Uncertain times ahead for charities amidst public sector cuts

I have been involved in running the GlaxoSmithKline IMPACT Awards at The King's Fund now for more than seven years. But never before has the scheme felt quite as important as a way of celebrating outstanding health charities and allowing them to continue their excellent work.

The prize money – £25K of unrestricted funds, plus free training worth an extra £4k – has always been coveted, but never more so than now, as charities face up to the difficult task of staying afloat financially whilst trying to figure out how they will fare amidst the health reforms and public sector cuts.

Assessing the 400 entries and choosing the 10 winning charities has been a fascinating and uplifting process, as always. We've heard some inspiring real-life stories about how charities have changed peoples' lives – and helped support and sometimes prop-up health and social care services.

Take for example the Derry-based charity Foyle Haven, which works with street drinkers, reducing visits to A&E among its service users by 50 per cent. Some staff and volunteers at the charity were once drinkers themselves, which as one service user put it 'makes all the difference. They know where you are coming from and it gives you hope for your own life'.

Age Concern Cardiff, another of this year's winners, made an outstanding contribution to improving health and social care among the over-60s in the region. It has carried out innovative projects such as a Placement Advisor's Scheme, whereby advisers work with older people who might need to move from hospital to a care home, as well as providing counselling and befriending services.

Voluntary and community groups such as these often focus on the 'upstream' management of people to help them to live healthy, independent lives and to reduce their reliance on the NHS. Their relationships with service users and communities often enable them to provide support across service boundaries, as well as being a vital source of information about local needs and gaps in services.

The NHS spends around £3.4 billion a year on services provided by the voluntary and community sector, which is mainly channelled via primary care trusts (PCTs). Many PCTs have worked hard to understand how their local voluntary and community sector operates and how it can help them. Given the number of pressures on the new GP consortia, is it unclear whether they will be able to develop a similar level of understanding of the sector's potential contribution to health care.

The 10 winning charities have been selected because of their outstanding contributions to improving health. But they are just 10 of hundreds and possibly thousands of similar groups working to support vulnerable people. Many such charities work on less than £500k a year and are supported by hundreds of volunteers.

For all the talk of the Big Society, what will happen if spending cuts and changes in commissioning force many of these organisations to significantly reduce their services, or even to close down? What will be the wider impact of this on health services and will it be felt soon enough for action to be taken to prevent it?

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