As CEO of a small Lincolnshire based charity, I was privileged to be invited to a roundtable discussion with ‘the big guys’ about what the NHS Long Term Plan means for people with long term conditions and frailty.
My personal tendency is to say ‘yes’ to everything, worrying about practicalities later. But sadly my first thought on getting this invite was “can we afford the train ticket?!”
Our vision is to be the local conscience for person-centred approaches in health and social care, but also to contribute to national thinking, rather than being a passive recipient of policy. Capacity, however, proves to be our main challenge. We have the passion and organisational ambition to positively influence, but how can you shape system thinking if you don’t have the capacity to get to the top table in the first place?
Reflecting on the challenges of being a small voluntary sector organisation contributing to this agenda, for me it boils down to:
- Sustainability and capacity – with funding based on pilot projects and sporadic bursts of cash, how can we build trusted services that are agile and not fragile? Being small helps us to respond to today’s latest plan, but if we don’t know if we’re going to be here in the long term, how can we build sustained partnership working?
- Power balance – how can we ensure that the small, local voluntary sector is seen as an equal partner that adds real value? I believe that where people learn together, they work better together. What if there were free training places for voluntary sector staff alongside health and social care staff?
- Complex and complicated – we need to loosen the shackles of commissioning and work to ‘grow it local’. It is so often a battle for all who interact with the system, including the people we support. If we can free up the voluntary sector to ‘get on and do’, we will reap the benefits.
- Valuing local – too often people are seen as a ‘frailty score’. Working with community organisations and valuing local knowledge and networks, will help to ensure people are seen as more than just numbers.
My reflections on the roundtable?
I am on a mission to develop our organisation’s knowledge, skills and confidence to facilitate co-production with people with lived experience. I was therefore thrilled to hear co-production mentioned at the meeting. But how do we ensure it moves beyond rhetoric and being a tick-box exercise? How do we enable services to genuinely understand and engage? How do we empower people to take part?
As a charity that supports unpaid carers, I welcomed the mention of carers at the roundtable. However there is still work to be done before the system understands carers and sees them as integral to health and care partnerships. This will include taking into account the community network of carers’ carers, their sons, daughters, neighbours and work colleagues – the people working behind the scenes to support loved ones. How can we put them centre stage?
Finally, the voluntary sector is vital. There is a clear need for collaborative and partnership working across systems and sectors, but it is too easy for the system to put the voluntary sector into a neat little box. The voluntary sector is big, diverse and beautiful. It comes in all shapes and sizes. Let’s not forget the wonderful work it does. If you want social prescribing, collaboration and integration, then love, nurture and invest in the diversity of the voluntary sector and that includes valuing us ‘little guys’.