The Voluntary Sector makes little contribution to wellbeing
You would believe the above heading if you were to rely on Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies for your evidence. Of course this is not the case at all.
I recently facilitated a workshop for Public Health England on “strengthening the voice of the voluntary sector in Joint Strategic Needs Assessments”. As I said at the workshop – I think thats the wrong question.
The key issue for me is how can the experience of the Voluntary and Community Sector be used to improve local commissioning to tackle health inequalities and improve wellbeing?
While I welcome the ambition in plans like the NHS England 5 year forward view and the Due North report on Heath Equity which aim for greater investment in the voluntary sector neither of these quite hits the nail on the head.
Its not sufficient for statutory agencies (local government and NHS commissioners) to try to make it easier for the VCS to bid for contracts. Treating the VCS purely as contractors will fail to allow the experiential wisdom of the voluntary sector to contribute to strategic change for the better.
In order for this to happen the system needs to be much more permeable to the voluntary sector perspective. Crucially, statutory services cannot treat the VCS as though it works to the same rules as big public sector bodies – because it does not.
- VCS organisations use a wide range of different data sets – which do not easily read across to local systems.
- VCS organisations are worried about sharing service data with potential competitors
- Many are not convinced that providing data into JSNA processes will justify the effort involved in providing it, a recent report (In Good Health) by the Royal Society of Public Health supports this view.
- Most importantly, much VCS insight is based on relational rather than quantitative data.
As I noted in an earlier blog statutory agencies and the voluntary sector need to be using approaches that allow the VCS to to share a perspective on its terms.
In an earlier blog I wrote about one methodology that I have developed with Involve Yorkshire and Humber (Rapid Reviews) which led to real change in commissioning priorities, but there are plenty of other examples. Here are some that I have found out about recently.
This is an amazing piece of work undertaken for peanuts by a consortium of Housing Associations with support from the University of York. The organisations involved use the relationships they have with tenants to capture and share a small scale but in depth perspective of the real life impact of welfare reform. Keeping track of 100 households over a period of two years with tracking reports produced every 6 months.
Real Life Reform Report 5
This is an important report from NESTA sharing examples of how voluntary sector data can be used to provide insights into real time and future challenges. One example is a collaboration between Citizens Advice and St Mungos – a homeless charity based in London. There are a number of things that are interesting:
Data Science expertise – through a collaboration with Datakind UK volunteers from the data science community did an initial scoping over a period of two days – this lead to a smaller team of volunteer ‘DataCorps’ working over a longer period of time to resolve tricky issues.
In this case the work led to St Mungos and Citizens Advice working together to share data on clients, and led to three principles:
- Embracing openness – especially ways of sharing data across organisations that did not sacrifice confidentiality
- Democratising access to data – supporting others to have the skills to analyse the data – this has similarities with the GP Patient Survey dashboard that I have mentioned before.
- Emphasis on questions and exploration – Placing analysis and data into the public domain and creating opportunities for others to consider what this data might mean for their area of interest.
More Rapid Reviews and Local Healthwatch
I have already mentioned the Rapid Review work that I have done in Wakefield and Sheffield – another example I came across recently was a project led by the Sheffield Parent Carer Forum which captured the views of parents of children and young people with disabilities.
I am currently completing a piece of work for Healthwatch England and have been impressed by the number of local Healthwatch who are increasingly using this sort of methodology in their investigations.
What will help?
Local Commissioners
Local Public Health teams should have an explicit longer term and funded strategy (which includes CCGs) to support the local voluntary and community sector build analytical capacity and competence. This could be built around addressing specific priority at the same time allowing it to build competence.
Public Health England and NHS England
These two agencies need to develop a robust long term programme to support sharing of good practice and raise the expectations of local decision makers – in particular CCGs and Directors of Public Health. It is frankly not acceptable for local leaders to assume that current systems and capability need to mirror existing statutory practice.
What do you think?
The voluntary sector has an important role to play in health, that much is agreed by most people. The difficulty is that different organisations have different expectations of the voluntary sector. We have created a website http://www.useyourcommunity.com which we are building up into a database of local organisations that people can locate using postcode search. We found a key barrier for people accessing local voluntary sector services is that people do not know where the organisations are located or how to contact them.
We would welcome better clarification locally about expectations of voluntary organisations and their role in the local health services system. The idea that participation should be left up to market forces depending on tender outcomes demonstrates a lack of awareness of the benefits that voluntary sector involvement can offer.