Don Redding is director of policy at National Voices, the coalition of health and care charities.
It’s hard to work with someone when you’re both aiming for different things. So it is with health and care.
The health and care system is messy and complicated. If you’ve got long term conditions you will no doubt have experienced failures to join up your care between the different services you use.
The NHS has long struggled to integrate with itself, never mind integrate with the voluntary sector. Yet for some time there has been broad recognition that the voluntary sector can, and must, play an important role in supporting people to live healthy and well lives.
Realising the value
The importance of the voluntary sector to health and care was underlined recently in the final recommendations of the Realising the Value programme.
It is an important body of work delivered by Nesta, the Health Foundation, National Voices, Regional Voices, NAVCA, Volunteering Matters and others.
The team examined the evidence for person-centred and community-centred approaches to health and care; such as community development, peer support and education for self management. They developed the approaches with voluntary sector partners across the country, and recently published an array of tools, guides and recommendations. It’s good stuff.
The authors call for the voluntary sector to be recognised as a ‘system partner’, which means being involved in strategic processes and local decision-making structures. They also specify the need for support for the voluntary sector and informal workforce, citing National Voices’ Wellbeing Our Way programme as a good example of support available to voluntary organisations.
On the same page
If statutory health and care services are to work effectively with the voluntary sector and others, everyone needs to be on the same page when it comes to what they are working towards. As part of Realising the Value, I honed in on this issue in New approaches to value in health and care.
Currently health services tend to measure clinical outcomes, the immediate outcomes of a single service or treatment, and process indicators that show how resources are being used.
If we are to re-focus services on what matters most to people and communities, then we need to be able to judge the outcomes of all of the services that support a person; and to measure wellbeing impacts such as quality of life and people feeling in control and independent.
To put that into real-speak – a person living with cancer who has received clinically successful chemotherapy may still be left to rebuild their life having left their job, suffered the implications of a decreased income, and drawn back from their social groups due to the pressure of the condition.
As a ‘survivor’ they must carefully manage their health to prevent recurrence and stay well. But if they now feel unsupported, socially isolated and lacking control of their own life, have they actually had a good outcome?
The things that matter to people
As health and care services develop new models of care, adopt place-based approaches, and work in new ways with new partners, they will need new outcomes by which to set their goals and measure their success.
Because the aim is to integrate systems and services in a ‘place’, we need common and consensual outcomes that can be used by the health, social care, public health and voluntary and community sectors equally. Integration requires a shared vision and shared values and outcomes.
For this reason, one of the most important recommendations from the Realising the Value programme is the need for national system leaders and local areas – working together with their partners, including voluntary organisations – to develop a new, shared and simplified outcomes framework, focused on what matters to local people and communities.
The health and care system, including its voluntary sector partners, needs to refocus on the outcomes that people and communities say matter most to them; and everyone involved should be working towards achieving these.
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