The future role of VCSE organisations in health and care Alex Fox, CEO of Shared Lives Plus & Chair of VCSE Review Advisory Group

NHS designed for shorter lives, fixable illnesses and injuries. Population living longer with long term support needs. The big challenges facing the NHS do not have a medical solution. Money and power remains glued to acute & crisis response. The National Illness Service?

Personalisation has made better progress in empowering individuals than empowering communities. Choice and control don’t always result in new forms of community support. A good / new service doesn’t guarantee a good life. Community is often mistaken for a location: it’s our connections. Social care isn’t always social and caring

The Care Act: social care’s primary purpose is wellbeing. NHS England 5 Year Forward View: ‘renewable energy’. Achieving wellbeing is not in services’ gift. It needs interventions which build capabilities and resilience. So for system change we need: A new ‘front end’ which is built around community capacity Acute & crisis interventions built around individuals & their networks Beyond better services

Health and care feel needs-based, short term & medicalised: Crisis-only: “Are things bad enough yet?” Means-testing: “Are you poor enough?” Complex: “We have labelled you & decided your care pathway.” Maintained dependence: “We can help if you stay ‘critical’.” A new ‘front end’

Move away from ‘pipelines’ and ‘pathways’: Informed Connected Confident e.g. Local Area Coordination Care banks and time banks ABCD Co-production A new ‘front end’ DanceSyndrome

(Re-)arranging interventions in support of informal networks: Shared Lives Homeshare Community enterprise Peer support Circles of Support KeyRing networks Community capacity built into individual support

A National Health and Well being Service  Rethink JSNAs: look for assets not just needs  Rethink prevention: instead think future-focused  Rethink integration: collaboration test  Rethink leadership: look for all the local leaders

The role of the VCSE sector?  Co-designing holistic local systems focused on long term goals  Strengthening families; communities: building resilience  Engaging the whole of the community  Building social action, volunteering and local leadership  Addressing the social determinants

The challenge for the VCSE sector  Getting a seat at the table  Changing the conversation during austerity  Sharing the resources, risks and responsibilities  Remaining close to communities  Demonstrating the impacts we claim

To reach and engage communities the statutory sector needs to collaborate effectively with people, community groups, charities and social enterprises. The Joint VCSE review

Initiated by NHS England, Dept Health and Public Health England 1. Investment and partnerships between health and care agencies and the VCSE sector across England. 2. A review of the Voluntary Sector Investment Programme. Managed by the Department of Health comprising three funds:  The Strategic Partner Programme;  The Innovation, Excellence and Strategic Development Fund;  The Health and Social Care Volunteering Fund The review is led by an advisory group of members from the statutory health and care system, VCSE sector and funders. The Joint VCSE review

 Early a series of focus groups and roundtables with the VCSE sector  March an interim report republished  August - November 2015 – second phase of engagement stakeholders  Share your views in today’s event  Complete either or both of the online surveys on the discussion papers:  Share your views by post if you cannot respond online  Online webinars and live chats  Comment on or contribute a blog on the VCSE Review website  Early 2016 – final recommendations published The Joint VCSE review

1. The value of the sector 2. The sector as a design partner 3. How the sector is funded 4. Commissioning 5. Infrastructure 6. Demonstrating impact 7. Promoting equality and addressing health inequalities 8. National grants & partnerships The Joint VCSE review

The strengths and USP of the sector  Holistic and personalised  Community- embedded  In it for the long term  Diverse and flexible  Innovative  A design partner What we heard in phase one. The sector at its best is:

The strengths and USP of the sector  Increased demand  Declining resources.  Contracts rather than grants.  Contracts are short term & narrow.  Some of the sector’s best work is best funded through grants: eg prevention, community building We heard the challenges include:

The strengths and USP of the sector  Contracts getting larger  Local infrastructure organisations shrinking  Equalities organisations suffering most  Disproportionate bureaucracy  Social impact is a USP  The Social Value Act (2012) is an important lever for improving investment and partnerships with the VCSE sector. We heard the challenges include:

The strengths and USP of the sector  Outcomes set elsewhere  Sector lacks tools to measure outcomes  Even when outcomes measured, the playing field does not feel level  Goals should be co- designed with the sector.  Desire for nationally recognised, affordable tools.  National datasets needed. We heard the challenges include:

The strengths and USP of the sector  Many VCSE organisations support marginalised groups.  The sector plays a crucial role in tackling health inequalities.  Equalities organisations: disproportionate loss of funding? Numbers falling?  Need clearer challenges to commissioners to address health inequalities and reach the whole community.  A national focus on supporting equalities organisations? We heard the challenges include:

Gathering views and evidence  Feedback from today’s discussion groups will be fed in  vcsereview.org.uk - comment on blogs or contribute your own vcsereview.org.uk  Contribute your own response via the two online surveys:  Voluntary Sector Investment Programme:  Challenges and solutions to better investment and partnerships:  Consultations close on 6 November 2015

Alex Fox, CEO, Shared Lives Plus, Can we have a People Powered NHS? RSA: The new social care, RSA: The State of Shared Lives in England: My contact details West Wales Adult Placement