There are more than 230 NHS charities in the UK today, with one attached to each hospital, trust and health board in every nation and region. Yet in spite of their number, their potential role in integrated care systems (ICSs) in England – and in the NHS overall – remains little understood and often overlooked.
Collectively, NHS charities give over £1 million every day to the NHS. Beyond that, NHS charities hold immense potential when it comes to tackling the wider determinants of ill health. Historically, however – perhaps simply due to lack of awareness – the NHS and public sector have not valued or invested in this particular pillar of the system’s architecture.
Many realise now that this has been to its detriment. Take social prescribing, for example. It’s becoming clear what an invaluable partner a well-resourced voluntary sector can be in this bridge between clinical and social outcomes.
NHS charities are playing a leading role in convening voluntary and community sector (VCS) organisations across ICS footprints and Health Board areas, as a direct result of NHS Charities Together’s Stage 2 Community Partnership Grants Programme.
The programme was launched in September 2020, in recognition of the vital work that voluntary and community groups do to support the NHS. Since then, we have invested more than £33 million from our Covid-19 Urgent Appeal to create 325 community partnership projects, working with 700 community and voluntary partners around the UK.
Each project began with the core objective of tackling the wider determinants of ill health and preventing hospital admissions. Ultimately, the aim is to take pressure off the health service. Recent projects include community football mental health interventions, discharge projects and cancer screening initiatives. There are also health outreach programmes for marginalised groups and projects that tackle isolation and loneliness or focus on improving fitness.
These projects, and many like them, are a realisation of our vision that the NHS charity sector acts as a bridge between the NHS and the wider voluntary sector. By working in this integrated way, NHS charities are showing their willingness and capacity to adapt for the benefit of their local communities – and to great effect.
From our results to date, we are excited about how this collaborative approach and investment could be expanded in the future, especially as the NHS moves towards more integrated ways of working.
The Community Partnership Grants Programme works by 68 of our members acting as ‘lead charities’, with those in England linking to ICS footprints, and those in other nations linking to local health boards. The lead charity acts as a project lead, liaising with other member charities within their regional patch and strategic partners within their ICS footprint. They identify funding priorities based on the needs of the region, and support NHS charity and VCS relationships, plus project delivery and ongoing funding of successful projects.
While many ICSs were in their infancy at the time initial grants were agreed upon, relationships have evolved as ICS infrastructure has matured. The Community Partnership Projects provide risk-free ‘proof of concept’ for statutory sector partners about the role of NHS charities and the wider voluntary sector.
We are currently carrying out a detailed evaluation of our Community Partnerships Programme, together with the lead NHS charities, voluntary and community sector organisations, and other system partners. The insight and learning generated will enable us to better support members, tailor future grants programmes, and continue conversations with strategic partners to ensure our work has relevance and impact at ICS level.
Our latest progress report begins to provide evidence of sustainable improvements made. It shines a light on changes to strategic approaches around the health and wellbeing of staff, and how successful pilot interventions have leveraged further investment from trusts and health boards.
A review of the first phase of funding alone shows that 98% of responding charities felt the grants had made a positive impact on the health and wellbeing of NHS staff, patients, volunteers and other beneficiary groups. And over 90% said projects had made a lasting impact.
But the voluntary sector can only continue on this trajectory if it is adequately resourced to cope with demand, and appropriate investment and support can continue. We also know from our members that there is inconsistency in ICS engagement with the voluntary sector. We are gathering further insight on this as part of our evaluation.
Some charities have utilised relationships with community foundations to act as an enabler. However, others have found it very difficult to establish relevant external partners – often due to a lack of capacity, or an amenable infrastructure. As such they will tend to rely on existing links, for example to other NHS charities.
Additionally, we know that NHS charities are at present more likely to get involved at a local rather than systems level and we want to understand this more. From initial findings and discussions with lead charities, it can be challenging but undoubtedly worthwhile to build projects and relationships between themselves and other VCS organisations. And ultimately the aim is for the voluntary sector to work as systems partners as well as providers of partnerships.
A seat at the table
NHS Charities Together plays a key role in convening these partnerships, supporting relevant infrastructure and harnessing this nationwide potential. We believe that sustainability of the voluntary sector needs to be on all ICB risk registers in England and, moving forward, we’re calling on health leaders to ensure continued support for the sector, and a permanent seat at the table – an issue relevant across all nations.
While our formal evaluation of these partnerships will not be complete until next year, the feedback received to date – from the charity partners, trusts and health boards, and the service users they support – has been eye-opening. But NHS charities need ongoing representation and investment for this to continue. We hope that the more detailed insight gathered from our Community Partnerships Programme will be the catalyst needed to make this happen. We hope to foster continued collaboration and encourage all healthcare leaders to consider their NHS charity as a strategic partner in ICS and VCS alliances. In the meantime, we look forward to sharing further learning, and to a bright future ahead.
For more information on the NHS charity sector visit www.nhscharitiestogether.co.uk