In April, news was shared that will have significant impact upon the future of the NHS. In this blog, Lisa Taylor, our Health and Wellbeing Director explains the news so far and the impact on the voluntary and charity sector. She also explains how the VCSE Partnership Programme, hosted by VONNE, will continue to advocate for meaningful sector integration both locally and nationally.
The government announced that NHS England is going to be dissolved, and its functions will be transferred over to the Department for Health and Social Care. In addition, all Integrated Care Boards (ICBs), which oversee the 42 Integrated Care Systems (ICSs) in England, will have to make around 50% reductions in their operational budget.
The abolition of NHS England is to move control of the NHS closer to the government and take away some of the bureaucracy that can often cause delays in decision making. The reduction in ICB operational costs is primarily to direct resources towards front line delivery and support more efficient working.
This leaves the VCSE sector in a very precarious position. On one hand, there is the ambition to move the NHS towards community-based services and prevention, as opposed to hospital-based care and addressing illness as it arises. This is where the VCSE sector often delivers its best work within health systems, even though in many cases our person-centred ways of working within communities are so much part of our daily business that they aren’t recognised as being part of healthcare pathways. On the other hand, there has been no confirmation of the VCSE sector remaining as strategic partner at board level within ICBs. This would make it more difficult for the sector to influence the ICB board. In the past year alone we have supported greater understanding of the sector by the North East and North Cumbria ICB to the extent that they acknowledged in their VCSE Stocktake Report some of the key issues that have affected VCSE organisations for decades, such as short term contracts and unfunded referrals, and set about planning systemic changes to resolve these issues, as well as stating an ambition to increase investment in the sector.
The VCSE Partnership Programme has been working locally and nationally to state the case for continued integration of the VCSE sector into the ICB, as both strategic and delivery partner. The ethos of the Partnership Programme is for it to be a real opportunity for all VCSE organisations to have their say within our healthcare systems as true system partners. This starts with delivery, consisting of a close partnership between VONNE and Cumbria CVS to ensure that the sector across the whole North East and North Cumbria ICS footprint is represented within everything we do, and expands into our all of work, which is directed by the members of our groups and networks, being as inclusive as possible. Wherever we can, we open up the creation of key documents to as much of our membership as practical, and include as much of everyone’s input as we can. This is to visibly demonstrate collective voice, which is a powerful tool not to be underestimated.
We have also combined our collective voice with other VCSE alliances across the country, to the extent that an independent group of all of the VCSE alliance leads in the country has been set up and invited to be part of the national Health and Wellbeing Alliance. I have the great honour of being the North East and Yorkshire lead, sitting on the national steering group, and even though this group is still very new, having only met formally once, we have already sent a letter directly to the Chair of NHS England to state our case for continued integration of the VCSE sector at strategic as well as delivery level within Integrated Care Systems during this period of change and beyond.
Locally, we have worked with our own networks and the organisations that provide health infrastructure support across our ICS to create a letter which we sent to the Chair and Chief Executive of our ICB, asking for the continuation of the ICB’s plans to support positive change relating to our sector, and seeking assurance that our strong history of partnership working will remain.
Concerns about the future are significant. The pace of the required changes is genuinely astounding, particularly given that there was a month between the announcement from the government and any further information about how to carry out these changes. Our ICB needs to cut 33% from its operational budget, reduce membership of its board, and change focus to have a role more as a strategic commissioner, with a plan in place of how to do this by the end of this month, and the changes being actioned by the end of December. The impact will be felt across every part of our system, including our sector. Our ICB is only a year past its last restructure, which came a handful of months after it was established. Asking systems to function under this kind of pressure seems unfair and unnecessary, however this is the situation we find ourselves in, and no matter what else is going on, the healthcare of 3 million people need to be maintained.
We don’t know what the future will hold. However, there are around 11,000 VCSE organisations within the North East and North Cumbria which is a huge amount of support that can be provided to our population - this is absolutely vital under the current circumstances. We hope that our ICB colleagues will continue to work with us to ensure that we remain stronger together, we feel their pain but we urge them to look outward towards partnership working and allow us to support our colleagues, our organisations and our communities during this incredibly difficult time.
To get in touch with the VCSE Partnership Programme team at VONNE email: healthandwellbeing@vonne.org.uk