Have your say!

WELCOME Introductions Housekeeping Outline of the session Introductions – Paul Martin (LGBT Foundation), Charlotte Ravenscroft, Tracey Bignall (Race Equality Foundation), Angie Macknight, Housekeeping – fire alarm, toilets etc Outline of the session – hope you enjoyed your lunch, we will have an additional refreshment break mid-afternoon and finish at 4 pm

Outline of the session Programme 1.00 – 4.00 pm The VCSE Review – our purpose and what we heard from the sector in phase one The State of the Sector nationally – Almanac data Working in partnership – a commissioner’s perspective Time to talk – challenges, solutions and evidence Shaping the future – key points to feed into the Review Presentation by Ben – 15 – 20 minutes Any questions 5 minutes Presentation by Commissioner – 10 – 15 minutes Break into two groups to discuss chosen topics

The VCSE sector is a vital partner in the health and care system, helping people live healthier lives and raising standards in health and care. In the context of the challenges faced by the system, it is important that we explore how the sector is funded to find the best ways to support and recognise commitment and innovation. I urge you to contribute to help us to ensure that co-ordinated efforts achieve greater impact. Alistair Burt MP, Minister of State Community and Social Care Alistair Burt is the new Minister of State for Community and Social Care. He gave his approval for the VCSE Review to continue its work after the General Election. The VCSE Review has been supported by Simon Stevens and Duncan Selbie, the CEOs of NHS England and Public Health England and Una O’Brien, Permanent Secretary for the Department of Health from the beginning. Call for Action!

VCSE Review background The VCSE Review has two elements: A review of the Voluntary Sector Investment Programme. Managed by the Department of Health this comprises three funds: The Strategic Partner Programme; the Innovation, Excellence and Strategic Development Fund; and the Health and Social Care Volunteering Fund A review of wider funding and partnerships between health and care agencies and the VCSE sector across England. This will focus on three areas: defining, achieving and demonstrating impact building capacity and staying sustainable promoting equality and addressing health inequalities The review is chaired by Alex Fox, CEO of Shared Lives Plus working with an advisory group of members from the statutory health and care system, VCSE sector and other funders In November 2014, the Department of Health (DH), Public Health England (PHE), and NHS England initiated a review of the role of the VCSE sector in improving health, wellbeing and care outcomes. The purpose of the review is to: Describe the role of the VCSE sector in contributing to improving health, well-being and care outcomes Identify and describe challenges and opportunities to realising the potential of 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 Chaired by Alex Fox, CEO of Shared Lives Plus working with an Advisory Group of representatives from the VCSE sector, Department of Health, NHS England, Public Health England, Cabinet Office, and other funders such as the Big Lottery Fund.

Engagement with the VCSE sector and commissioners Early 2015 - a series of focus groups and roundtables with the VCSE sector March 2015 - an interim report republished August - November 2015 – second phase of engagement stakeholders Share your views in today’s workshop Complete either or both of the online surveys on the discussion papers: Voluntary Sector Investment Programme Challenges and solutions to better investment in and partnership with the VCSE sector 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 initial engagement was just with the Voluntary Community and Social Enterprise sector. This second stage of engagement (7 August – 6 November) will be open to commissioners and funders e.g. local authorities, clinical commissioning groups, NHS trusts In early 2015 the VCSE Review Advisory Group held a series of focus groups and roundtables with the VCSE sector to find out more about the challenges facing their organisations and communities, and what was working well. We published what we heard in an interim report in March 2015. In August we launch(ed) a second phase of engagement with the VCSE sector and commissioners to share what we heard in phase one, find out what we missed and identify additional solutions. Share your views via: This workshop The VCSE Review website blogs Consultation titled VCSE Review: Discussion Paper on the Voluntary Sector Investment Programme: https://www.engage.england.nhs.uk/consultation/vcse -review-vsip Consultation titled VCSE Review: A discussion paper to gather views on the challenges and solutions to investment in and better partnership working with the VCSE sector VCSE Review: https://www.engage.england.nhs.uk/consultation/vcse- review Online webinars and live chats, details of which can be found on the VCSE Review website By post to the programme manager, Angie Macknight, National Council for Voluntary Organisations, Society Building, 8 All Saints Street, London N1 9RL In 2016 we will publish our recommendations about investment and partnership working. We need your views and experience to help shape those priorities and solutions.

