The NHS Long Term Plan sets out an ambition to work in partnership with voluntary and community sector organisations. But the basis for that partnership reflects traditional views about the value of charities, focusing on their role as service providers and facilitators of the voice of populations they support more widely. As a consequence, when it comes to conversations on how best to design care, those organisations are too often on the agenda but not at the table.
So are we losing out by taking a one-size-fits-all approach to the voluntary and community sector? A new report from the King’s Fund, Investing in Quality: the Contribution of Large Charities to Shaping Future Health and Care, certainly makes that case.
The challenges facing health and care services are well documented. A commitment from government to increase NHS funding provides an opportunity to improve care, but growing financial and service pressures mean that hard choices still have to be made.
Social care had no such investment, and budget pressures are affecting what and how services are provided. The ever-increasing workforce crisis in health and care presents a further limiting factor. This requires approaches that are able not only to take account of current constraints, but also to offer innovative solutions and identify ways forward.
We looked to six charities funded by the National Garden Scheme, including Marie Curie and Hospice UK, for inspiration with these challenges. What was immediately evident was the diverse range of approaches that had been developed, offering solutions to different problems and in some cases different approaches to the same problem.
Conversations with those involved highlighted that in many cases the approaches they were taking were not just ways of working that emerged, but were borne of strategic decisions based on how best to support the populations they serve. Bringing these large charities into the fold of national and local planning offers an opportunity to capitalise on this strategic vision and the innovative solutions that have emerged as a result.
Gaining that crucial seat at the table is likely to be dependent on the ability of large charities to establish a balance between their fundraising activities – where advocacy for the organisation is imperative – and the ability to work with others to improve care beyond the conditions and settings on which individual charities will focus. This will require a willingness to share innovations and take a long-term view of where they can best add value to people and communities in need of support.
Throughout this work, the relationship between who charities support and what they do has been evident. The ability to combine generation of income with strategic investment informed by the needs of their target populations has resulted in these organisations not only making a significant contribution to the quality of care that people receive, but also shaping the landscape of current and future health and care.
Helen Gilburt is a senior fellow at the King’s Fund and joint author of Investing in Quality: the Contribution of Large Charities to Shaping Future Health and Care