SF EH 5253/07 Designed to Add Value - A Third Dimension
Designed to Add Value
- A Third Dimension
A strategic direction for the voluntary & community sector in supporting Health & Social Care
Contents
1. Summary
2. Introduction
3. Policy context
4. Background
5. The contribution of the voluntary sector in supporting health & well being
6. Current position
7. Current evidence
8. Service attributes
9. Key issues
Ø Stronger partnership working within the voluntary sector and between the sectors
Ø Better and consistent commissioning
Ø Promoting self care and independence
Ø Improving access to services for disadvantaged and rural communities
Ø Strengthening volunteering in Health & Social Care
Ø Developing social enterprises in Health & Social Care
Ø Integrated workforce planning
Ø Reducing admissions and improved discharge
Ø Research & development
10. Recommendations and actions
References
Appendices
1. Summary
· Designed to Add Value – A Third Dimension has been produced by the Welsh Assembly Government to inform future directions and support the evidence base of the voluntary sector’s contribution to health and social care .It will serve to inform planners and commissioners in the development of the Health Social Care & Well being Strategies and the commissioning process across Wales.
· Ensuring that the right services are provided ‘in the right place, to the right person, at the right time’ will require a more innovative and flexible approach to local service provision supporting health & social care in the community.
· Delivering health & social care services is no longer the preserve of statutory services but will require stronger and co-ordinated partnerships across the statutory, independent and voluntary sectors as well as with local people, carers and patients.
· The voluntary sector has a key role to play in supporting health, social care & well being, particularly in preventing ill health; shifting the balance of provision closer to where people live; involving local people and delivering the type of responsive services and support people want.
· The voluntary sector also has a role in empowering the citizens of Wales to live more vibrant and fulfilled lives, through community development, using volunteering as a vehicle for capacity and skill building, engagement with minority or hard to reach groups and through supporting people to reach their full potential through advocacy, advice and self care.
· Building Strong Bridges (2002) identified opportunities to strengthen links between Health & Social Care and the voluntary sector at national and local levels. This provides a sound framework and basis for improving partnership working between the voluntary sector and health & social care. The Building Strong Bridges (BSB) Health & Social Care Facilitators have supported local and national developments to take this forward and an independent evaluation supported continued funding to build on and continue the delivery of Designed for Life. Designed to Add Value – A Third Dimension will be important in informing the next steps for BSB.
· Designed to Add Value – A Third Dimension builds upon and responds to the key themes identified in the Welsh Assembly Government’s Strategic Action Plan for the Voluntary Sector Scheme.
· It sets out where we are now, where we want to be and how we will get there and identifies the strategic direction for the voluntary sector in supporting health & social care in the future through nine key strategic themes;
Ø Stronger partnership working within the voluntary sector and between the sectors
Ø Better and consistent commissioning
Ø Supporting self care and independence
Ø Improving access to services for disadvantaged and rural communities
Ø Strengthening volunteering in health & social care
Ø Developing social enterprises in health & social care
Ø Integrated workforce planning
Ø Reducing hospital admissions and improved discharge
Ø Research & development
· Investment in the voluntary sector will bring many gains; financial, social and health gains which together will help ensure a more sustainable system working in harmony for the benefit of local people. It recognises the added value the sector brings as well as the synergy it realises when working effectively with all partners.
· The recommendations and actions identified to support these will help to guide future directions focusing effort and resources in those areas where added value for all can best be achieved. Designed to Add Value - A Third Dimension should help stimulate discussion and debate on how best the voluntary sector can work most effectively with health & social care to add value to health and social care services throughout Wales.
2. Introduction
2.1. The voluntary sector is a vital element of the rich diversity of our society. The voluntary sector describes the range of organisations which occupy the space between the state and the private sector. These include a wide range of organisations such as small local community and voluntary groups, registered charities both large and small and a growing number of social enterprises.
2.2. The voluntary sector plays an important part in the prevention of ill health, the provision of health, social care and well being services and supporting carers in Wales. It has a role in providing services including; advocacy, volunteering, information and advice provision, needs identification & analysis and fundraising As such it is recognised by the Welsh Assembly Government as a key partner in the delivery of its Health, Social Care and Well being policy.
2.3. The Welsh Assembly Government recognises that the sector -
Ø Encourages flexible, responsive and accessible people centered Health & Social Care services and local ownership
Ø It can harnesses the knowledge and expertise of the sector to help design better policies and services
Ø Has the capacity to strengthen health ,social care and well-being within local communities
2.4. The Welsh Assembly Government’s consultation on the Voluntary Sector Scheme[1] highlighted the special qualities that the sector can contribute to public service delivery including; being flexible & responsive, non judgemental, independent and widely trusted, caring in its approach and focused on people with multiple needs.
2.5. During 2006 as part of Building Strong Bridges [2]a mapping of health, social care & well being services provided by voluntary organisations in Wales was undertaken[3]. The findings identified that there are more than 4,000 voluntary organisations engaged in providing health & social care services in Wales with an annual budget of approximately £292 million (2004-5).
2.6. Current reform of the NHS, away from the traditional model of service provision towards a new vision for provision in the health & social care system means that different organisations will contribute from their different strengths. Providers will need to be more flexible, innovative and responsive to the changing needs of patients, service users and carers. The balance of provision is shifting and more services will be provided closer to home. There will be new opportunities for innovative providers from any sector to meet the needs of users.
2.7. Designed to Add Value – A Third Dimension sets out where we are now, where we want to be and how we will get there and identifies the strategic direction for the voluntary sector within Health & Social Care for the future. It identifies how the voluntary sector plays a key role in supporting the reform of the health & social care to make a real difference to the health of individuals and the community ensuring -
· The right services are delivered at the right time and in the right place, to the right person across the care pathway.
