Place-based partnerships are part of the new NHS integrated care systems (see previous article). They are the bit of the system that operates at what the NHS calls ‘place’. They might be called different things – like integrated locality partnerships or local care partnerships – but they usually cover one or two local authority areas.
Commissioned by Kensington & Chelsea Social and Council and One Westminster, we are working on a strategy with the voluntary and community sector (VCS) in Kensington & Chelsea and Westminster for how they will work together and within their place-based partnership. So far, we have heard views and experiences from over 50 local organisations involved in supporting people’s health and wellbeing as well as key NHS and local authority partners. This is giving us some great insight into what both VCS and NHS colleagues think needs to change if it is to be a success.
What a good place-based partnership will look like
First and foremost, everyone wants people’s experiences to improve.
This means:
- People feel more empowered, involved and engaged from the start and they are seen and treated in a timely way, so that health and wellbeing actually improves, and the social determinants of health are addressed alongside clinical issues.
- People with special needs and lived experience, from different communities of interest and identity, are involved in planning services at all stages. Their concerns are addressed rather than just recognised.
Second, people understand this is about relationships and genuine culture change.
This means:
- VCS organisations are embedded in a system that has a shared culture; not (as before) the sector being asked to rearrange itself to fit in with an NHS restructure and way of working.
- Good communication channels exist, and these are two-way – within and between sectors – so people feel they can “pick up the phone” and discuss problems openly. There are also channels for people furthest away from decision-making to raise their concerns and find out what is going on.
Systems can only change when people change;
people can only change when their thinking changes.
Third, it is understood that system working means integration and inclusion.
This means:
- Better integration across the wider public sector (all council departments, public libraries, transport, criminal justice system, housing, advice services), not just with the VCS.
- The full range of VCS organisations – from very small organisations and community groups to larger specialist providers of support and services – can participate and are invested in.
- Data and intelligence, from a diverse range of sources (including the VCS and lived experience), is valued and shared, and used to identify and plan for needs (for example, intelligence picked up by link workers is recorded and acted upon).
Fourth, the need to broaden the focus of the health and care system beyond the medical is understood.
This means:
- The system prioritises prevention, early intervention, and tackling the wider determinants of health and inequalities alongside (and as a route to) improving clinical treatment and care pathways. There is also a much greater emphasis on wider wellbeing outcomes, not just clinical.
- Clinicians (including GPs) feel supported to find appropriate support in the community to address people’s social, emotional and practical needs.
- Above all – if the sector is to have the serious role in health and care that is envisaged in the policy – now is the time to consider the sustainability of the VCS organisations that contribute so much to communities and people’s lives through the work they do.
Sustainability means:
- All functions of the VCS are recognised and invested in, including delivery, strategic input, ‘voice’, representation, leadership and the local infrastructure function. Capacity is created to enable participation.
- Commissioning is reformed, for example, there are adequate timescales for partnership bids and a mix of grants and contracts used to fund delivery, appropriate to the size and complexity of the project or service; competitive tendering is no longer the default funding option.
Like ICSs, place-based partnerships have a big job to do. We are now looking forward to getting into the detail of codesigning the strategy with the Westminster and Kensington & Chelsea VCS. We are always keen to receive input on our work. Please contact us to let us know if you agree with these insights, and if they chime with the experience in your local area.
Lev Pedro and Aimie Cole are consultants, specialising in the role of charities in public service transformation and delivery, currently working as associates to NAVCA and NHS England building VCSE leadership and representation structures and facilitating cross-sector partnerships.
Last Updated on 30 November 2022