Topics covered in the review A selection will be covered in today’s discussion Recognising the value of the sector and making the most of local assets National investment in the VCSE sector Developing services and policies together How the sector is funded Commissioning Local partnerships Infrastructure/networks Improving national relationships with the sector Demonstrating impact Partnerships to promote equality and address health inequalities Investing in organisations that promote equality and address health inequalities The discussion paper on the challenges and solutions to better investment in and partnership with the VCSE sector https://www.engage.england.nhs.uk/consultation/vcse-review covers all the headings listed above. This is too many to have a useful discussion. It is better to pick the key issues and talk about how these matter for your organisation and communities. You can show all of the list on the slide and highlight the topics you will cover during the workshop discussion These will be based on the preferences of attendees gathered during lunch and registration Flipcharts around the room for other topics – please put ideas on post-its

NCVO UK Civil Society Almanac – an overview The State of the Sector NCVO UK Civil Society Almanac – an overview

THE VOLUNTARY SECTOR’S ECONOMY IS DOMINATED BY LARGE CHARITIES, BUT MOST ORGANISATIONS ARE SMALL Proportion of organisations and income by size of organisation, 2012/13 (%) Source: NCVO, TSRC, Charity Commission

VOLUNTARY SECTOR HAS SEEN NO GROWTH IN SPENDING SINCE 2006/07 Voluntary sector income and spending, 2000/01 to 2013/14 (£ billions, 2012/13 prices) Source: NCVO, TSRC, Charity Commission Note: Figures for 2013/14 are provisional

Where the sector’s funding comes from Graph showing income by source to the sector – UK Civil Society Almanac 2015

GOVERNMENT GRANTS AND CONTRACTS HAVE CONTINUED TO FALL AS GOVERNMENT SPENDING IS CUT Government grant and contract income to the UK voluntary sector, 2000/01 to 2012/13 (£ billions, 2012/13 prices) Source: NCVO, TSRC, Charity Commission

INCOME FROM BOTH LOCAL AND CENTRAL GOVERNMENT HAS FALLEN Local and central government spending on the voluntary sector, cumulative change, 2008/09 to 2012/13 (2008/09 = 100) Source: NCVO, TSRC, Charity Commission

CHANGES IN GOVERNMENT INCOME DEPEND ON ORGANISATION SIZE Government spending on the voluntary sector, cumulative change, 2008/09 to 2012/13 (2008/09 = 100) Source: NCVO, TSRC, Charity Commission

MAJOR ORGANISATIONS ARE TAKING A GREATER SHARE OF GOVERNMENT INCOME Proportion of government income received by size of voluntary sector organisation, 2008/09 to 2012/13 (2012/13 prices) Source: NCVO, TSRC, Charity Commission

THE INCREASE IN INCOME FROM INDIVIDUALS IS ENTIRELY FROM FEES FOR SERVICES Voluntary sector income from individuals, cumulative change, 2007/08 to 2012/13 (2007/08 = 100) Source: NCVO, TSRC, Charity Commission

86% OF VOLUNTARY SECTOR SPENDING WAS ON CHARITABLE ACTIVITIES AND GRANTS Spending breakdown, 2012/13 (£ billions) Source: NCVO, Charity Commission

TWO-THIRDS OF THE VOLUNTARY SECTOR WORKFORCE ARE FEMALE Voluntary sector employees by gender, 2004 to 2014 (headcount, thousands) Source: Labour Force Survey

THE MAJORITY OF ASSETS ARE HELD BY THE TOP 1% OF ASSET OWNERS Assets held by the top 1% of asset owners, 2012/13 (% of total assets) Source: NCVO, TSRC, Charity Commission

Commissioner’s perspective Either apologies as unable to secure one for the date or Hand over to NHS England colleague (TBC)

Time to talk – challenges, solutions and evidence Discussion session

Structure for the discussion Summary of what the VCSE Review has heard so far Tell us if your views and experiences reflect those that we heard in phase one. Tell us about anything we may have missed or misunderstood Any other related challenges or issues? Give us examples of good practice that we can share Look at relevant questions from the consultation (handout) The discussion paper on the challenges and solutions to better investment in and partnership with the VCSE sector https://www.engage.england.nhs.uk/consultation/vcse-review covers 11 headings (next slide). This is too many to have a useful discussion. It is better to pick the key issues and talk about how these matter for your organisation and communities.

