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Communities need flexible funders to influence the public sector

Over the last three weeks, I’ve met 32 leaders of small and medium voluntary organisations at four online peer support sessions. I have been inspired by their dedication and creativity: by hook or by crook, they have made it possible for services to reach people in dire need. Used to a turbulent environment and light on bureaucracy, their organisations moved remarkably quickly in response to the immediate crisis of lockdown, and have proved remarkably adaptable and resilient throughout the twists and turns that followed. Children with learning disabilities; undocumented young migrants; families of prisoners; housebound older people – all, and many more, have been supported by local organisations.

But the duration of the crisis, and the extreme levels of uncertainty, have stretched many close to their limits. And now, as we emerge out of an extended period of restrictions into a period of unpredictability, leaders are faced with harsh realities. On the one hand, demand for services is growing, from people with increasingly complex needs; on the other, staff are exhausted and funding is precarious.  

Our recent conversations – like with charity CEOs we met through our Leading in Uncertainty peer support sessions   echo much of what we heard in our 2012 study of social welfare voluntary organisations and their experiences of navigating their way through the recession. Then, as now, we heard stories of resilience and determination, as well as anxiety and despair.

‘I found the lack of recognition of our sector during the pandemic difficult… it was often forgotten that charities were still open and providing essential services too.’

At the same time, through both the recession and the pandemic, we have been reminded of the disproportionately important role that trusts and foundations play in supporting these organisations. Since March 2020, their flexibility has offered a lifeline, ensuring the continuation of essential services and activities.

In particular, the emergency has shown us that lighter, more flexible, more trusting funding practices are possible.  And hopes are now high that trusts and foundations will ‘keep the faith’ through the period of prolonged upheaval and uncertainty that lies ahead. This is the driver behind the open and trusting grant-making campaign , with its commitment to sustain and build on progressive practices for the future.

In 2012, we heard a plea for trusts and foundations to step into an advocacy role, using their influence to stimulate and facilitate debate and action about the adverse effect of public sector funding cuts and the decimation of public services. The response was, largely, to remain silent. For some, taking on this role felt like a step too far away from independence and into ‘campaigning’. For others, there was a concern that sweeping statements would ignore the constraints faced by public agencies, and might ‘tar everyone with the same brush and ignore the pockets of flexible public sector practice’.

However, almost ten years later – faced with similar difficulties around government funding, and in ‘the foothills of the economic shock’, the need for someone to speak out remains urgent:

‘We have put in a massive shift. Often unheralded, or taken for granted. Our work is vital, but it can’t just happen on a wing and a prayer. And it’s not just about one tweak here, and one tweak there. We need the whole system to change.’

‘If reporting deadlines on one grant shift, or processes for another become easier, that’s great. But unless that becomes standard practice across the board, the stress and the burden are still there.’

‘Our vital contribution isn’t really understood by statutory authorities. But without the support of these bigger players, we will not be here to make the system work: reaching minoritised communities, interpreting the benefits system, plugging gaps and mopping up mess.’

Trusts and foundations – with their prize assets of independence and leverage – are perfectly placed to step up and argue for greater consistency and flexibility in how the work of voluntary organisations is funded, both within their own sector, as well across all levels of government. This is not the moment to be bashful. For, without vocal and concerted effort, there is a genuine risk that vital organisations providing essential services will buckle under the strain.

A Community Action Network – West End, Morecambe Bay

Since January 2020, the Institute for Voluntary Action Research (IVAR) has been supporting the Lancashire & South Cumbria Health and Care System on a test and learn initiative. Working at a place-based level, we looked at ways to draw on local leadership and the power and capacity of communities to improve their own health and wellbeing – in the context of the changing role of commissioning, with a more community-centred focus in the Integrated Care System (ICS).

The West End (Morecambe Bay) vision has been to find ways to improve local lives through sharing resources, seeking investment, supporting each other and, most importantly, involving local people in the conversations and decisions that affect them. In this case study, we review the journey so far, lessons learnt and the next steps forward. Not only is this a reflective document for the ICS in Lancashire and South Cumbria and the Community Action Network set up in the West End (Morecambe Bay), but inspiration for other locales developing and progressing cross-sector partnerships. 

