The ongoing and heavily documented NHS crisis is forcing people to think in new ways, not only about how to deliver care, but also how to make the NHS more sustainable in the long-run. Funding undoubtedly plays a role in a better functioning health service, but the Richmond Group of Charities, of which Macmillan is a member, believes better collaboration across sectors is also essential.
We know the third sector already plays a vital role, but our experience in cancer care suggests the third sector has more to offer than it currently provides. In Untapped Potential, a report for the Richmond Group, the think tank New Philanthropy Capital says collaboration is crucial to making the most of the sector. But it also says that we all – public services and third sector alike – need to get better at doing it. We therefore decided to invest time and money into figuring out how to make this happen.
To put theory into practice, we needed to find a system partner who would be willing to take the plunge and embark on a rather open-ended journey with the aim of finding out whether, if we collaborated in a local area – with no preconceived recommendations about products or providers – we could help people live better, healthier lives and help the NHS to spend its money better.
We were thrilled the Somerset Sustainability and Transformation Partnership invited us to work with it on this idea. The area displays some of the demographic trends that are predicted to shape health and care across the country over coming years: one in four people will be aged 65 and over by 2021, something that won’t happen nationally until 2050. And about 44 per cent of people live with long-term conditions, compared with 28 per cent nationally.
The Richmond Group funded and recruited two programme managers to work part time for six months – one in Somerset and one nationally. The local programme manager met people across the county to introduce the collaboration and learn about the area, its people and its health and care system.
As we looked more closely at people’s needs, it became clear that demand for GP services was rising while the number of GPs was falling. However, some people have been going to their GPs with problems for which there are no medical solutions. For example, someone may be geographically isolated, lonely and struggling with the emotional toll of living with a long-term condition.
New services (called "social prescribing" by the NHS) have been established to link people with practical and emotional support from the third sector through their GPs. They are working well, but are available in only a few parts of Somerset. It feels sensible to work together to improve access across the county.
Our Somerset collaboration of public bodies, Richmond Group charities and the wider third sector has agreed to focus on scaling social prescribing, but a similar collaboration in another area might decide to focus on something completely different. However, we feel it’s important to articulate our learning about the collaborative approach itself, and have therefore worked with NPC on Tapping the Potential, which is published today.
What have we learned so far on this journey? One standout learning at this stage is that if England is to develop a really joined-up, cross-sector way of working, then we need a fresh approach that is based on trust, open minds and relationships. These strong relationships don’t happen overnight, and they require sustained hard work from everyone involved, whether in the NHS, the local authority or the third sector.
We feel we’ve documented a new and productive kind of leadership in health and care – one that is not centralised, that is pragmatic and consultative. I know from our work at Macmillan that the sector is well placed to bring leadership to further developing this kind of approach.
Lynda Thomas is chief executive of Macmillan Cancer Support