Topics for discussion today Recognising the value of the sector and making the most of local assets National investment in the VCSE sector Developing services and policies together How the sector is funded Commissioning Local partnerships Infrastructure/networks Improving national relationships with the sector Demonstrating impact Partnerships to promote equality and address health inequalities Investing in organisations that promote equality and address health inequalities The topics selected by attendees to discuss today Keep in one group if numbers remain lower. Otherwise, split into two groups or more groups Review what we have already heard for each topic Any gaps? Look at the questions Promising practice or evidence?

Recognising the value of the sector and making the most of local assets OPTIONAL SLIDE

Recognising the value of the sector and making the most of local assets What we heard in phase one: The sector’s strength lies in its holistic, community-embedded and personalised approaches. Groups affected by issues in local planning and funding decisions are not always involved as often as they should be. Its diversity, flexibility and level of innovation helps it to meet the needs of people that the statutory sector may find more difficult to support. Commissioners need to: know and understand the VCSE sector in their area, Commissioners are not always encouraged to see funding as just one part of the wider resources of their communities. recognise how well it meets the needs of communities and build a full picture of all parts of the community, particularly groups which are often overlooked or experience health and wellbeing inequalities. The needs of smaller communities and people at high risk of poor experiences and outcomes are often not fully understood. OPTIONAL SLIDE How can Joint Strategic Needs Assessments (JSNAs) become more focused on VCSE and community assets locally? How can commissioners and VCSE organisations at a local level be encouraged to better work together in co-producing local plans? Do you know of any relevant evidence or examples of good practice locally of good partnership working between the VCSE and statutory organisations? For some smaller VCSE providers it is not always about money. It is where money is cut (e.g. from infrastructure support). We would like to know how commissioners can and do reduce barriers and other support to enable community and VCSE sector provision to thrive.

Recognising the value of the sector and making the most of local assets Questions: How can Joint Strategic Needs Assessments (JSNAs) become more focused on VCSE and community assets locally? Do you know of any relevant evidence or examples of good practice locally of good partnership working between the VCSE and statutory organisations? How can commissioners and VCSE organisations at a local level be encouraged to better work together in co-producing local plans? OPTIONAL SLIDE Do you have experience of how the public sector work can work more closely with the whole of the VCSE sector to make sure strategies take account of VCSE and community assets. Does this include smaller organisations or groups? If not what are barriers to this?

How the sector is funded OPTIONAL SLIDE

How the sector is funded What we heard in phase one: There is evidence that many charities are facing increased demand for services as well as a decline in resources. Better use needs to be made of alternative funding models that deliver social good such as loans and Social Impact Bonds. Funding is on a reduced cost basis, with lower expectations and shorter- term goals. The diversity of the market also needs to be better recognised. Personal budgets, including those taken as direct payments, have the potential to be an effective form of funding for certain types of VCSE organisation and activity. A shift away from grants towards contracts, but grants are still a valuable payment mechanism. Many of the activities the VCSE sector specialises in – such as engaging overlooked groups and prevention - are often not funded through contracts. OPTIONAL SLIDE Social impact bonds (SIBs) are a new tool that unlock private finance and public investment so that organisations which are best placed to tackle social problems can do so. SIBs enable commissioners to draw on the expertise of the Voluntary, Community and Social Enterprise (VCSE) sector in tackling complex problems. They only pay for success and provide the VCSE sector with upfront capital to deliver payment by results contracts. SIBs enable social investors to use their money to achieve both a social impact and a financial return for themselves. The Centre for Social Impact Bonds in the Cabinet Office supports the development of social impact bonds. They do this by: building a repository of expert information and guidance on how to develop SIBs making available practical tools so that SIBs can be developed easily and cost-effectively providing funding for a portion of outcome payments for new SIBs showcasing how SIBs are transforming public service delivery and building an evidence base of what works stimulating and sharing the latest thinking, research and media coverage on SIBs The Market means the market place where providers (VCSE organisations, private and public sector) compete and at times collaborate to supply the range of services which could be bought/ purchased either by local authority or NHS commissioners or individuals through personal budgets. This might involve contracts and competitive tenders or direct payments.