To speak with IVAR about commissioning a project or for more information on cross-sector partnerships, please contact us on enquiries@ivar.org.uk 

For more information on this case study, please contact:

Yakub Patel – Chief Executive Officer of the Lancaster District Community and Voluntary Solutions –  yakpatel@lancastercvs.org.uk  

The contribution and value of the VCSE sector in East Sussex

This report explores the value and contribution of the voluntary, community and social enterprise sector in East Sussex – including how the sector responded to Covid-19 and how people see the sector’s future. As well as a detailed look at the positive contribution organisations are making in East Sussex specifically, we offer an interesting perspective on how to present the value of the voluntary sector in a way that goes beyond traditional ‘impact’ or economic metrics; and explores how funders, the public sector and VCSEs can best support each other in the future.

 

We hope this work informs both future thinking about cross-sector collaboration in East Sussex; and how other local authorities consider the contribution and value of the voluntary sector. 

You can read highlights from this report and find out more about how commissioners and VCSE organisations can work together here

Health inequalities and Covid-19: How can we respond collaboratively?

In partnership with SEUK, IVAR hosted the Transforming Healthcare Together Virtual Conference on 17th and 18th November 2020. Panellists on the health inequalities and Covid-19 session, Dr Esther Oenga and Cecily Mwaniki from Utulivu, who co-ran the session with Sharmake Diriye from GOSAD (Golden Opportunity Skills and Development), reflect on how responding collaboratively can help us to address health inequalities among ethnically diverse and refugee communities.

‘Before Covid-19 it was bad, now it is worse’

Covid-19 has demonstrated the impact health inequalities has on individuals’ susceptibility to illness in real time. Health inequalities are not just about health, but the way that education, housing, poverty and opportunities interact to impact on an individuals’ health outcomes. Ethnically diverse and refugee communities have been affected disproportionately during the pandemic. Increased health inequalities and the Black Lives Matter movement highlighted a wide range of equality issues, often prompting difficult conversations and tensions.

From our experience of working with the communities and employing the Discover, Engage, Empower, and Collaborate model, here are four practical ways partnerships can adopt to engage with and respond better to health inequalities:

1. Changing the language

Changing the language is the first step for partnerships to consider when they aim to reduce health inequalities. While working in collaboration, partnerships must use terms like ‘less engaged communities’ and move away from terms such as ‘hard to reach’. ‘As the less people are ‘reached’, the more invisible they become.’

We need to stop using the term ‘BAME’ as it tries to group different communities into a single group when challenges faced by each community are very different.

For example, the needs of a Punjabi community are different to those of a Syrian one, which is why it is important to differentiate and ask them for the solution, rather than assuming one solution will work for all.

2. Person-centred approaches

Taking person-centred approaches is the second step partnerships must consider. By adopting a person-centred approach, we appreciate the differences individuals have, we move away from grouping people or communities and can help work with them towards change.

The tick box approach is undermining. We feel used and demotivated when services ‘pop in’ and don’t take time to actually engage and understand our needs.

 

3. Use asset-based approaches

Use asset-based approaches to understand and appreciate specialist organisations like GOSAD and Utulivu, among many others. Involving us to represent the voice of specific communities is key.

Organisations and community groups, who have worked with the communities you are trying to reach for a long time, can support you to understand what helps people respond better.

Small steps like involving experts from within the community make a big difference.

4. Collaborative co-production

When co-production is done well i.e. the approach is collaborative, instead of top-down; there is sharing of power. You reach out to groups where they are and addresses health inequalities.

We’d like to end with some Dos and Don’ts:

A diagram which shows the dos and donts with engaging the community to address health inequalities.
Here at IVAR, we’re thankful to hear and share the insights of experts in their fields. From the Transforming Healthcare Together project, we have gathered case studies and produced resources on cross-partnership working in the health and care system. You can view our findings here: https://www.ivar.org.uk/transforming-together/learning-resources

Measuring what matters: Valuing the voluntary sector in East Sussex

How do you want to be judged? By how much you earn? By your kindness and humanity? It’s not an easy question to answer. By the same token, it is difficult to determine the best way to value the voluntary, community and social enterprise (VCSE) sector. Despite the social and environmental contribution of the VCSE sector, there’s an overriding tendency to value it in standard economic terms. In this short blog, we argue that perhaps we need to think more carefully about what we choose to measure.

