the voluntary community & social enterprise sector’s role in supporting health and wellbeing
TRANSCRIPT
The Voluntary, Community & Social
Enterprise (VCSE) Sector’s Role in
Supporting Health & Wellbeing
Jane Hartley Chief Executive VONNE
Wider Determinants of Health &
Wellbeing & the VCSE
Due North: Independent Inquiry into
Health Equity for the North
Health Inequalities due to differences between
socioeconomic groups in poverty, power and
resources needed for health
Those who have less influence are less able to affect
the use of public resources to improve their health and
well-being
Due North: Recommendations
- Tackle poverty and economic inequality
- Promote healthy development in early
childhood
- Share power over resources and
increase the influence that the public
has on how resources are used
- Strengthen the role of the health
sector in promoting health equity
Public Service Reform Local Authorities
Significant Budget Cuts
Pressures on social care
Lack of room to innovate and manoeuvre
Combined Authorities
Devolution Deals - Decentralisation: centralised control to local control
Significant shortfall in NHS funding
- Demographic & technological impact – NHS
5YFV: greater community involvement & shift from acute to preventative & community based care & support
New Models of Care
Integration of care services
Health Devolution
Decentralisation - Opportunities
Address inequalities
Local community empowerment
Use local knowledge & community capacity
Create local ownership
Develop local solutions
VCSE as partner and facilitator
VCSE Supporting 5 Ways to Wellbeing
Connect – supporting individuals to connect and engage within their
local community, building social networks and social capital
Be Active – encouraging individuals to be physically active and active
within their local communities through volunteering
Take Notice – Supporting individuals to be involved in their local
community and building their capacity to influence local decision
making
Keep Learning – linking individuals into learning opportunities to
improve their knowledge, skills and confidence
Give – encouraging individuals to volunteer and contribute to
supporting their local community
Participation & Volunteering
Participation in a group cuts a person’s chance of dying in the next
year by half, and joining two groups cuts the risk by 75 per cent.
Putnam (2000)
Volunteering can improve the wellbeing of volunteers particularly
those from most marginalised groups
People who volunteer spend 38% less time in hospital. Harvard School
of Public Health
VCSE role in Health & Care
‘VCSE sector has significant expertise that is invaluable in helping us achieve improvements across the health, social care and public health system’ Department of Health, NHS England and Public Health England
VCSE organisations are an integral part of the wider health and care system
Support focus on early intervention, prevention & self care/management – NHS & LA (Care Act)
Key to NHS strategic shift - acute care > community based care & support & self management
Joint review of role of the VCSE sector in
improving health, wellbeing and care
outcomes & partnerships
Background to VCSE Review Commissioned by the Department of Health, Public Health England,
and NHS England
Purpose :
Describe the role of the VCSE sector in contributing to improving
health, well-being and care outcomes
Identify and describe challenges and opportunities for the sector
to contribute to these outcomes
Consult on options for policy and practice changes to address
challenges and maximise opportunities, then develop final
recommendations
Review co-produced by representatives of the VCSE sector and the
Department of Health, NHS England, and Public Health England
Final Report March 16
Recognising the value of the sector and
making the most of local assets
No wrong door -The sector’s
strength lies in its holistic,
community-embedded and
personalised approaches.
Track record of trust
VCSE organisations promote
understanding of the specific
needs of their communities.
Its diversity, flexibility and level of
innovation helps it reach and
support those hardest to engage
Builds emotional resilience and
promotes self-care and
independence
VCSE organisations involve people
experiencing health inequalities
and builds their capacity for social
action
Provides vehicle for asset based
approaches to community
engagement in addressing health
inequalities
Expertise of lived experience in
designing more effective,
sustainable services
What we heard:
Investing in organisations that promote
equality and address health inequalities
The sector is recognised as
having particular strengths in
reaching parts of the
community that the statutory
sector finds difficult to reach
and, therefore, plays a
crucial role in tackling health
inequalities.
The number of charities
specifically focusing on
progressing equality in health
and social care has seen a
dramatic decline in the past
five years, along with the
resources available to them.
