Jane Hartley, Chief Executive VONNE

1. The Voluntary, Community & Social
Enterprise (VCSE) Sector’s Role in
Supporting Health & Wellbeing
Jane Hartley Chief Executive VONNE

2. Wider Determinants of Health &
Wellbeing & the VCSE

3. Due North: Independent Inquiry into
Health Equity for the North
 Health Inequalities due to differences between
socioeconomic groups in poverty, power and
resources needed for health
 Those who have less influence are less able to affect
the use of public resources to improve their health and
well-being

4. Due North: Recommendations
- Tackle poverty and economic inequality
- Promote healthy development in early
childhood
- Share power over resources and
increase the influence that the public
has on how resources are used
- Strengthen the role of the health
sector in promoting health equity

5. Public Service Reform
Local Authorities
 Significant Budget Cuts
 Pressures on social care
 Lack of room to innovate and manoeuvre
 Combined Authorities
 Devolution Deals - Decentralisation: centralised control to local control
Significant shortfall in NHS funding
- Demographic & technological impact – NHS
 5YFV: greater community involvement & shift from acute to preventative &
community based care & support
 New Models of Care
 Integration of care services
 Health Devolution

6. Decentralisation - Opportunities
Address inequalities
Local community empowerment
Use local knowledge & community
capacity
Create local ownership
 Develop local solutions
VCSE as partner and facilitator

7. VCSE Supporting 5 Ways to Wellbeing
 Connect – supporting individuals to connect and engage within their
local community, building social networks and social capital
 Be Active – encouraging individuals to be physically active and active
within their local communities through volunteering
 Take Notice – Supporting individuals to be involved in their local
community and building their capacity to influence local decision
making
 Keep Learning – linking individuals into learning opportunities to
improve their knowledge, skills and confidence
 Give – encouraging individuals to volunteer and contribute to
supporting their local community

8. Participation & Volunteering
 Participation in a group cuts a person’s chance of dying in the next
year by half, and joining two groups cuts the risk by 75 per cent.
Putnam (2000)
 Volunteering can improve the wellbeing of volunteers particularly
those from most marginalised groups
 People who volunteer spend 38% less time in hospital. Harvard School
of Public Health

9. VCSE role in Health & Care
 ‘VCSE sector has significant expertise that is invaluable in
helping us achieve improvements across the health, social
care and public health system’ Department of Health,
NHS England and Public Health England
 VCSE organisations are an integral part of the wider
health and care system
 Support focus on early intervention, prevention & self
care/management – NHS & LA (Care Act)
 Key to NHS strategic shift - acute care > community based
care & support & self management

10. Joint review of role of the VCSE sector in
improving health, wellbeing and care
outcomes & partnerships

11. Background to VCSE Review
 Commissioned by the Department of Health, Public Health England,
and NHS England
 Purpose :
 Describe the role of the VCSE sector in contributing to improving
health, well-being and care outcomes
 Identify and describe challenges and opportunities for 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
 Review co-produced by representatives of the VCSE sector and the
Department of Health, NHS England, and Public Health England
 Final Report March 16

12. Recognising the value of the sector and
making the most of local assets
 No wrong door -The sector’s
strength lies in its holistic,
community-embedded and
personalised approaches.
 Track record of trust
 VCSE organisations promote
understanding of the specific
needs of their communities.
 Its diversity, flexibility and level of
innovation helps it reach and
support those hardest to engage
 Builds emotional resilience and
promotes self-care and
independence
 VCSE organisations involve people
experiencing health inequalities
and builds their capacity for social
action
 Provides vehicle for asset based
approaches to community
engagement in addressing health
inequalities
 Expertise of lived experience in
designing more effective,
sustainable services
What we heard:

13. Investing in organisations that promote
equality and address health inequalities
 The sector is recognised as
having particular strengths in
reaching parts of the
community that the statutory
sector finds difficult to reach
and, therefore, plays a
crucial role in tackling health
inequalities.
 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.
What we heard in phase one:

