A group of attendees and staff having a chat at the gofod3 2024 event

Health and care in Wales and Cornwall

Published: 04/07/24 | Categories: Information & support, Author: Kate Mitchell

Kate Mitchell took part in a gofod3 session, ‘The value and values of the voluntary sector in health and care’. We asked her to share her reflections.

I was delighted to be invited to such a vibrant and positive day. You could feel the energy as soon as you stepped in, with various organisations showcasing their worth through enthusiastic conversations, bowls of tempting chocolates or interactive games.

It was clear from the outset what a vast array of voluntary, community and social enterprises there are in Wales.


I am a Lead Commissioner for adult community and voluntary sector services at Cornwall and Isles of Scilly Integrated Care Board. We, like you in Wales, highly value our voluntary sector. We embed it in key areas such as community led prevention, personal health budgets, community reablement, discharge support and community hubs. However, we still have progress to make to ensure that the sector is equally involved in co-designing, delivering and evaluating services.

I initially felt a bit of a fraud being in a Welsh event, coming from 200 miles away in England, but there are many similarities across our communities.

Both Wales and Cornwall have similar ageing populations, spots of high social deprivation, as well as coastal and rural areas with their own challenges of service delivery and transport. We both have strong vibrant communities that, despite health and care system challenges, are still making a difference.

We also share strong Celtic heritages and languages. I even googled the similarities and found there is a signed agreement between Cornwall Council and Welsh Government to work together on areas of shared interest where there would be mutual benefit!


I was asked to share my thoughts on the Bevan commission paper ‘The values and value of the third sector: collaboration with the statutory sector to deliver health and social care in Wales’.

The themes of the paper all resonate with my experiences. It was an honest, but uplifting read, if you read it through a lens of a ‘positive future’.

The paper captures the five elements I wanted to share as key areas of learning and focus for me working in Cornwall. I offered them as five Ps: people, place, personalisation, partnerships and positivity.

I could perhaps have added another P, for perseverance!



People who deliver and commission services, staff, volunteers and people who receive services and support, now and in the future. We are unique individuals and can bring our strengths and assets to co-design, deliver and evaluate services and support.


Just as people are unique, so are places and communities. The health and social care that is required in one area may not be the same in the next. We need to be flexible in how we tailor services to local need and trust communities and local providers to understand.


Personalisation is what the voluntary sector does really well. Organisations keep people at the heart of all they do and can be agile and flexible in their response. The sector can have a  conversation with people about ‘what matters to you’ rather than ‘what’s the matter with you?’ which naturally leads to different solutions and outcomes.


The sector gains strength when it stands united to show what can be achieved through collaboration. It’s not always easy if the environment is competitive, but strong partnerships can achieve much more and can give each other ‘air cover’ when the going gets tough.


Working in a sector where resources are stretched can be a challenge and feel isolating as an individual or a sole organisation – that’s why partnerships help. Surrounding yourself with the ‘can do’ and ‘will do’ people who’ll try something out in a trusting and learning environment makes all the difference.


Ultimately, all good service change and improvement is about building trusting relationships. Change really does proceed at the speed of trust and relationships. When you’ve got that you can make changes overnight, believing that although it may not be perfect today, it will be better tomorrow. And if  not, you’ll learn, adjust and try something different using the five P approach.

I had some lovely conversations after the event and reflected on how we’ve been able to commission in a different way in Cornwall. In addition to the above approach, I have learnt that we can commission for collaboration and not competition.

Building trusting and learning environments through partnerships is a more effective way of delivering a responsive service change or a new service, than prescribing in a specification or contract. Using grants, an outcomes-focussed approach, memorandums of agreements and working through shared values and agreed principles is far more effective. Most importantly, it’s more fun!


For more on the voluntary sector’s work in health and care please visit our health and care project page.