back to the Dept Health, NHS England and Public Health England a wide range of experiences of funding, investment and partnership approaches taken by local health and care bodies such as councils, Clinical Commissioning Groups and NHS Trusts.

The national strategies are unequivocal about the value of our sector. But, whether you are working in a VCSE organisation, have a health and care need yourself, or work in a statutory body, what are your real experiences? And how can we best use limited public resources to build effective, sustainable and independent charities, community groups and social enterprises in a time of austerity?

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