Johanna Davies, WCVA’s Head of Health and Care, considers how lessons learned from Scotland can be applied to the health and care system in Wales.
Recently I spoke to the Voluntary Health Scotland Conference about our Health and Care Project and its involvement in developing the National Framework for Social Prescribing. It was wonderful to share some good practice from Wales, but also to learn from contributions in Scotland, whose government has committed to developing its own National Framework for Social Prescribing as part of a Population Health Framework.
IT’S GREAT TO COLLABORATE
Collaboration was the conference’s theme, and there were some excellent speakers and panel discussions about Collaboration for Change. Two speakers particularly made me think about similar challenges we have in Wales around health and care being more integrated and more prevention-focused.
Professor Devi Sridhar, Chair of Global Public Health, provided sage advice on collaboration between partners with varied responsibilities and remits. Rather than trying to tackle the issues or problems as a whole, partners could agree on the top three things to do in the next year together. In Wales, I think we could do some more focused work in key areas such as hospital to home support with great results.
Professor Nicola McEwen, Director of the Centre for Public Policy, reminded us of the importance of people’s stories in understanding our systems. Realistically there will be no additional funding coming to enable current demand to be managed while simultaneously increasing preventative interventions. Difficult decisions will need to be made in Scotland about the reprioritisation of investment.
The questions and comments in response to all the speakers and panel discussions were all too familiar.
MISSION IMPOSSIBLE?
On my long train journey home, I thought about Welsh Government’s plans for an integrated community care system and aim to become a Marmot Nation. Whole system change seems almost an impossible task when considering the systems we operate in. We have the legislation, governance and guidance to deliver a healthier, more equal Wales in theory – but we seem to fall short when it comes to implementation.
Health and social care accounts for over half of the Welsh Government budget. Asking health boards, social services and Regional Partnership Boards to make the difficult decision to disinvest in acute health and social care services that are under exceptional pressure, to prioritise prevention is, frankly, unrealistic. Trickle-down economics doesn’t work – so why do we think trickle-down funding to the preventative services, through acute focused organisations, will? If the next Welsh Government wants to make progress on prioritising prevention, it will have to take more decisive action to secure funding streams for organisations working in the field of prevention.
VOLUNTARY SECTOR PARTNERSHIP ACT
That’s why WCVA is calling for a Voluntary Sector Partnership Act in its maniffesto, with five duties to support better ways of working with the voluntary sector. By creating a fair funding duty, a volunteering duty, a communities duty, a partnership duty and an oversight duty, we can start to tackle some of the most ‘wicked’ problems in health and social care.
- A fair funding duty will mean more consistent and sustainable funding to the voluntary sector, ensuring our vital services are there across years and not just from year to year.
- A volunteering duty will create a robust infrastructure to support high quality volunteering that supports individual wellbeing and adds value to existing services.
- A communities duty will sharpen focus and channel efforts in prevention towards the things communities need and want.
- A partnership duty will further enhance our involvement in collaborative spaces, from tokenistic to more meaningful and proactive relationships as delivery partners.
- An oversight duty will acknowledge and value the voluntary sector and ensure those subject to the Act will be accountable for complying with the duties.
MORE MEANINGFUL PARTNERSHIP
My visit to Scotland reminded me that the challenges we face are not unique to Wales and that we have come a long way in terms of our approach to partnership. However, in terms of meeting the objective of a healthier Wales, I think this can only be achieved with more meaningful partnership with the voluntary sector. A Voluntary Sector Partnership Act will cement the role of the sector as critical to health and wellbeing in Wales.
FURTHER INFORMATION
If you’re interested in learning more about WCVA’s Health and Care Project, please visit the webpage.