Whatever your views on the government’s reform of health, social care and public health, as things starts to settle the third sector will need to quickly take stock and consider its offer.
On the face of it, the case for involvement is as clear as ever – the sector delivers more than £4.7bn of health and social care services and, if you adhere to the direction of travel of the government’s big society agenda, this contribution seems only set to increase.
Yet, despite lots of noise about engaging communities, scant detail has been given of exactly how the sector can contribute to the leadership of health and wellbeing by engaging and playing an active part in setting the strategic agenda.
The simplest advice in such an environment is to waste little time and take nothing for granted; the sector must start building the case again from scratch immediately.
In particular, the local stage is set to be key – government reforms outline increased powers for upper-tier local authorities leading new health and wellbeing boards. Even if the letter of the law is not yet set in stone, the spirit largely is: behind the reforms lies recognition that big picture issues such as persistent health inequalities and changing demographics must be consistently taken on at local level as shared ‘place-based’ challenges.
The health and wellbeing boards will have many functions, and the Joint Strategic Needs Assessment, together with the joint health and wellbeing strategy it is supposed to drive, emerges as central after being recast as the linchpin of local strategic planning for health and wellbeing.
Through the board, clinical commissioning groups and the local authority will lead a JSNA process through which they and other local partners – voluntary and private sector, as well as the community – agree a comprehensive picture of local health and wellbeing, and negotiate and agree overarching priorities that result from it. The process should ensure commissioning and decision-making are in line with strategic priorities, and provide summary information on this for wider health and wellbeing audiences.
The history of JSNA is far from perfect, but voluntary and community sector organisations have a lot to offer, both as consumers of and contributors to the JSNA process.
However, we know from experience that good reasons and good intentions are not enough on their own. Voluntary sector organisations will need to pursue intelligent influencing strategies that embrace the new leaders and new realities, warts and all, with a savvy offer that caters for individual professional outlooks, performance management regimes and incentives.
Implementing the new vision for health and social care will be no mean feat. It is too early to know which areas or agencies have really grasped either the scale of the challenge or the scope of the opportunity. However, it is clear that now is the time for the voluntary and community sector to get involved in their local JSNAs and to ensure that the local strategic framework is fit for purpose. Around the country, minds are being made up and ground rules are being laid that will set the tone for years to come. Be sure to be there when it happens.
Michelle Kane is a partner at specialist health consultancy HK Consulting and previously played a part in the Department of Health National JSNA Development programme