How do we enable VCSE commissioning in health, wellbeing and care?
In the light of the issues that arose in the paper "The Voluntary and Community Sector and Localised Commissioning", this working paper is a short look at questions that it would be useful to address nationally, to get the most of partnership work with the voluntary, community and social enterprise sector (VCSE). The questions are posed to the Department of Health, NHS England, Public Health England, the Health and Care Voluntary Sector Strategic Partnership and other VCSE infrastructure organisations. Progress is already being made towards answering some of the questions in some areas, and work over the next year will continue to find solutions to the issues and sharing good practice from around the country.
How do we Enable VCS Commissioning in Health, Wellbeing and Care asks: how do we better support....
- JSNA lead officers to engage effectively with VCS organisations (both small local and wider- for insight into local assets and issues (see Comparing Apples with Oranges: Using VCS evidence to improve health outcomes)
- JSNAs to use the best available evidence- up to date and building on existing assets (see RNIB/Diabetes UK/National Voices and CSV)
- use of disaggregated data to help address equalities issues (build on the work of the Lesbian and Gay Foundation, Women's Health and Equality Consortium and Men's Health Forum)
- smaller local organisations to engage effectively with commissioners (for instance through effective infrastructure arrangements)
- small/stretched national services to engage with relevant commissioners across the country- both to inform needs assessments and/or to be commissioned
- clarity as to where commissioning responsibilities lie between different types of commissioners e.g. area teams, CCGs, PCCs and local authorities, especially in context of developing of co-commissioning. (see MNDA and Menopause UK)
- proportionate commissioning processes/funding mechanisms for the VCSE (build on Simon Steven's promise in NHS 5YFV and on development of "Standard Contract Light" and the soon to be published NHS England "Bite Sized Guide to Grants")
- joined up commissioning/contracting where organisations need to manage multiple small value contracts across CCG areas
- productive quality improvement conversations with existing providers- to help reshape and personalise services (e.g. hospices and learning disability service providers)
- local VCSE provision being valued appropriately, i.e. not treated as "free", putting services at risk (e.g. MNDA communication aids, IAPT, rape crisis, small patient groups providing peer support, mental health recovery support, social prescribed services, befriending...) if there are referrals, or it's valuable- it needs to be commissioned.
- ensuring market position strategies, and broader work about demand management, include VCSE provision: services on offer/could be offered; change in demand; risks to services
- moving commissioning out of "silos"- joining up of grant funding processes, procurement of contracts, community development funding- which can all be moving towards similar outcomes, but are in different departments and have different timescales.
- commissioners working with people with lived experience to define outcomes for commissioned services (see Disability Rights UK)
- VCSE organisations participating as equal partners in integration programmes and service/pathway redesign (including addressing issues of data sharing)- use all available expertise, insight and networks
- getting the best value from commissioning- economic and social value, creating choice of personalised and high quality services tailored to local areas (see the Realising the Value programme)
Making the links as efficiently as possible
- Commissioners with multiple VCSE organisations in their area (though sustainably funded local infrastructure arrangements)
- VCSE organisations working over several co-terminus health economies to link with commissioners (through regional networking and/or CSUs?)
- VCSEs working across the whole country to make links with multiple commissioners (though Commissioning Assembly and...)
- Mechanism for linking with all JSNA lead officers/inputting onto multiple JSNAs (maybe a nationally agreed template that could slot into differently structured JSNAs?)
Regional Voices is committed to sharing good practice, which overcomes barriers to VCSE engagement, through its networks and the wider Health and Care Voluntary Sector Strategic Partnership This is a working paper- do contact firstname.lastname@example.org if you have issues/solutions/good practice to share.
Jo Whaley, December 2014