How the sector is funded Questions: How might grant processes be strengthened to enable greater sustainability within the VCSE sector? What support would be beneficial for commissioners in recognising and working with the diversity of the market? If you know of any relevant evidence or examples of good practice in how the VCSE sector is funded or have any suggestions for other ways of supporting the sector please provide details. Do you think the VCSE sector need additional support to enable it to respond to alternative funding models e.g. social impact bonds? If yes, what type of support do you think would be beneficial? How could commissioners make better use of social prescribing? OPTIONAL SLIDE Qu. 1 Think about what commissioners can do through their grant support of VCSE organisations to help them prepare for their future and sustainability at a time of cuts. Social impact bonds (SIBs) are a new tool that unlock private finance and public investment so that organisations which are best placed to tackle social problems can do so on a payment by results basis. SIBs enable commissioners to draw on the expertise of the Voluntary, Community and Social Enterprise (VCSE) sector in tackling complex problems. They only pay for success and provide the VCSE sector with upfront capital to deliver payment by results contracts. SIBs enable social investors to use their money to achieve both a social impact and a financial return for themselves. The Centre for Social Impact Bonds in the Cabinet Office supports the development of social impact bonds. They do this by: building a repository of expert information and guidance on how to develop SIBs making available practical tools so that SIBs can be developed easily and cost-effectively providing funding for a portion of outcome payments for new SIBs showcasing how SIBs are transforming public service delivery and building an evidence base of what works stimulating and sharing the latest thinking, research and media coverage on SIBs Social prescribing has been developed in a number of areas around the country. Wellbeing Enterprises describes their social prescribing programme. “It is about linking people up to activities in the community that they might benefit from. It’s about connecting people to non-medical sources of support. There is increasing evidence to support the use of social interventions for people experiencing a range of common mental health problems. Social prescribing provides an opportunity to respond effectively, and at an early stage, to symptoms of mental distress, and has been shown to be particularly applicable for: Vulnerable and at risk groups People with mild to moderate depression and anxiety People who are frequent attendees in primary care http://www.wellbeingenterprises.org.uk/what-we-do/our-work/social-prescribing/ Social prescribing has also been used as an approach to support people around physical activity, weight management, reducing social isolation and managing other long term chronic health conditions. Small providers, whether local or national, can find barriers to reaching the market of individual purchasers. What is your experience of getting the word out about your services?

Commissioning OPTIONAL SLIDE

Commissioning What we heard in phase one: A drive to reduce both transaction costs and unit costs of services has led to increased investment in large-scale provision, through fewer, larger contracts. A shift in thinking is needed to move commissioning from an understanding of value based on lowest cost, to one centred on quality and social value. Many smaller VCSE organisations do not feel equipped to engage effectively and compete with larger providers in tender or procurement processes. Many small local community-based organisations can find it difficult to secure contracts meaning that power is being shifted away from communities. This is a particular issue for equalities organisations, or those working with specific communities of interest. Processes and paperwork, for both grants and contracts, need to better match the amount of money being applied for. OPTIONAL SLIDE We are interested in hearing from smaller community-based organisations as commissioning and contracting has not always been easy for them to access. They are often well placed to deliver services to groups and communities which may have been overlooked and underserved. So commissioners should be interested in making better links with them to meet the needs of all groups and communities.