Valuing the VCSE in East Sussex

 

Earlier this year, IVAR was commissioned by East Sussex County Council to research the social and economic value of the county’s VCSE sector. The Council wanted to understand the scale, scope, and contribution of the sector. As we discuss below, arriving at reliable economic valuations was far from easy. Nevertheless, we made the following estimates about the VCSE sector in East Sussex:

  • Over 3,500 organisations
  • Generates an economic gross value added of at least £76m
  • Employs at least 6,000 people, roughly equivalent to 3% of the county’s workforce
  • Harnesses £110m from volunteers contributing 9.6m hours per annum, equivalent to a workforce of 6,000 full-time workers

Numbers like these are useful. They give us a feel for the size and significance of the VCSE sector. They remind policy-makers that civil society should be taken seriously. However, they also need to be interpreted with care.

 

Challenges

 

There are significant challenges in estimating the economic value of the VCSE sector. Government data rarely separately identifies VCSE organisations. Furthermore, a large number of small, local voluntary organisations are not registered with their regulators, often because their income falls below registration thresholds. As such, we have to make educated guesses about the size and scale of ‘below the radar’ organisations.

The issue of ‘below the radar’ organisations is especially significant because the vast majority of VCSE organisations are small. We estimate that over half of the VCSE organisations in East Sussex have an income of less than £25,000. Much of the value of volunteering (calculated from survey data) resides in these organisations, yet we cannot readily identify them all.

 

Limitations

 

Valuing small voluntary organisations in economic terms has an air of nonsense about it. When we think about voluntary organisations, is economic productivity really what comes to mind first? Are VCSE organisations best understood by their monetary value? As part of our East Sussex research, we have spoken to various local voluntary organisations. It seems clear to us that, while there is economic value in what these organisations do, there is other more significant value. For example, there is enormous value in the social relationships that form in and around local voluntary organisations. There is value in the trust that forms through participation. There is a value in the way that VCSE organisations help people to feel better.

 

Reconceptualizing VCSE value

 

It is important that the VCSE sector can articulate its value in ways other than economic terms. Civil society is distinctive and should be proud of its unique contribution. We need to articulate how VCSE organisations contribute to what is beneficial and important in our lives.

Measures of wellbeing offer one potential alternative to understanding the contribution of voluntary organisations. Measuring wellbeing takes us away from an emphasis on productivity and consumption, towards an understanding of our happiness and life satisfaction. That said, there are challenges in measuring wellbeing and establishing causal relationships between VCSE activity and improved wellbeing. Wellbeing measures may also not suit every situation.

What is important varies with context and perspective. For example, the way an environment group improves our enjoyment of the natural world may differ from the way a youth charity builds the confidence of young people. Thus, the assertion of value becomes a judgment as to what is important and beneficial in our lives.

 

Conclusion

Measuring the contribution of the VCSE sector is incredibly hard.  We can place economic values on it, but perhaps this does it a disservice. The VCSE sector provides fabric to many people’s lives and surely deserves to valued on its own terms. So, rather than looking at estimates of economic worth, let’s be bolder in asserting the value of VCSE organisations according to what is important and beneficial in our lives.

In the next stage of our work in East Sussex, we will holding a Share & Build Share & Build event on Thursday 17th  December. We will share initial findings from the research and provide  an opportunity for organisations in East Sussex to add further insights and discuss these with colleagues from across the VCSE and public sectors. For more information about this work or to join on the 17th of December, please contact houda@ivar.org.uk.

We’re better together

This report shares eight factors that have enabled health partnerships to respond effectively to Covid-19. Previous barriers to the NHS, councils and the voluntary sector working together – such as information governance, organisational boundaries or agendas, and lack of trust – were removed, or set aside, in order to respond swiftly to a ‘tsunami of need’. The research is based on learning from 11 partnerships in different areas of England, who took part in the Building Health Partnerships programme. 

