I spoke last week for the first time at the annual NHS Confederation Conference, where both Jeremy Hunt and Norman Lamb hailed the “enthusiasm” for integration, which has seen £5.2bn of health and care budgets pooled; well exceeding the proposed £3.8bn.
I’d been invited to speak about our ground breaking national Cancer Older People and Advocacy project, developed and supported by Macmillan Cancer Support and the Big Lottery Flagship team’s recent £1,000,000 investment. I was fortunate to share a platform with distinguished colleagues including Richard Bowden UK Managing Director BUPA, Caroline Abrahams Charity Director from Age UK and Ian sutherland Director of Social Care – South Eastern Health and Social Care Trust NI, and my colleague, a lady who completely stole the show Marion Summers a Volunteer Peer Advocate from Dorset.
Marion is a fairly typical cancer advocacy project volunteer. An ex member of the NHS Marion has a good professional understanding of how the health system operates, she’s been touched by cancer herself so is full of compassion and empathy for her peers and critically she is highly motivated to retrain as an Advocate and to ‘give something back’ providing a vital link and support to older people affected by cancer needing both health and social care. Marion supports people in need daily and often struggles to understand why we don’t work more closely together to pool resources and provide personalised integrated care as ‘after all we are all trying to do the best we can for the same person’. Marion is right of course.
I’m with Mike Adamson, Managing Director, British Red Cross when he argues today in his excellent article in Community Care that the voluntary sector is key to health and social care integration, not an optional extra, a truly preventative system will need more than the integration of the NHS and social services. As Parliament debates health, including the Better Care Fund today, we urge the government to regard voluntary organisations as a core part of the health and social care system, not merely as an optional extra – not least because of our experience in bridging gaps between these services.
I’ve reproduced much of Mike’s article below as I feel he encapsulates my views on the thorny subject of integration entirely.
For years, the voluntary sector has added significant value to the work of health and social care professionals, in many areas essentially helping to integrate them. According to the King’s Fund, three million people across England already volunteer in health and social care. The benefits are many and by no means purely financial. For many individuals the company of a dedicated and passionate volunteer can be invaluable, particularly when needs are primarily practical and social and linked to isolation.
The link between people living lonely, isolated lives and deterioration of their physical and mental health is widely acknowledged, including by Norman Lamb. Providing low-level, but high-impact, preventative support through volunteering opportunities enables more people to play a role in looking after our ageing population in the community, including older people themselves.
If the Better Care Fund is going to keep people out of hospital and result in better care, the role of the voluntary sector in delivering it needs to be strengthened. We specifically want health and wellbeing Boards to be mandated to engage with the voluntary sector as an equal and active partner in planning and delivering the Better Care Fund.
We want recognition that, particularly in the context of limited public funds, only a true tripartite of health, care and the voluntary and community sector will achieve the Better Care Fund’s aims. Lessons need to be learnt from Scotland’s Change Fund, where engagement with the voluntary and community sector is now mandatory, after the first year of funding resulted in little of its ambition to innovate and transform. ‘Third Sector Interfaces’ now ensure this engagement happens.
There is further to go, but the learning is there – ready for us to utilise. The mandate has secured legitimate and meaningful engagement, and the vast majority of Third Sector Interfaces report that their partners now have a much stronger understanding of the sector, what it has to offer and the expertise it brings.
Within the context of an ageing population, the voluntary sector has a crucial role to play in creating a sustainable health and social care system. Many hospitals already work closely with both social services and voluntary sector organisations like the Red Cross and see volunteers as an integral part of their team, particularly when it comes to discharging patients – but this is by no means consistent. The Better Care Fund offers our best chance to replicate this integrated practice across the system. By engaging the voluntary sector and focusing on preventative services, health and wellbeing boards can utilise the Better Care Fund in a way that improves the sustainability of the system.
Only by health, social care and voluntary sector services working together will we be able to provide adequate care to all who need it, and we believe that none can fulfil their true potential without the support of the other. The challenge is to make the most of these opportunities – and the Better Care Fund is one we should seize.