Commissioning continued What we heard in phase one: Payment by Results and other contracting approaches can lead to cash flow risks being unequally shared by commissioners and providers. This can deter smaller organisations from applying and does not take count of innovation. The Social Value Act (2012) is an important lever for improving investment and partnerships with the VCSE sector. A review of the Social Value Act found that: commissioning for social value is having a positive impact on local communities but, The NHS Standard Contract can be a barrier to commissioning. NHS England is already working to address this through a shortened contract for small providers. the majority of local healthcare commissioners are still not familiar with it. OPTIONAL SLIDE Payment by Results – Contracts which use this approach include a proportion of funding (sometimes 100%) which is only payable if certain outcomes are met. However, this had led to problems with cash flow as organisations provide services which can take time to deliver the necessary outcomes. Some areas have overcome this by providing some funding upfront. In June 2015 NCVO’s Public Policy Director commented that the National Audit Office’s report on Payment by Results echoed charities concerns. He said ‘The principle of payment by results is hard to object to, but the practicalities of getting the mechanism right mean it is often far more effective and efficient to use straightforward contracts and grants.' https://www.ncvo.org.uk/about-us/media-centre/press-releases/914-ncvo-nao-report-echoes-charities-concerns-on-payment-by-results Social Value Act (2012) - It requires people who commission public services to think about how they can also secure wider social, economic and environmental benefits. Before they start the procurement process, commissioners should think about whether the services they are going to buy, or the way they are going to buy them, could secure these benefits for their area or stakeholders.

Commissioning Questions: How can we ensure that social value principles are included in commissioning processes? What more do you think could be done through commissioning to ensure that risks are effectively shared between commissioners and providers? If you have any examples of social value being demonstrated in commissioning, please share these here. If you have any other suggestions to help improve commissioning of the VCSE sector please provide details. Are you aware of any local areas where a level playing field has been achieved for smaller VCSE organisations and, if so, please provide details of where this currently happens? OPTIONAL SLIDE

VCSE infrastructure/networks OPTIONAL SLIDE

VCSE infrastructure/networks What we heard in phase one: There is a need for investment in infrastructure organisations, but this needs to be targeted to deliver capacity by unlocking social capital and leverage. VCSE infrastructure organisations play a vital but often hidden role in civic life. They connect VCSE organisations, strengthening their capability and capacity and ensuring effective communication between the statutory and the VCSE sectors. Infrastructure organisations could be key partners in the health and care economy if effectively supported and their operating principles co-designed with the wider sector. One of the challenges facing frontline VCSE organisations is the loss of infrastructure organisations due to reductions in funding. OPTIONAL SLIDE VCSE infrastructure organisations can be quite different acting locally, regionally or nationally and supporting particular sub-sectors or any charity in the area.

VCSE infrastructure/networks Questions: What support could be given to the local VCSE infrastructure sector (e.g. Council for Voluntary Service, support organisations for social enterprises etc.) to enable it to demonstrate the impact of its work and achieve sustainability? How could commissioners be encouraged/ incentivised to support VCSE infrastructure? What, if anything, needs to change about local VCSE infrastructure organisations? OPTIONAL SLIDE What needs to change to enable local VCSE infrastructure organisations to provide effective support to the full range of VCSE providers in your area?

Demonstrating impact OPTIONAL SLIDE

Demonstrating impact What we heard in phase one: Defining, measuring and capturing long term outcomes and social value are crucial to making the most of the VCSE sector’s contribution. Some VCSE organisations feel there is not a level playing between the VCSE and other sectors when it comes to the challenge of showing their impact. Commissioners do not consistently use a holistic and long-term notion of value when designing contracts, nor do they consistently co-design services with citizens. VCSE organisations, especially the smallest, need support to show their social impact in ways that are consistently understood and valued by commissioners. It is difficult to demonstrate impact in short term projects, so the way that organisations are funded is affecting how the system measures and achieves long-term outcomes. Equally, commissioners need support to capture, measure and value the outcomes and impact of VCSE organisations. OPTIONAL SLIDE The Charities Evaluation Service CES has a great jargon busting website for these terms. http://www.jargonbusters.org.uk/ and their main website: http://www.ces-vol.org.uk/tools-and-resources They describe impact as: Broader or longer-term effects of a project’s or organisation’s outputs, outcomes and activities. The word impact has a number of different uses in project work. The two most often encountered are as follows. Many people use it simply to mean ‘the results of their work’. A commonly accepted use is ‘the broader or longer-term effects of a project’s or organisation’s activities, outputs and outcomes’. Often, these are effects on people other than the direct users of a project, or on a broader field such as government policy. Outcomes are described as: The changes, benefits, learning or other effects that result from what the project or organisation makes, offers or provides. When people use a project or organisation, they expect it will make some kind of difference to them. For example, if they have a problem with reading they hope the reading classes will teach them to read better. This difference ‘comes out’ of the things the project or organisation ‘puts out’. (This is why it is an ‘out – come’.) Outcomes are all the things that happen because of the project’s or organisation’s services, facilities or products. This includes the bad and not so good, as well as the good; the unexpected as well as the expected. Outcomes can be for individuals, families, or whole communities. We can also talk about outcomes in organisations, or in other fields such as policy, law or the natural environment.