 

As a result of working together, health partnerships:

 

  • Reached the most isolated and vulnerable community members
  • Protected against overwhelming demand on statutory health services
  • Improved referral pathways and access to services
  • Provided a more focused/targeted response when required
  • Ensured that services meet local needs
  • Distributed information to communities quickly and efficiently
  • Built on, and made best use of, community assets (e.g. volunteers)
  • Ensured the right people are at the decision-making table.

 

‘Without the third sector, Wirral wouldn’t have been able to cope and mitigate against the impact of Covid-19 the way it has.’

 

Who is the report for? 

The report is aimed at anyone interested in building cross-sector relationships to improve local health and care outcomes – NHS systems (particularly ICS/STP leads and PCNs), commissioners, clinicians, local authorities and professionals from the VCSE sector.

How we set up a social prescribing service during lockdown

As in many areas, the Social Prescribing Link Worker role is new in Lytham St Anne’s Primary Care Network. Two link workers were employed in March 2020, and in the midst of us learning the role, the country almost immediately went into lockdown due to the COVID-19 pandemic.

Working from home with restrictions on face-to-face meetings had an impact on the way we were able to reach patients, and the closure of local groups made it increasingly difficult to carry out the usual objectives of this kind of role.

Like many areas, Lytham St Anne’s saw an incredible response from local volunteers who were keen to help their neighbours, particularly the elderly, vulnerable and those advised to shield by the government.

We had access to the list of shielding patients and worked alongside primary care colleagues to contact each of these patients by telephone for a supportive chat, finding out what additional needs they may have during lockdown. For those that needed help with shopping, collecting medications or dog walking, we were able to signpost or refer to local mutual aid volunteer groups, as well as to NHS volunteers.

For patients who were found to be especially isolated or lonely, or struggling with their mental health, we provided regular check-up calls, in addition to signposting to telephone befriending services.

We found that patients were appreciative of the calls, even if they had no additional needs; they were grateful that they hadn’t been forgotten. Others chose to receive a weekly wellbeing call from us and reported that this helped them to get through the difficult months of lockdown.

Inevitably, a major challenge of this period has been the lack of active community groups and services to prescribe to patients. While some groups have gone online to hold virtual meetings, the large elderly population in Lytham St Anne’s faced barriers to accessing these groups. Age UK Lancashire provided tablets on loan to people who were without the relevant technology and there were volunteers available to teach people how to access apps such as Facetime or Zoom. Despite this, many patients proved to be reluctant to make the move online, and others do not have access to the internet at all. Furthermore, we found that many local groups did not create an online presence, and have simply been waiting to be allowed to meet again in person.

One prominent local group, Just Good Friends, usually provides regular meetings including dancing, quizzes, musical entertainment and exercise sessions. During lockdown, the group leaders kept in touch with their members via telephone and once guidelines lifted to allow people to meet outdoors in small groups, members began to meet in a local park in socially distanced “pods” of up to six. They have recently started some chair-based exercise sessions in the same pods. We have been able to refer new members to this group.

Although groups and services have been restricted during the pandemic, we have been able to build relationships with local group leaders, establishing a good network of contacts which will be invaluable as the community comes to terms with the “new normal”. We have also started seeing some patients for face-to-face appointments and hope to see more and more groups opening up following lockdown, depending on further restrictions that may arise. Drawing from our learning and the need to work more across sectors, we are looking at developing a local Social Prescribing Network in Lytham.

Sign up for our virtual Transforming Healthcare Together Conference to hear more stories about cross-sector partnership working during Covid. We’ll hear from some amazing speakers who will offer local, national and system perspectives.

#iwill: youth volunteering in the NHS

Four London Trust’s – Chelsea & Westminster, Imperial, UCLH and South London & Maudsley partnered on a beacon project. “We want to use the funding to demonstrate the impact youth NHS volunteering is having in London, but also as a legacy project that can be used to promote future initiatives and support. We commissioned an animator to work with us on the film … During the February half term, 12 volunteers from the 4 Trust’s joined us for a workshop with the animator. This allowed Volunteer Coordinators to take a step back and ensure the messaging came from the volunteers themselves – what they wanted people to know. Four young volunteers also contributed to the video by recording voice overs – which they managed by recording on their phones under duvets in their homes to manage it during lockdown! We’re really proud of the final product, and hope it will encourage more leaders in education and health sectors to buy in to NHS youth volunteering.”