What we heard in phase one:
How the sector is funded
Strong evidence that charities are
facing increased demand for
services as well as a decline in
resources.
A shift away from grants towards
contracts prohibitive to smaller
VCSE
Payment by Results type contracts
prohibitive for smaller
organisations from applying
Many of the activities the VCSE
sector specialises in – such as
engaging overlooked groups - not
funded through contracts.
Drive to reduce costs – increase in
large-scale provision & larger
contracts.
Tender or procurement processes
prohibitive to smaller
organisations.
Commissioners need recognise
value based on quality and social
value
( Social Value Act 2012)
What we heard :
Developing services and policies together
VCSE organisations that are rooted
in their community and understand
the needs and capabilities of the
community that they serve.
VCSE sector has led on the
adoption of asset-based
approaches and community
leadership
It can support individuals and
communities to achieve holistic
goals for a good life.
Many small organisations are
struggling to make links with and
gain acceptance among local GPs
and commissioners.
For health and wellbeing to be
community-based and
collaborative, statutory systems
need to learn to work with
community groups and the
charities and social enterprises
born out of them.
Co-production requires “mutual
respect between commissioners
and VCSE organisations”
What we heard in phase one:
Final Report https://www.engage.england.nhs.uk/consultation/
vcse-review
How are we doing
locally?
Community Health Champions
Community Health Trainer & Health Champions
The Alcohol Health Trainer Service has trained 26 people from the
recovery community to become Community Health Trainers, of whom
4 have gained employment with the service as Health Trainers and 20
have gone on to actively volunteer as Health Champions supporting
over 350 individuals in 1 year
Outcomes for individuals & communities:
Increased knowledge, confidence, self esteem, social interaction,
wellbeing, emotional resilience
building capacity, connectedness, community support and
resources
Social Prescribing
Stockton Health Initiatives
Stockton and Hartlepool CCG &
Stockton Borough Council Public
Health funded social prescribing
grant programme
16 projects funded
Fuse commissioned SROI
evaluation – Teesside University
Social return on investment
overall 2.82 ( input 653,067,
output 1,843,168)
Durham Healthy Village
Challenge
Public Health Grants programme
Local Community Centres/
Regeneration partnerships
Local people – activities to
promote health & wellbeing
Local programmes
Locally Owned – locally driven
Provides help to
people with Long term
health conditions who
live in the west of
Newcastle upon Tyne
Non-medical ‘link
workers’ help them to
have better quality of
lives and, as a result,
to reduce the cost of
their care to the NHS
The Service Link workers
Help people with non-medical
lifestyle, emotional and practical
matters that affect their health and
wellbeing
On average support lasts for 21
months
Eligible conditions • COPD or Asthma
• Diabetes (Type 1 or Type 2)
• Heart Disease
• Epilepsy
• Thinning of the bones
(osteoporosis)
• Any of the above with
depression and/or anxiety
GPs
Bridges Ventures Social Investor
Newcastle
Gateshead CCG Commissioner
Cabinet
Office Big Lottery
Fund
8,500 Patients
over 6 years
4 Providers - Changing Lives - HealthWORKS Newcastle
- First Contact Clinical - Mental Health Concern
30 Link Workers
Outcomes A: Improved self management B: Reduction in secondary healthcare
costs
Refer eligible patients
Paid base
payment and per patient
Help people to manage their condition(s)
Pay up to £8.2m
based on outcomes
Commissioning Better Outcomes
Fund £2m
Social outcomes
Fund £1m
Ways to Wellness
People with Long Term Conditions
in the west of
Newcastle upon Tyne
£1.65m Loan repaid based on outcomes
Ways to Wellness
Foundation
What can the VCSE contribute?
Rooted in communities and trusted
Understands their needs
Mechanism to engage and involve communities of interest and place
Especially those most excluded and hardest to reach
Focus on prevention & holistic person centred approach
Facilitate asset based approaches, co-production and design of services
Can deliver innovative ‘user’ led solutions in environment of reduction in public sector services & resource
