Consortia need to wise up on voluntary and community bodies

Consortia need to view these organisations as healthcare providers with valuable roles. By Lisa Weaks

Lisa Weaks: 'The sector is particularly good at reaching parts of the community that the NHS finds difficult to access' (Photograph: The King's Fund)
Lisa Weaks: 'The sector is particularly good at reaching parts of the community that the NHS finds difficult to access' (Photograph: The King's Fund)

Earlier this week, the King's Fund announced the winners of the 2011 GlaxoSmithKline Impact Awards.

Ten out of over 400 charities that entered have won £25,000 each in unrestricted funds plus access to free training.

Not only do the awards provide a vital source of funding for the winners and play a key role in promoting innovation and good practice. The work of the winning organisations is a reminder of the importance of the voluntary and community sector (VCS) in providing healthcare.

This is particularly significant given the scale of the health reforms and the spending cuts that are taking place.

Vast budget
The NHS spends around £3.4 billion a year on services provided by the VCS, which may include disease-specific advice services, or those to promote healthy lifestyles, encourage self-management of health conditions, or increase access to healthcare.

Funding from the public sector is now one of the VCS's most important sources of income, most of which currently comes via PCTs. As the new GP commissioning arrangements are implemented, the VCS will have to dedicate significant resources to developing relationships and proving its worth to multiple new commissioners.

Transition worries
There is concern in the sector about how the transition to GP commissioning will work and whether health charities, and particularly the smaller ones, will lose out in the fight for contracts from the bigger players.

The VCS is recognised as a valuable provider of public services and a key partner for the public sector. Among other things, it leverages considerable extra resource to public services - through volunteering, social interest, assets and multiple funding streams - and is particularly good at reaching parts of the community that the NHS finds difficult to access.

However there are a number of barriers to effective partnerships between the two sectors. For example:

  • VCS organisations often have difficulty in demonstrating the outcomes of, and value brought to, services and presenting them in ways commissioners need.
  • In particular, those who do not understand the sector's governance arrangements tend to see it as high risk.
  • Many commissioners have gaps in their awareness of the VCS in their area and what it can offer.

The key questions now confronting the VCS is whether the reforms will improve or hinder working relationships with and service provision in the NHS.

How can GP consortia, public health teams, the wider local authority and the VCS work together to ensure that communities' needs continue to be met? And how can VCS organisations better quantify and articulate their value in health and social care?

VCS involvement
GP consortia will have an important role in determining VCS involvement in health - both as commissioners of services from the VCS, and as strategic partners to the sector when planning to meet local populations' health and social care needs. Will they want to and be able to build effective partnerships with the VCS to best serve patient and public needs?

These are timely and important issues. If the role for these frontline community-based services is weakened by the reforms, the impact on the communities they serve and the cost to public services would be considerable.

GP commissioners will have many new responsibilities, but it is essential that they do not lose sight of the VCS and the role it plays in healthcare.

These are some of the issues that will be explored in a report from the King's Fund and National Council for Voluntary Organisations to be published in May.

FOUR PRIZE-WINNING CHARITIES

Examples of the innovative ways GSK Impact Award winners have been working with the NHS:

The Alzheimer's and Dementia Support Service, based in Kent, works to enable people with mild to moderate dementia to stay in their own homes for as long as possible. The service runs an early diagnosis of dementia project, working with 30 GP practices across Kent, Surrey and Sussex.
Step Forward, based in Tower Hamlets, east London works to improve the quality of life of young people in one of the most deprived areas in England. Its annual income is only £300,000, but it supports over 2,000 young people a year and works in partnership with the NHS to provide sexual health services.
Project 6, based in Keighley, West Yorkshire, works to reduce the harm caused by alcohol and drug misuse. It provides an alcohol intervention service based in six GP practices which has reduced the stigma attached to using a specialist alcohol service and has increased service take-up.
Age Concern Cardiff's services are supported by 400 volunteers and include a placement advisors scheme working with 12 hospitals; advisers work with older people who might need to move from hospital to a care home. It also has a partnership with the multi-disciplinary health team and has achieved a reduction in hospital admissions.
  • Lisa Weaks is third sector programme manager at the King's Fund
  • The Impact Awards to recognise and reward charities that are doing excellent work to improve people's health are funded by GlaxoSmithKline and are run in partnership with the King's Fund, www.kingsfund.org.uk/gskimpactawards

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