New roles and adaptations for young hospital volunteers

Since April, we have facilitated a series of peer support sessions for Volunteer Coordinators from NHS Trusts. Through these sessions, hospital volunteer coordinators have shared their experiences and challenges, and explored adaptations to their youth volunteering programmes. We published this briefing paper in April – since then, have continued to hear about the creative and thoughtful adaptations that volunteer teams have made to enable young people to continue volunteering. 

The following are examples of how our network of 32 NHS Trusts have been working with young volunteers during Covid-19. 


Roles based in hospitals

  • Introducing a patient belonging hub. Young volunteers have been delivering patients belongings from families and friends up to the entrances of ward.
  • Setting up a specific email address for family and friends of patients to send emails that are then printed off, laminated and distributed to the appropriate ward entrance.  
  • Offering young volunteers the role to ring patients who have recently left hospital to hear how they are experiencing being home. Part of this role involves signposting people to local community support.
  • Developing training and safeguarding procedures for young volunteers to work at the entrance of hospitals for the ‘meet and greet’ role. Young volunteers in this role are accompanied by a member of staff or security and have been providing ‘a friendly face behind the mask at the welcome desk.’
  • Supporting the bereavement team – for example, returning possessions to family members as quickly as possible without the family having to come into the hospital.
  • Establishing a volunteer hub. Many trusts have recognised the importance of having a physical space, even just a small space with a sofa, within the hospital for young volunteers. One volunteer coordinator thinks this has helped to build retention in the volunteering programme and is keen to keep this as a permanent space in the future.

Remote opportunities outside hospital settings

  • Community response to making PPE – one volunteer coordinator team has been using an art centre in a community hall near the hospital. After carefully planning the risk management for this space, they have made and supplied over 30,000 gowns to their NHS Trust. ‘It started as there was a shortage of PPE and a need and everyone wanted to help… you get brains together and make it community-led, speak with other NHS Charities and pass on to each other what’s working and what’s not. An Art director from a school allowed us to use their sewing machines and volunteers wanted to help.’ 
  • Setting up weekly activity packs to share with patients. These packs can be accessed online and create a way for young people to develop new ideas and to contribute but from outside the hospital. Packs include resources, activities and support for patients and families during Covid-19
  • A 16-year-old volunteer created a pen pal system within the hospital called ‘Ward Wire’– volunteers writing to patients within the Trust.
  • Running a telephone befriending service and finding creative ways to develop this idea – for example, some young volunteers have been sharing recipes or YouTube workout videos with each other.
  • Testing out potential new roles involving tech support – digital championing roles. One Trust is responding to the increase in zoom appointments and is developing the equivalent of a meet-and-greet role to help people access and use tech. Young volunteers have been doing trial runs with patients before their outpatient appointments online – supporting both the patient during this process, as well as boosting the efficiency of the appointment schedule.

 

Maintaining communication

 

  • Continuing Forums for young people. One Trust has moved their forums onto zoom and has maintained their monthly meetings. Each month the agenda/ theme is different and has been chosen by the young volunteers. For example, Black Lives Matter, mental health, long term health conditions, have all be topics explored during these monthly calls. 
  • Developing relationships with new volunteers online. One Trust thinks this has been an inclusive process for many young volunteers who have preferred joining the volunteer programme by text and calls rather than face-to-face meetings straight away.
  • Maintaining WhatsApp for groups of volunteers.

We’ve learnt new and smarter ways of working. Once this has settled, there will be a revaluation of what’s worked and what are new ways of working going forwards. This has been a massive learning and will impact how our young volunteers work in the future.’ 

You can find resources for setting up youth volunteering in your hospital here. They have been collated from 30 NHS Trusts and their respective charities, who have been welcoming young volunteers since early 2018 with support from the Pears #iwill Fund.

Trust, power and collaboration

Trust, power and collaboration shares practical suggestions for taking a ‘human learning systems’ approach to commissioning and funding relationships. We aimed to capture the varying experiences of those adapting their practice, and identify both what is happening and what needs to change to enable different ways of working – for both VCS organisations and funders/commissioners. This research was carried out in partnership with Northumbria University and The Tudor Trust.

 

You can read a summary of practical tips for trust-based commissioning here