The Care Act: new opportunities for the voluntary, community and social enterprise sector

Report from SCIE/Madano Roundtable held on 30 November 2015

SCIE Report 74

Published: January 2016

Let’s design the new system together. We need the expertise and reach of the VCSE sector in order to do this. And we need a proportionate process of commissioning that works for smaller organisations.

Alex Fox, Chair of the VCSE Review and Chief Executive, Shared Lives

SCIE and Madano were delighted to bring together representatives from the voluntary, community and social enterprise (VCSE) sector that deliver health and social care services, with people who use services, commissioners and experts in the sector, to discuss the impact of the Care Act on the VCSE sector and the new opportunities it offers.

The roundtable discussion was jointly hosted by SCIE and Madano, and chaired by SCIE Chair, Lord Michael Bichard.
Lord Bichard noted in his welcoming comments that VCSE organisations – particularly the smaller organisations – make a significant contribution to the health and social care sector, particularly at this challenging time of reduced budgets. Volunteer-led groups are often trusted and committed members of their community and this can be invaluable in providing personalised care and support services. What can such services contribute to the health and social care agenda, and how has the Care Act impacted on their ability to do so?

Our speakers and attendees explored a range of issues:

• What opportunities and challenges does the prevention and wellbeing agenda offer to the VCSE sector?
• What does it mean for the type of services that the VCSE sector provides?
• What does it mean for commissioning practice?
• What enables greater engagement between the VCSE sector and other parties? What are the barriers to greater engagement?

Key messages

Co-production and co-design will be essential in meeting the requirements of the Care Act. This is starting to happen, particularly with seed funded projects acting as a catalyst for small community projects, but requires genuine dialogue between parties to continue to grow.

A competitive culture has developed amongst providers in response to commissioning by tender. A holistic response, rather than competitive, where the VCSE sector can work together without fear of losing their intellectual property would help towards co-production and co-design with commissioners. There is a question whether the current pressure to compete is driving down quality.
Both commissioners and providers need to understand where preventative care ‘fits’; it can be health and social care, health and wellbeing or public health to name a few.

Cross-discipline working which focuses on outcomes can open opportunities for preventative care. The support is there for preventative care from the Care Act, but there is a ‘leap of faith’ required to ensure such services are delivered.

The Care Act is welcomed by commissioners and providers, and all are in agreement that it offers opportunities. It could, however, be ‘just words’ without cultural and behavioural changes. A culture change is required by all parties. For commissioners this means a shift to inclusive procurement, where commissioners work with providers to commission services which deliver the best outcomes for local people. For the VCSE sector, it means a willingness to engage with commissioners and demonstrate how they achieve such outcomes to justify spend.