14. How the sector is funded
 Strong evidence that charities are
facing increased demand for
services as well as a decline in
resources.
 A shift away from grants towards
contracts prohibitive to smaller
VCSE
 Payment by Results type contracts
prohibitive for smaller
organisations from applying
 Many of the activities the VCSE
sector specialises in – such as
engaging overlooked groups - not
funded through contracts.
 Drive to reduce costs – increase in
large-scale provision & larger
contracts.
 Tender or procurement processes
prohibitive to smaller
organisations.
 Commissioners need recognise
value based on quality and social
value
( Social Value Act 2012)
What we heard :

15. Developing services and policies together
 VCSE organisations that are rooted
in their community and understand
the needs and capabilities of the
community that they serve.
 VCSE sector has led on the
adoption of asset-based
approaches and community
leadership
 It can support individuals and
communities to achieve holistic
goals for a good life.
 Many small organisations are
struggling to make links with and
gain acceptance among local GPs
and commissioners.
 For health and wellbeing 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.
 Co-production requires “mutual
respect between commissioners
and VCSE organisations”
What we heard in phase one:

16. Final Report
https://www.engage.england.nhs.uk/consultation/
vcse-review

17. How are we doing
locally?

18. Community Health Champions
 Community Health Trainer & Health Champions
 The Alcohol Health Trainer Service has trained 26 people from the
recovery community to become Community Health Trainers, of whom
4 have gained employment with the service as Health Trainers and 20
have gone on to actively volunteer as Health Champions supporting
over 350 individuals in 1 year
 Outcomes for individuals & communities:
 Increased knowledge, confidence, self esteem, social interaction,
wellbeing, emotional resilience
 building capacity, connectedness, community support and
resources

19. Social Prescribing
 Stockton Health Initiatives
 Stockton and Hartlepool CCG &
Stockton Borough Council Public
Health funded social prescribing
grant programme
 16 projects funded
 Fuse commissioned SROI
evaluation – Teesside University
 Social return on investment
overall 2.82 ( input 653,067,
output 1,843,168)
 Durham Healthy Village
Challenge
 Public Health Grants programme
 Local Community Centres/
Regeneration partnerships
 Local people – activities to
promote health & wellbeing
 Local programmes
 Locally Owned – locally driven

20. Provides help to
people with Long term
health conditions who
live in the west of
Newcastle upon Tyne
Non-medical ‘link
workers’ help them to
have better quality of
lives and, as a result,
to reduce the cost of
their care to the NHS

21. The Service
Link workers
Help people with non-medical
lifestyle, emotional and practical
matters that affect their health and
wellbeing
On average support lasts for 21
months
Eligible conditions
• COPD or Asthma
• Diabetes (Type 1 or Type 2)
• Heart Disease
• Epilepsy
• Thinning of the bones
(osteoporosis)
• Any of the above with
depression and/or anxiety

22. GPs
Bridges Ventures
Social Investor
Newcastle
Gateshead CCG
Commissioner
Cabinet
Office
Big Lottery
Fund
8,500 Patients
over 6 years
4 Providers
- Changing Lives
- HealthWORKS
Newcastle
- First Contact Clinical
- Mental Health
Concern
30 Link Workers
Outcomes
A: Improved self management
B: Reduction in secondary healthcare
costs
Refer
eligible
patients
Paid base
payment
and per
patient
Help people to
manage their
condition(s)
Pay up to £8.2m
based on
outcomes
Commissioning
Better Outcomes
Fund £2m
Social
outcomes
Fund £1m
Ways to Wellness
People with Long Term Conditions
in the west of
Newcastle upon Tyne
£1.65m Loan
repaid based
on outcomes
Ways to
Wellness
Foundation

23. What can the VCSE contribute?
 Rooted in communities and trusted
 Understands their needs
 Mechanism to engage and involve communities of interest
and place
 Especially those most excluded and hardest to reach
 Focus on prevention & holistic person centred approach
 Facilitate asset based approaches, co-production and
design of services
 Can deliver innovative ‘user’ led solutions in environment
of reduction in public sector services & resource

24. Any Questions
Jane.Hartley@vonne.org.uk
www.vonne.org.uk