Demonstrating impact continued What we heard in phase one: VCSE organisations often struggle to access and use the data they need. The concept of added value and social value should be fundamental to all contracts and grants. Many organisations are not aware of the Health and Social Care Information Centre (HSCIC), which is the national provider of data for health and social care. More needs to be done to promote this as a source of data and make it easy to access. OPTIONAL SLIDE

Demonstrating impact Questions: What more can be done to increase the availability and accessibility of outcomes/ social value/ impact data? How could learning from funded grants and projects be better shared and disseminated? What kinds of outcomes and impact does the VCSE sector need support to measure and demonstrate? OPTIONAL SLIDE

Investing in organisations that promote equality and address health inequalities OPTIONAL SLIDE

Investing in organisations that promote equality and address health inequalities What we heard in phase one: Many VCSE organisations see their key function as promoting equality and tackling health inequalities through supporting marginalised groups and people with complex needs to gain greater access to services. It appears that parts of the sector with equalities functions are particularly challenged by current approaches, and have experienced an unequal, disproportionate loss of funding. 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. The sector is recognised as having particular strengths in reaching parts of the community that the statutory sector finds difficult to access and, therefore, plays a crucial role in tackling health inequalities. OPTIONAL SLIDE

Investing in organisations that promote equality and address health inequalities Questions: How can we best prioritise progressing equality and addressing health inequalities? Please provide any evidence of good practice in promoting equality / addressing health inequality through funding that you are aware of. OPTIONAL SLIDE What is happening in your area about equality and health inequalities? What could be done differently to better support people from overlooked groups and communities and the organisations working with them?

National investment in the VCSE sector OPTIONAL SLIDE

National investment in the VCSE sector What we heard in phase one: National VCSE organisations need adequate investment in order to continue to support the communities that they serve. The current Voluntary Sector Investment Programme has funded important and impactful work. In its current form, there are three main funding schemes: The Department of Health, NHS England and Public Health England invest approximately £150million in the VCSE sector each year. the Innovation, Excellence and Strategic Development Fund; the Health and Social Care Volunteering Fund; and This is in addition to the £22million that is invested through the Voluntary Sector Investment Programme of central grants. However, little information is captured on the effectiveness of this investment. the Health and Care Voluntary Sector Strategic Partners’ Programme. OPTIONAL SLIDE

National investment in the VCSE sector What we heard in phase one continued: In order to prioritise the national investment in the VCSE, the VCSE Review group proposes simplifying the programme to two main aims: The VCSE Review group is seeking views on this through a separate survey open to anyone who wishes to participate but most relevant to VCSE organisations that have applied for this funding before, national organisations, or policy staff working in the system partner organisations. promoting equality and addressing health inequalities contributing to health and well-being outcomes for all communities in England. If you would like to be involved in this discussion, please complete the Voluntary Sector Improvement Programme survey. This would re-focus the programme and seek to fund projects capable of being evaluated individually and collectively to demonstrate impact. As a national source of funding, this programme is relevant to fewer organisations. OPTIONAL SLIDE VCSE Review: Discussion Paper on the Voluntary Sector Investment Programme: https://www.engage.england.nhs.uk/consultation/vcse-review-vsip

National investment in the VCSE sector Questions: Do you agree with the new aims? If not, how would you change them?

