Position Statements

The Alliance would like to see the continuation of sector involvement in committees and Boards. The ICB will need to invest in infrastructure to support this and maximise the benefits. This feels particularly important given the move towards neighbourhood health, the focus on reducing inequality, and the loss of independence of Healthwatch in the future.

We want the new model to be informed by local learning, including from the sector, building on what we have done so far alongside incorporating whatever is feasible within the resources that the ICB makes available.

We are concerned about potential risks of the ICB losing connection with local experiences and with seldom-heard groups. A strong Alliance can help mitigate this risk. Sub-regional networks can also help keep the ICB close to neighbourhoods.

What we would like to see:

• Input into the development of new ICB, what it looks like and how it will be monitored.
• Recognition that the VCSE and VCSE Alliance are a source of solutions to support health partners with the realisation of the 10 Year Plan, but that they are also under increasing pressure as demand and needs grow.
• Commitment to a continued seat at the table within ICB structures.
• Clarity about the future role of the Alliance, how this will be supported, and where the Alliance members will sit in the new structure as this is developed.

We welcome the opportunity to meet with NWL and develop a model.

We strongly advocate for the timely inclusion of the local VCSE sector where appropriate within neighbourhood teams, holistic, ongoing support is where the sector brings expertise and added value. To fully realise this potential, roles need to be properly funded, with appropriate supervision arrangements, roles need to be clearly articulated to the wider team. Neighbourhood teams should work to develop pathways to other neighbourhood services (wider determinants) to ensure a joined up response to community challenges.

(Taken from VCSE Alliance letters to Integrators): The sector has much to contribute to the successful delivery of the neighbourhood model. We know our communities, we support people from a wide range of backgrounds, with a wide range of needs in a person-centred way. We’re already delivering positive outcomes for residents and communities at place, sometimes in partnership with partners within the integrator.

What we would like to see:

• A clear strategy from the ICB and integrators for how to engage with the sector, including principles around fair reimbursement for their time and expertise and a payment model that allows for fair terms and conditions for staff involved in delivery.
• Early involvement of the VCSE within each borough.

The plan suggests that over time digital tools will increasingly link to services outside the NHS – in the voluntary sector, from social enterprises, social care, community groups or local government. It will be a digital social prescriber. We welcome engagement with the sector, in both planning and implementation to ensure that digitisation doesn’t exacerbate inequity. The sector plays a vital role in supporting people to manage the wider determinants of health. However, the sector is facing unprecedented challenges.

With signposting already highlighted as a concern by the sector, we are concerned this risks further displacing responsibility onto underfunded VCSE services without ensuring the support, investment, and coordination needed to make such referrals meaningful.

The sector is working with residents who experience digital exclusion and low levels of digital confidence.

What we would like to see:

• Commitment from the ICB (or ICS) to involve residents in testing new technologies before they are rolled out to maximise their useability.
• Commitment from the ICB (or ICS) to always advocate for alternatives to online tools for residents who cannot get online.

VCSE Alliance members are keen to continue work with the ICB to build on the ‘Involving People and Communities Strategy’ to develop a shared understanding of engagement/ consultation, co-design and co-production, when it is needed, how to resource it and how to make it inclusive.

Often co-production is not feasible due to resourcing or time constraints. The Alliance can support the development of alternative approaches. However, the resourcing of meaningful engagement is essential if we want to design services that reduce inequity.

The Alliance feel it is essential to putting the needs of local people and communities at the centre of planning, both at ICB and neighbourhood level.

Co-producing with communities: Community voices need to be embedded in reporting, strategy and decision-making, on an on-going basis and experiences shared across commissioning teams to ensure maximum impact from the learning and experiences shared by communities.

Collaborating with the sector: the Alliance welcomes a seat at the table, and early involvement both as advocates for inclusion and as experts in delivery.

What we would like to see:

• We hope that the new ICB will be transparent and accountable regarding how decisions are made and how progress is measured, from a commissioner, provider and resident perspective.
• We need a seat at the table for the VCSE (Alliance) and clear mechanisms and timeframes for the ICB to respond to VCSE input.

The 10 Year Plan implies that residents will be able to feedback regularly via the NHS App. Whilst this might be useful as a way of rating services, we know that many residents still haven’t downloaded the app, and that the meaningful engagement needed to ensure our services meet need can’t be delivered by a series of closed questions through an online tool.

Most importantly, Alliance members would like regular updates from the ICB on how the engagement insight they have gathered and shared is being used within the ICB.

What we would like to see:

• For greater impact we must use this insight across commissioning areas.
• We must report back to the sector and to residents about these impacts. This will help the ICB build trust with local communities.

While the 10 Year Plan does reference primary prevention and the social determinants of health, including a headline ambition to halve the gap in healthy life expectancy, it explicitly states that secondary prevention will be the primary lever for short-term results. This includes identifying and managing risk factors or early-stage illness through targeted interventions, screenings, and technology.

What we would like to see:

• Appropriate targeting of services to increase equity of treatment and we want to be involved in the development and delivery of services to increase equity.

While the Plan calls for a cross-societal effort on prevention, it makes no direct mention of the local VCSE sector or its proven role in addressing upstream drivers of health such as poverty, housing, food insecurity, and social isolation. Local VCSE organisations are well placed to lead this work, but doing so requires targeted investment, sustained partnership, and meaningful recognition of the sector’s contribution to building healthier, more resilient communities.

The VCSE has a vital role to play within the ICB’s ambition to reduce health inequalities. We’re working with residents in the most deprived wards, experiencing unemployment, under-employment and poor conditions at work, those living in unfit housing and with a wide range of physical and mental health needs. We’ve worked with the ICB at borough and cross-borough level to target activities to those most in need and/or who are missing out on the universal offer. We also deliver a wide range of support to help people with recovery or to stay well by maintaining social connectedness.

We want to see stronger recognition of the ways in which:

• The VCSE bears costs and plays its part in increasing access. VCSE partners host a lot of NHS services with residents who may be excluded from health care. We’d welcome stronger recognition of how the.
• The work that the VCSE does support peoples to access statutory services, and access them earlier
• Some services delivered by the VCSE will have better engagement from residents, and better experiences and outcomes than those delivered by statutory partners.

We are concerned about the loss of independent voice within the ICB, as well as the loss of the signposting functions and networks that Healthwatch in NCL have developed. Healthwatch has played a vital role in amplifying community insight, challenging poor practice, and bridging gaps between people and services.

We are committed to working with the ICB and local Healthwatch to manage the transition from the current system, ensuring that meaningful patient voice can be heard within the system.