Doing the Right Thing Unlocking the voluntary and community sector’s potential for making change happen in health and care

Doing the Right Thing: who are we? A collaboration of the Richmond Group of Charities and five other key voluntary sector partners – Alzheimer’s Society; Arthritis Research UK; British Red Cross; Mind; and the Royal Voluntary Service – and one statutory partner – Public Health England Supported by a steering group of experts from across the health and care system, including NHS England, the Cabinet Office, the Nuffield Trust, Local Government Association etc.

Doing the Right Thing: what did we set out to do? We want to influence redesign of the health and care system as part of the 5YFV implementation and other health and care transformation initiatives such as devolution, integration pioneers and so on Build the case for change, by putting forward robust evidence of the current and potential value of our contribution to improving outcomes across the health and care system Arrive at a shared call for action which will establish consensus among leading health and care charities and set out practical, evidence- based, ambitious steps that need to be taken to achieve a better deal for people using the health and care system.

Doing the Right Thing: what have we done so far? Worked with NPC to undertake research to answer the following questions: 1.To what extent can we evidence the impact of third sector interventions in the health and care system in terms of outcomes across different domains of value? 2.What are the processes by which impactful third sector interventions in the health and care system come into being? 3.What are the barriers to, and success factors for, impactful third sector intervention in the health and care system? Brought together 100 documents from partner organisations to inform our review (with each partner selecting their “top five” evaluations) Discussed our early findings with partners from across the health and care system and beyond

Areas of work Emotional, psychological and practical support Engaging people in keeping healthy Supported self-management Involving families and carers Integrated, person-centred care System redesign Support for health and care professionals Individuals The system A new taxonomy of what we do in the system, based on focus groups and workshops RESULTS Note: This work is ongoing and this document presents interim findings. Details may be subject to change

Areas of work Examples of activity Evidence against outcomes Health and wellbeing Productivity and efficiency Engagement, resilience and cohesion Emotional, psychological and practical support Direct services Engaging people in keeping healthy Behaviour change campaigns, information services, services (eg, sports clubs) Supported self-management Information services, personal support Involving families and carers Direct support for carers and families System redesign Pilots of innovative approaches, work with commissioners on service design Support for health and care professionals Training, creating communities of interest Integrated, person-centred care Helping patients navigate the system A framework for understanding the value of our work RESULTS Note: This work is ongoing and this document presents interim findings. Details may be subject to change

X AXIS LOWER LIMIT UPPER LIMIT CHART TOP Y AXIS LIMIT RESULTS Assessment of evidence quality Across all the data points, the spread of evidence was as follows: Descriptive Describes what has been done and why it matters Single method evaluation Captures data using a single method that shows a change (cannot confirm the cause of this change) Comparative evaluation Demonstrates causality using a control or comparison group Randomised comparative evaluation Demonstrates causality through the random allocation of control and test subjects (ie, RCT) Mixed methods evaluation Captures data using mixed methods that shows a change (cannot confirm the cause of this change) Level of Evidence 43% 40% 16% Note: This work is ongoing and this document presents interim findings. Details may be subject to change

X AXIS LOWER LIMIT UPPER LIMIT CHART TOP Y AXIS LIMIT RESULTS Assessment of evidence by risk category High riskComplex, co-morbidity, Intensive case/ care management (end of life care, specialist services) Medium risk Long Term Conditions requiring fairly constant medical attention/poorly controlled single condition and those whose lifestyle makes them relatively intensive users of healthcare Lower riskSelf-managed conditions people in a situation where they are making use of healthcare more often. People with Long Term Conditions that are broadly under control Population wide Population wide prevention, health improvement and health promotion Note: This work is ongoing and this document presents interim findings. Details may be subject to change

X AXIS LOWER LIMIT UPPER LIMIT CHART TOP Y AXIS LIMIT RESULTS A ‘heat map’ of where submitted evidence is strongest Health and wellbeing Productivity and efficiency Engagement resilience and cohesion Emotional, psychological and practical support Engaging people in keeping healthy Supported self-management Involving families and carers Integrated, person-centred care System redesign Support for health and care professionals Very low Low Medium High Key: Note: This work is ongoing and this document presents interim findings. Details may be subject to change

X AXIS LOWER LIMIT UPPER LIMIT CHART TOP Y AXIS LIMIT RESULTS Ways the third sector works What the third sector does and the outcomes it achieves The added value or ‘USP’ of the third sector Focus of ongoing work Product of initial evidence review Focus of ongoing work Recognition that ‘what we do’ is only part of our contribution Note: This work is ongoing and this document presents interim findings. Details may be subject to change

Doing the Right Thing: learning so far Our work has demonstrated that it is possible to produce a strong evidence-based case for the value created by our contribution to the health and care system – with particularly strong evidence of delivering value in health and wellbeing, and productivity and efficiency outcomes However, in exposing this evidence to key system leaders we have also uncovered a sense that evidence alone will not be sufficient to persuade the system to develop a new relationship with our sector We have also found that while system leaders are interested in the value created by “what we do”, it is also keen to hear more about the “ways we work”, and our “value-add”

Doing the Right Thing: learning so far We have found an instinctive consensus amongst project partners about our role and value, but a lack of shared language and framework to describe it. We have found a lack of consensus: among system leadership bodies themselves; between those operating at different ‘levels’ in the system; and between statutory and voluntary actors, about what is needed to create a shift in the relationships between sectors. We have found a reluctance to acknowledge the difficulties we face when trying to work with the NHS, and a lack of explicit vision, or strategy for improved partnership working.

Doing the Right Thing: What we will produce A new framework for understanding our contribution An assessment of the state of the evidence held by project partners, and how this demonstrates the value we as large charities bring to the health and care system A compendium of case studies and examples of practice, which can be drawn upon by those looking to take action An assessment of the cultural and practical barriers to better working between our sector and the health and care system, and some proposals for breaking these down.