The bits beyond the boundaries: aligning policy with local action in health and social care

Jane South, Ruth Cross, Louise Warwick-Booth

Paper presentation at Policy & Politics conference, Transforming Policy & Politics: The Future of the State in the 21st Century

17th-18th September 2013, Bristol

Aim of presentation

• To discuss the role of the state in supporting volunteering that occurs beyond the boundaries of commissioned public services, using an evaluation of the Department of Health’s Health and Social Care Volunteering Fund

Volunteering

‘An activity that involves spending time, unpaid, doing something that aims to benefit the environment or individuals or groups other than (or in addition to) close relatives’Volunteering England, 2012

“Our vision is of a society in which social action and reciprocity are the norm and where volunteering is encouraged, promoted and supported because it has the power to enhance quality, reduce inequality or improve outcomes in health, public health and social care.” DH Strategic Vision for Volunteering (2011:6)

Social action

Public sector

VolunteeringIN health & social

care

Commissioning volunteer services (3rd sector)Regulation e.g. CRB

Independent social action

State provision and duty of care

CAN government stimulate volunteering?

SHOULD government stimulate volunteering?

What are the SOCIAL JUSTICE implications?

Department of Health’s Health and Social Care Volunteering Fund

• Capacity building programme – funds and support package

• 2010 & 2011 rounds, 94 local and 13 national projects based in VCSE organisations

• For further details of projects see: http://volunteeringfund.com/map

Evaluation of HSCVF – Theory of Change

Key findings - Strategic to local• The HSCVF is explicitly linked to

national policy priorities• Having the HSCVF sends a strong

signal about the value of volunteering and building stronger communities.

• Capacity building with VSCE organisations was mechanism to strengthen grassroots volunteering

• Vertical links from national strategic priorities to local social action

• “

“It is capacity building within the sector but …I get a sense that it is also about trying to secure strategic shift at a local level in the way that volunteering organisations help to promote the independence and wellbeing of individuals with whom they are working ….” (National interviewee)

“Definitely there's been ongoing support throughout it, and the offer of attending workshops, networking, looking at partnerships, looking at sustainability and evaluation, is a real benefit, compared to other pieces of funding, when you're just left to get on with it.” (London workshop)

Local projects by funding theme

Themes %

2010 projects (n=43)

Addressing Social Care priorities 16

Health inequalities 21

Both themes 63

2011 projects (n=51)

Patient-led NHS 14

Delivering better health outcomes 12

Improving public health 26

Improving health and social care 49Source: HSCVF project monitoring forms

Community level• HSCVF was successful at stimulating

and strengthening volunteering. • Volunteering in grassroots health

projects was often fluid and contextual, with volunteers taking on a mix of informal and formal roles.

• The value of many local projects was in being independent and in touch with ‘seldom heard’ communities. Many of the volunteers were drawn from those communities.

• Projects faced uncertainty over securing future funding from local commissioning bodies.

“…I’ve befriended lots of parents unofficially because you can’t stop it once you start doing it. You can’t see somebody trapped if you can just chat to them, even if it’s just let’s go down to Sainsbury’s and have a quick cup of coffee and a laugh.” [Calderdale Parent and Carers]

“So there’s a credibility issue there as well and people want real experiences and how it’s worked for them and they want to know what if I do this what will happen about that? The volunteers can give that real life experience.” [Older People’s Budgets]

CAN government stimulate volunteering?

SHOULD government stimulate volunteering?

What are the SOCIAL JUSTICE implications?

Concluding remarks• CAN government stimulate volunteering in health & social care?

– YES. HSCVF is a successful mechanism to link national priorities to social action in communities through supporting VCSE organisations

• SHOULD government stimulate volunteering?– YES BUT. Our research suggests that volunteering needs support but

not at expense of being incorporated: local action may need to remain ‘beyond the boundaries’ of statutory control.

• What are the SOCIAL JUSTICE implications?– Stimulating independent social action without chances to shape health

systems/commissioning will lead to further marginalisation of groups/health issues.

Acknowledgements

• HSCVF evaluation was commissioned by ECORYS and HSCVF partners

• For further information please contact

j.south@leedsmet.ac.uk