Developing services and policies together OPTIONAL SLIDE

Developing services and policies together What we heard in phase one: Many small organisations are struggling to find the capacity to make links with and gain acceptance among local GPs and commissioners. As a result, the numbers of referrals to their services are reducing. VCSE organisations that are rooted in their community have networks of relationships and understand the needs and capabilities of the community that they serve. This risks reducing patient choice and weakens the ability of commissioners to provide people with access to the most appropriate services. The VCSE sector has the potential to provide expert, niche advice that is firmly grounded in the needs of patients, service users and carers. For health and care 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. It is often better at looking at the assets they bring and can support them to achieve holistic goals for a good life. OPTIONAL SLIDE

Developing services and policies together What we heard in phase one continued: The system needs to have co-design and collaboration as its core values and recognise all of the resources available to it, including community resources, social action, peer leadership and volunteering. Commissioners need to understand the principles of social prescribing and make better use of it. OPTIONAL SLIDE

Developing services and policies together Questions: Do you think the VCSE is better placed than the statutory sector to achieve improved health and care outcomes in some areas? We are looking for examples of good practice of co-production in the development of plans or strategies either in localities or in particular specialisms. Please provide examples of any such plans that you have come across. If yes, please let us know which outcomes and why you think the VCSE sector is better placed to achieve these How can social prescribing (or similar mechanisms) be used in building better partnerships and strengthening collaborative working? OPTIONAL SLIDE Social prescribing has been developed in a number of areas around the country. Social prescribing is about linking people up to activities in the community that they might benefit from. It’s about connecting people to non-medical sources of support. There is increasing evidence to support the use of social interventions for people experiencing a range of common mental health problems. Social prescribing provides an opportunity to respond effectively, and at an early stage, to symptoms of mental distress, and has been shown to be particularly applicable for: Vulnerable and at risk groups People with mild to moderate depression and anxiety People who are frequent attendees in primary care Social prescribing has also been used as an approach to support people around physical activity, weight management, reducing social isolation and managing other long term chronic health conditions. It might be helpful to share what has happened elsewhere in the UK. The Scottish Government and Convention of Scottish Local Authorities have taken an ‘assets-based approach’ using co-production amongst others to start shifting health and care towards prevention and independence. ‘Co-production recognises that people have ‘assets’ such as knowledge, skills, characteristics, experience, friends, family, colleagues, and communities. These assets can be brought to bear to support their health and well-being. Co-production begins and ends with the person, placing them at the heart of any given service and involving them in it, from the creation and commissioning of that service through to its design and delivery, its assessment and sometimes, where appropriate, its end.’ http://www.govint.org/fileadmin/user_upload/publications/Co-Production_of_Health_and_Wellbeing_in_Scotland.pdf

Local partnerships OPTIONAL SLIDE

Local partnerships What we heard in phase one: Often the contribution of the voluntary sector is narrowly focused on support for patient and public engagement. While this is a key area, the sector offers expertise in terms of its in-depth knowledge and legitimacy through its close relationships with service users. There are some areas of commissioning support where the VCSE sector offers particular expertise, including needs assessments, service re-design and public and patient engagement. However, some commissioners lack awareness of what the sector can offer and where the gaps in provision are. The VCSE sector can help support statutory agencies to co-design services and systems with their communities. It may represent the ‘voice’ of the communities it serves which can be harder to hear views and experiences. The system needs to value all of the resources available to it, not just money and the staff and equipment that it can buy, but also community resources, social action, peer leadership and volunteering. OPTIONAL SLIDE

Local partnerships What we heard in phase one continued: By co-producing services with the VCSE sector, the system will have a much stronger focus on building personal family and community resilience, to delay, reduce, or avoid the need for more formal kinds of support. Working in equal partnership with statutory bodies, VCSE organisations can overcome barriers based on institutional, departmental budget and service silos. They provide a focus on working together with people, families and communities to identify needs, strengths and capabilities, and develop solutions that meet those needs. Much of the commissioning support currently provided by the sector is unpaid (pro bono) and partnerships are not being invested in properly. The potential of the sector to act independently and ensure the voice and influence of service users and communities needs to be maximised and used to shape public services in ways that improve outcomes. OPTIONAL SLIDE

