One lesson from the wide consultation we carried out during the Joint VCSE Review is that there is still a gap between how some people see the work of voluntary, community and social enterprise organisations and the work which they actually do.
Some people still believe that VCSE organisations are only able to carry out low level support. It’s true that VCSE organisations can often offer support to people who may not meet statutory thresholds. Many work in ways which are early-action or preventative. This work is vital to a sustainable and effective health and care system. But many organisations are also providing highly complex and challenging care and support to an incredibly high standard.
So the challenge which is often made to the VCSE sector, to ‘professionalise’, arguably ignores the fact that many VCSE organisations are highly effective and professional already. Charities, social enterprises and community groups can reach people whom mainstream health and care services find ‘hard to reach’ or ‘challenging’, get to know them more deeply, and draw upon volunteers to achieve more than paid staff alone can achieve.
The Review’s recommendations challenge the wider system to identify, measure, value and invest in that crucial work. Many recommendations cut both ways: we felt that the VCSE sector needs to get better at measuring its outcomes, but that central bodies needed to facilitate that through producing accessible, evidence-based measuring tools, and that commissioners need to recognise and act on that evidence when it is produced. The sector painted a picture of ‘ignored if you do, damned if you don’t’: a lack of evidence is often cited as a reason not to commission a VCSE organisation, particularly in place of an existing statutory provider, but when providers can demonstrate that their work is more effective than existing alternatives, there is no guarantee that investment will follow. A number of respondents talked about statutory provision as their ‘core’ work, with VCSE work assumed to be secondary.
Tackling what could be characterised as a lack of ‘parity of esteem’ between statutory and VCSE provision will, we argued, need to start with a new consensus around the primary purpose of health and care services, drawing on the broad definition of ‘wellbeing’ established as the primary purpose of social care services by the Care Act. The best – the only - people who can redefine health and care services around human goals of living well in the community, are people who use services, their families and communities. So a key role for the VCSE sector is to reach and engage with those groups, especially with those most often overlooked, working with them as health and care design partners. If that approach was taken, the case for good VCSE organisations makes itself and the outcomes and added social value that they achieve will be seen by all as core to success.
So VCSE organisations of all kinds and sizes have a range of roles to play in designing and delivering the future health and care system. There is a role for the smallest and most grassroots organisations and for the largest. It would be an own-goal to force VCSE organisations to ‘professionalise’ in a way which made them indistinguishable from the statutory or private sectors. The rhetoric of professionalisation often hides short term or medical thinking about services and a desire to reduce the commissioner’s transaction costs with little clarity on the overall complexity and cost-effectiveness of the system as a whole. Whilst VCSE organisations should be prepared to demonstrate that their resources are deployed cost-effectively, even the largest and most complex should never lose sight of the added social value only achieved by organisations which retain strong community roots.
Download the full report from https://vcsereview.org.uk/ or download a short version comprising the vision and recommendations.
Alex Fox, CEO of Shared Lives Plus (www.SharedLivesPlus.org.uk) and the independent Chair of the Review.