· The integration of the contribution of volunteers, carers and the voluntary sector in better health.
· Engagement of the public, including vulnerable groups, in identifying needs and determining how best they can be met
2.8. Methodology - This work has been undertaken in close partnership with Wales Council for Voluntary Action (WCVA), the local and national Health & Social Care networks and voluntary organisations through the BSB Health & Social Care Facilitators network across Wales. There has been wide consultation with formal and informal local and national voluntary sector Health & Social Care networks, as well as the statutory Health & Social Care sector and others with whom they work closely. The BSB Health & Social Care Facilitators provided an essential role in gaining local input and communicated the feedback at the three regional workshops.
A summary of the consultation is on the BSB website- www.buildingstrongbridges.co.uk
3. Policy Context
3.1. Partnership working is the core principle for delivery of the Welsh Assembly Government’s policies and plans.
“Our vision is of a fair and just Wales in which all citizens are empowered to determine their own lives and to shape the communities in which they live”.
One Wales, 2007
3.2. One Wales [4] – outlines the shared values, common goals and joint aspirations for the four year period of government. This agenda includes a commitment to social justice, sustainability and inclusivity for the people of Wales. It outlines the commitment to improving the well being of all vulnerable and disadvantaged who rely heavily on our health service and confirms a determination to see that services provided by the NHS should be genuinely shaped by and meet the needs of the people it serves. It also refers specifically to further support for the Voluntary Sector Scheme and to further enhancing the role of the sector in policy formation.
3.2. Making the Connections & Local Service Boards – the context for the introduction of Local Service Boards (LSBs) is the review of local service delivery, led by Sir Jeremy Beecham (July 2006) and the Welsh Assembly Government’s response Making the Connections: Delivering Beyond Boundaries (November 2006). LSBs are the new model for engaging the whole of Wales’ public services in a new way of working by integrating services and responding more effectively to citizens’ needs. The driving force for the LSBs is the citizen whose voice, needs and aspirations should guide the design and delivery of services. The voluntary sector has a key role to play in citizen engagement with and through its’ stakeholders.
3.3 The Welsh Assembly Government’s Voluntary Sector Scheme[5] provides a sound steer and framework to guide implementation and develop best practice across a range of policies in partnership with the voluntary sector. A review of the Scheme found it ‘‘fit for purpose’’ however it recommended the preparation of a Strategic Action Plan to ‘set out the next steps in implementing the Scheme’. This has been taken forward in Empowering active citizens to contribute to Wales[6] which presents a vision for the Assembly Government’s future work with the sector.
3.4. The Review of Health & Social Care [7] identified the need to;
Ø Encourage people to take responsibility for their own health
Ø Make a strategic adjustment of services to focus them on prevention and early intervention
Ø Reshape services to make them seamless and integrated
Ø Make workforce planning more sophisticated, robust and long term and based on future models of service provision
3.5. Designed for Life[8] identified an ambitious reform programme radically to transform health and social care in Wales. This included-
Ø Promoting health and well-being by addressing the determinants of ill health and dealing with inequality;
Ø Adopting a citizen-centred model for the provision of public services across all sectors in Wales;
Ø Delivering cost-effective care safely, sustainably, and as locally as possible in accordance with published quality standards throughout Wales;
Ø Where possible, providing care in the home, or the community, rather than in hospital;
3.6. Fulfilled Lives; Supportive Communities[9] – sets out the vision, key themes and the future direction for social services in Wales. It outlines the principles for better services for citizens including different services and different organisations working effectively together to meet people’s needs and confirms the voluntary sector as a key partner in promoting inclusion and aims to develop the contribution of the voluntary and private sector within the commissioning of services. Within the strategy the voluntary sector is recognised as a diverse mix of agencies ranging from small volunteer based advocacy and self help groups to large not for profit providers including registered social landlords. It recognises that they are already significant providers of social care and related services but that it could have a much greater role in designing and providing the services of the future.
3.7. The Health, Social Care & Well being Strategies and the Children and Young Peoples Plans- they must clarify the future direction of community services. LHBs and local authorities with local partners have a duty to assess local health & social care needs and engage with local communities to map out expected progress against a three year timeline for improvement with clear milestones, dates and lead organisations responsibilities.
3.8. The Community Services Framework[10]- highlights the need for agencies in the public, voluntary and independent sectors to work together to combine skills and resources and link with individuals, carers and local communities to meet the growing complexity of health & social care needs in Wales. This was drawn up to support the above Health, Social Care and Well-being Guidance. A broadly based Reference Group assisted in its preparation, including a representative of the WCVA, and the document gave strong recognition to the role of the Voluntary Sector in the present pattern of services and the future vision.
3.9. Designed to Improve Health & the Management of Chronic Conditions in Wales [11] - chronic conditions are placing increasing demands on the NHS in Wales and demographic trends suggest that these are likely to rise. The voluntary sector plays a key role in supporting chronic conditions and self management initiatives locally and nationally.
4. Background
Building Strong Bridges (BSB)
4.1. Building Strong Bridges (2002) identified opportunities to strengthen partnership working between health & social care and the voluntary sector at national and local levels. The Welsh Assembly Government recognised the voluntary sector as a key partner in delivering its health & well being policy and made financial resources available in 2003 for thee years to support the actions identified to take forward the twenty two recommendations in BSB. Following an independent evaluation of the BSB Health & Social Care Facilitators continued funding was announced from 2006 - 2009 to build on developments to date and supporting the delivery of Designed for Life through partnership working between Health & Social Care and the voluntary sector in Wales. Designed to Add Value will be important in informing the next steps for BSB.