Do local voluntary organisations hold the key to improving health outcomes?

Comments: 5

The central pillar of the Health and Social Care Act 2012 is localism – involving clinical commissioning groups, health and wellbeing boards and Healthwatch. This drive for localism is also reflected in the coalition government's vision for the Big Society which aims to empower communities and boost social action and volunteering.

The voluntary and community sector (VCS) is an excellent example of why localism in health care can be so effective. Overall, the NHS spends £3.4 billion annually in the voluntary and community sector, which has a strong track record of working with communities and supporting individuals to manage their health better.

Small community-based charities provide excellent examples of how national health issues can be tackled at a local level. It is often these organisations' detailed understanding of local need, the trust they gain from their communities and their ability and willingness to work holistically across multiple services that allows them to be so effective.

The winners of this year's GlaxoSmithKline IMPACT Awards, run in partnership with The King's Fund, showcase these qualities. For example, in Bradford, the Hale Project has worked with local people to improve their blood pressure, tackle obesity and reduce alcohol consumption, with many participants reporting less need to visit their GP. Last year, the organisation delivered 175 different programmes, costing just over £400,000.

Blackburn with Darwen Healthy Living have put local people at the centre of the design and delivery of their services to combat high levels of obesity and alcohol abuse. Healthy Valleys in Lanarkshire, which works in a very deprived area, has used local volunteers to almost double pregnant mothers' attendance at health care appointments – in a group that was not previously engaging with health services. Providing services to more than 11,000 local people annually, Age UK Cheshire East has helped support the health and wellbeing of an ageing population and can demonstrate direct savings to the NHS, as well as the wider social value of its work.

All of these organisations are held in high regard by their local communities and benefit from huge volunteer involvement that helps to keep costs low. However, many smaller community-based charities are concerned that the health reforms may make it difficult for them to continue to provide their services. Complicated procurement services give larger providers the advantage as they can offer services across a wider area. Some smaller organisations are also frustrated by their lack of influence in the commissioning process as they struggle to have the same profile and powers of negotiation as the larger providers.

While the NHS implements the current reforms, it will be important to ensure that community-based work is able to flourish. However, this will present some challenges for the new commissioners. For example, do they understand the scale and scope of their local voluntary and community sector? Do they know how to engage effectively with it to improve local health outcomes, and what will happen if they don’t? Do they understand the direct and wider value of this work and have they thought through the pros and cons of only engaging via a larger lead provider? Conversely, does the VCS understand and know how to deliver what the local commissioners need, and does it know how to articulate its own value, in order for these partnerships to flourish? Many of these areas were explored in a recent report by The King's Fund and the National Council for Voluntary Organisations that examined the potential impact of the health reforms for the voluntary and community sector.

There are, of course, no simple answers to these questions, and most solutions will need to be found at a local level. This will only happen if the NHS and local authorities do not lose sight of the invaluable contribution made by local VCS organisations and if dedicated commitment, time and resource is made available to support the sector.

Find out more about the GSK IMPACT Awards 2012 winners

Comments

#1008 John Trott
T/Detective Chief Inspector
Devon and Cornwall Police

It is fantastic news that WRSAC's work is being awarded with the GSK IMPACT Award. It acknowledges the hard work that they do with victims of Domestic Abuse.
As a Chair of MARAC for Cornwall, I am always really impressed with the work that WRSAC does and the commitment shown to victims.
Thank you to the WRSAC team for all thier energy and drive to protect the vulnerable and well done!
Best wishes
John
T/Detective Chief Inspector John Trott
Crime Manager, Cornwall & Isles of Scilly

#1009 Marie Wheldon
Manager
WHISC

This award means so much to everyone at Women's Health Information & Support Centre in Liverpool; our volunteers work tremendously hard to support women experiencing social , emotional and physical challenges in their lives. THANK YOU !

#1010 Will Sopwith

Very pertinent questions. The scale and scope and therefore the value of the voluntary sector is something we are actively pursuing in Wirral. We are evaluating the impact of the sector in terms of delivering on the outcomes that the Health & Wellbeing Board are tasked with achieving, very much in partnership with our local VCS. It's an ambitious but exciting project that also hopes to further empower the sector in demonstrating its long term contribution

#1011 Nick Pahl
CEO
British Acupuncture Council

We mustnt forget that there are thousands of local health practitioners who are outside the NHS who can help improve self care and health outcomes - for example, our 3,100 members offer robust evidence based services that help people with long term conditions. In case you need a reminder of some of the evidence:

for patients suffering with musculoskeletal pain NICE Guideline CG88 supports the use of acupuncture for lower back pain - according to this guideline, acupuncture is significantly better than no intervention and also significantly better than standard/best medical care.

There is also significant evidence that acupuncture can assist in key areas of NHS provision e.g.
• For palliative care, the evidence base is that acupuncture works as an adjunctive and integrated therapy – not just for specific symptoms and side effects of orthodox treatments but also for complex symptom mixes and overall wellbeing.

• For stroke, a Canadian systematic review of acupuncture in post-stroke rehab has recently produced very positive findings (Wu et al 2010) with evidence that progress made during treatment phase may be maintained 6 months later (Guo 2007). Post-stroke acupuncture patients were also found to have increased independence – and better able to look after themselves at home (Hopwood and Lewith 2005).

• A recent study found acupuncture used within the NHS for people with severe long-term illness can stimulate an adaptive effect and hence improve their quality of life (Foell 2012).

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