Local partnerships Questions: How can we ensure voluntary organisations are able to work in equal partnership with statutory sector in the design of services or local plans? Do you think there is a good relationship in your area between the statutory sector working in health and care and the VCSE sector? What kinds of infrastructure or organisations are needed to support better partnership working? If yes, what do you think makes this successful? If no, how do you think this could be improved? Is there a VCSE representative on your local Health and Wellbeing Board? Do you think VCSE organisations in your area have a good and effective route to the Health and Wellbeing Board? OPTIONAL SLIDE Health and Wellbeing Boards were established by the Health and Social Care Act 2012 – the Local Government Association describes them as: “a forum where key leaders from the health and care system work together to improve the health and wellbeing of their local population and reduce health inequalities. Health and wellbeing board members will collaborate to understand their local community's needs, agree priorities and encourage commissioners to work in a more joined-up way. As a result, patients and the public should experience more joined-up services from the NHS and local councils in the future”. - See more at: http://www.local.gov.uk/health/-/journal_content/56/10180/3510973/ARTICLE#sthash.58Ia6jBC.dpuf

Improving national relationships with the sector OPTIONAL SLIDE

Improving national relationships with the sector What we heard in phase one: Stable and successful partnerships are required at a national level in order for the VCSE sector to be effectively involved in delivering better outcomes for people and communities. The programme was designed as a mechanism for the Department of Health before the 2012 health reforms. The separate discussion paper is seeking to explore what the key features of a new programme might be within the current health and care landscape. In recognition of the importance of this, the Health and Care Voluntary Sector Strategic Partnership Programme was developed as a strategic relationship and funding programme to maintain close engagement between central government and the health and care VCSE sector. If you would like to be involved in this discussion, please complete the Voluntary Sector Investment Programme survey. OPTIONAL SLIDE VCSE Review: Discussion Paper on the Voluntary Sector Investment Programme: https://www.engage.england.nhs.uk/consultation/vcse-review-vsip

Improving national relationships with the sector What we heard in phase one continued: Given the diversity of the sector, it is not possible to have a relationship with all organisations at a national level. VCSE infrastructure organisations play a vital role in supporting this and should be a key partner in the health and care economy, but need to be effectively supported in order to do this. Infrastructure organisations typically enable others to deliver frontline services rather than doing so themselves, which means that they often lose out on funding that requires the demonstration of how their work impacts directly on outcomes. The Strategic Partnership Programme resources national infrastructure organisations to enable local voice to be amplified and to provide a conduit to the sector. OPTIONAL SLIDE

Improving national relationships with the sector Questions: How best can national VCSE infrastructure organisations be supported? What, if anything, needs to change about national VCSE infrastructure organisations to enable them to better support the wider VCSE sector? OPTIONAL SLIDE

Partnerships to promote equality and address health inequalities OPTIONAL SLIDE

Partnerships to promote equality and address health inequalities What we heard in phase one: The voluntary and community sector is a key partner in addressing the wider determinants of health and achieving better public health outcomes for local populations. The VCSE sector is recognised as having particular strengths in reaching parts of the community that the statutory sector finds difficult to access and, therefore, plays a crucial role in tackling health inequalities. Voluntary and community organisations are often formed in response to needs that are not being met by statutory services and, in this way, they enable community members to exercise choice and voice. A basic problem is that the present health and care system does not appear to be good at identifying the needs of a range of groups. It is important that VCSE organisations are involved throughout the whole commissioning process if these issues are going to be addressed. OPTIONAL SLIDE

Promoting equality and addressing health inequalities Questions: What is needed to support better co- production with organisations focusing on progressing equality and tackling health inequalities?

Shaping the future – key points to feed into the Review Feedback from the group discussion

Gathering views and evidence Complete the resource pack feedback form and submit to programme manager, Angie.Macknight@ncvo.org.uk vcsereview.org.uk – visit the website to comment on blogs or contribute your own Contribute your own response via the two online surveys: VCSE Review: Discussion Paper on the Voluntary Sector Investment Programme: https://www.engage.england.nhs.uk/consultation/vcse-review- vsip VCSE Review: Discussion paper on the challenges and solutions to better investment in and partnership with the VCSE sector: https://www.engage.england.nhs.uk/consultation/vcse-review If you cannot complete the surveys online, please send your views on investment in and partnership with the VCSE sector to the programme manager, Angie Macknight, National Council for Voluntary Organisations, Society Building, 8 All Saints Street, London N1 9RL  Consultations close on 6 November 2015

Thank you for contributing to the VCSE Review! Thanks for giving your time and sharing your views. Thank you for contributing to the VCSE Review!