How is VCS faring in the localised health commissioning landscape?
The paper "The Voluntary and Community Sector and Localised Health Commissioning" has been drafted following a series of meetings of voluntary and community sector infrastructure organisations with NHS England. With the move towards more localised commissioning in health, some voluntary and community organisations (VCOs) have been reporting difficulties in linking new commissioners, in order to get the issues of their beneficiaries addressed. This can be because:
- the needs of communities not being fully understood (e.g. each JSNA does not pick up the needs of each community),
- the groups that are affected by the issue are not involved in commissioning decisions locally (e.g. shaping pathways) - so little co-design to impact on issues
- VCO services are not funded (and its a difficult funding environment)
These difficulties can be more pronounced for organisations with a larger geographic footprint, which need to deal with more than one set of commissioners. Often these are condition specific organisations- but also equalities groups, and have in common that:
- nationally they work with a significant community
- small numbers of people locally
- they do not all fall under the remit of NHS E's "specialised commissioning" or commissioning of a pathway is split between specialised commissioning and local commissioning.
More widely, it is being increasingly recognised that voluntary and community sector (VCS) inputs will form a significant part of future care provision, for example through:
- social prescribing,
- community development approaches to health,
- the ‘more than medicine’ elements of the House of Care,
- user-led organisations can facilitate conversations between service users and commissioners and establish peer-led activities
- support for people to understand and use personal budgets
However, there has so far been little policy discussion about how best to remove barriers and design the partnerships, incentives, contracts and other mechanisms that would enable VCS organisations to make these contributions. The Commissioning Assembly, however, could be a useful forum to engage in a collective conversation with VCS infrastructure/umbrella bodies, as it brings together leaders from CCGs, Area Teams and NHS England. We need to work together across the system to help create bridges between the VCS and the commissioning system, locally and in particular across larger geographic areas.
Aim of this work - to explore, develop and share learning around resources, levers, incentives, wider guidance and contracting models that will help VCOs work with commissioners to improve health outcomes for the communities they serve.
Support to address the issues- The Health and Social Care Voluntary Sector Strategic Partnership, and VCS Infrastructure Bodies, would like to work with the Commissioning Assembly to address these issues- to help commissioners work better with the voluntary sector (and the people they work with)- to evidence needs and assets in their area and to co-produce plans and commissioning intentions with the VCS- with a view of reducing health inequalities and improving outcomes for people.
Drafted by Jo Whaley (Regional Voices) with Don Redding at National Voices and Richard Caulfield (VSNW), with input from Disability Rights UK, Women's Health and Equality Consortium, NAVCA, CSV, Clinks- from the Health and Care Voluntary Sector Strategic Partnership. Email Jo Whaley if you have any examples or comments about this work.