building from the bottom up the growing role for voluntary sector providers in tackling health...
TRANSCRIPT
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Building from the bottom up
The growing role for voluntary sector
providers in tackling health inequalities
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We won't just do nothing if 100 flowers don't bloom in 100 places. The 100 flowers will bloom, but we'll have to do some gardening and sow some seeds
If I had a plan, it would be the wrong plan. The big society will look a bit chaotic and
disorderly.
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Building from the bottom up
• The context
• Addressing inequalities
• Small, local organisations
• Changes to commissioning
• How the VCS adapts
• GMCVO’s work in this area
• What kind of gardener is needed
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The context
• Investment targeted at most costly care which is emergency care
• Need to invest in areas that stop problems from occuring
• Demographic change
• Need to change investment profile
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Addressing inequalities
• Health inequalities increasing
• Those furthest from employment, education and services affected worse
• Public sector struggling to engage
• If healthcare is to be rationed or co-payments required this group will suffer worst
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Small, local organisations
• There are organisations that are engaged with groups in most need
• These organisations are trusted
• Small, local organisations struggle to engage in commissioning processes
• When organisations grow they lose their reach
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Changes to commissioning
• GP consortiums
• Local authorities centralising
• AGMA partners sharing services
• National government commissioning from the center
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The problem
• Solutions are close
• Funding is distant
• Large organisations have a mixed track record in subcontracting with small, local groups but there is good practice.
• A gap needs to be bridged
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Developing commissioning
• Directory: voluntarysectorhealth.org.uk
• Prime Contractor: towpath
• Consortium: Greater Manchester Health and wellbeing consortium
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Directory
• Over 100 providers
• Maps along care continuum: crisis care to self care & prevention
• Details impact against health priorities
• Allows an understanding of service boundaries and market supply
• Basis for partnerships
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Prime Contractor
• LSC contract: approx £650k bringing those distant from job market closer to work
• Turned into 67 grants of at most £12k• 2 failures – cash recovered from 1• Over-delivered and exceeded expectations• Reduced transaction costs – monitoring
delivered by GMCVO through 1 officer • Organisations built capacity
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Health and Wellbeing Consortium• Special purpose vehicle
• Fiscal shield
• Hub and spokes model
• Quality assured membership
• Subcontracts to members
• Enables market entry for voluntary sector into large scale contracting
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Our strength
• We are the solution
• Not engaging with us is more expensive than engagement
• We don’t have to engage in processes that don’t suit us
• By working together we can deliver and create efficiency – it doesn’t have to be more expensive
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But
• Marketplace structures will form – especially if payment by results becomes common
• Work programme points at “tescoisation” of sector
• Co-operative structures will be more to our liking but we have to create them
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Questions
• Are small organisations the solution as we present it?
• How best can small organisations be involved? How best can they work with larger providers?
• What support will the voluntary sector need in working in the changed environment?