The presentation was a workshop at Evolve 2014: the annual event for the voluntary sector in London on Monday 16 June 2014.
The presentation was chaired by Shane Brennan, from Age Concern Kingston and looks at the changing context of public service commissioning.
Find out more about the Evolve Conference from NCVO: http://www.ncvo.org.uk/training-and-events/evolve-conference
Find out more about NCVO's work on volunteering: http://www.ncvo.org.uk/practical-support/volunteering
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Understanding the new public service commissioning environment and volunteer’s place within it
1. Workshops
AM1: Understanding the new public
service commissioning environment
and volunteers’ place within it
CHAIR: Shane Brennan, Chief Executive, Age Concern
Kingston and Chair of NCVO’s Public Services Advisory
Group
2. This workshop is about
• The changing context of public service
commissioning
• The role of volunteers
• Challenges and opportunities
8. What is being outsourced?
• Services
• Management / commissioning functions – e.g.
• Transforming Rehabilitation
• Clinical Commissioning Groups?
• Child Protection?
9. Opportunities
• Market share
• Social Value Act 2012
• Changing procurement rules – Autumn 2014
• Target for 25% government contracts to be
delivered by SMEs by 2015
10. Threats
• Reduced overall funding
• Private sector competition
• Internal competition in VCSE sector (e.g. locals
vs nationals)
• Lack of scale and structure – VCSE
• Poor commissioning expertise – commissioners
11. Volunteering: opportunities
• Added value of volunteers – time,
responsiveness, skills
• Volunteers’ self-development, employability
• Community coherence, resilience
but …
• Job replacement/ substitution, “cheap labour”
• Danger of damage to “volunteering movement”
12. Problems for management / commissioning
• How to incorporate volunteering in procurement
• How to include in bids
• How to cost the management of volunteers
• How to demonstrate added value - impact
• What difference volunteers make when they’re
involved
13. Volunteers and Public Service Commissioning
Christine Mead
Behaviour Change Commissioner
Triborough Public Health Service
14. The economic and policy context
• Changes to public services
– Health care budgets reducing
– Pressures on adult social care budgets
• Changes to population needs
– Communities and ethnic groups remain isolated and disenfranchised
– Ageing population
– Challenges to children’s health, diet and school readiness
• Changes to service providers
– Cross sector working
– Integrated working
– New forms of partnerships
– Commissioning and procurement approaches
16. Community Champions: Policy Background
Addressing root causes of poor health and well-being requires
better approaches to deliver health and care that is ‘owned by
communities and shaped by their needs’ (Public Health
White Paper)
UK Parliament’s Committee of Public Accounts confirmed that the
gap in life expectancy between people in deprived areas and the
general population has continued to widen,
Health and Social Care Act (2012): local authorities have
responsibility for improving the health of their local populations,
and sets out to ‘tackle health inequalities across the life course,
and across the social determinants of health’
17. Community Champions
• Local residents rooted in the community
• Bringing local residents and services together
• Improve health and wellbeing of residents
• Trained to Level 2: Understanding Health Improvement
(RSPH)
• Running and promoting health ad wellbeing activities
• Knowledge transfer about health, best practice and
access
• Signposting and health advice
18. Social Return on Investment
The Social Value Act has the power to
transform spending on public services
This ambitious new act requires public authorities to take into account
social and environmental value when they choose suppliers, rather
than focusing solely on cost
Patrick Butler, The Guardian, 5 Feb 2013
19. What does this mean for providers and programmes?
National Audit Office: Value for money and TSOs
‘Make sure your programme is really focused on outcomes, the
impact on service users and communities that you are seeking
to achieve, and not just on outputs, process or inputs.
Not all outcomes will be obvious, direct or easily values. You and/or
providers may need to use evaluations and techniques such as
Social Return on Investment (SROI) to establish the full impact of a
programme and its worth.’
23. STAKEHOLDER OUTCOMES PRESENT VALUE OF IMPACT
(£ Attributed Value)
HOUSEHOLDS
DIRECTLY REACHED per Hub
CHAMPIONS
i.e. Improved health (exercise, healthy eating) and reduced diabetes issues
Improved well-being
Skills & knowledge
Employability
Fairer access to treatment
£248,000 76
RESIDENTS
i.e. Improved health (exercise, healthy eating) and reduced diabetes issues
Reduced prevalence of long term conditions
Improved well-being
Knowledge
Fairer access to treatment
£845,000 circa 150-200 households per Hub (or approx
1000 households)
CHILDREN
i.e. Improved health
Improved well-being
Knowledge
£526,500 circa 150-200 households per Hub
(or approx 1000 households)
LOCAL AUTHORITY
i.e. Reduced care need for reduced diabetes
Reduced adult and elderly care need due to poor mental health and isolation
Improved school readiness
£907,500 circa 150-200 households per Hub
(or approx 1000 households)
Central GOVERNMENT SAVINGS
i.e. Resource savings to Health and Social care, and DWP
£255,500 circa 150-200 households per Hub
(or approx 1000 households)
SOCIAL & ECONOMIC VALUE over 12 month benefit period ONLY c. £2.56 million -
PRESENT SOCIAL & ECONOMIC VALUE forecasted across 3 year benefit period for
specific outcomes
Circa £2.78 million -
Table 1. Social, Economic and Environmental Value created by Community Champions
27. Policy-Personalisation, Choice and Control
“Our overall vision is about promoting
people's wellbeing and independence
and enabling them to be active citizens”
Glen Mason, Director of People,
Communities and Local Government, DH
“There is a strong emphasis in the Care
Act on improving people's overall
wellbeing, which shifts the emphasis
from a remedial, 'deficit' based system,
to one which seeks to take pre-emptive,
preventive and supportive measures.”
Bridget Warr, CEO UK Home Care
Association and TLAP Board Member
28. Contribution through Volunteering
● Asset based approach to improving community
engagement, individual health and wellbeing, and
commissioning
● Enables individuals with a range of support needs to
contribute to their communities through volunteering with
the support of trained mentors from the local community
● Enables them to be trained to increase their skills and
enhance their ability to contribute
● Breaks down barriers and builds relationships through
using community volunteers as support mentors
28
29. Impact
● King’s Fund Volunteering in Health and Care (2013) - support
provided by volunteers/mentors is of particular value to those who
rely most heavily on services.
● CSV Reports On: Mental Health, Volunteering and Social Inclusion
(2008):
more likely to have a positive outcome due to the informal nature
of the relationship and the responsibility it gives the service user
for their own recovery
encourages community and peer responsibility
● Self-reported outcomes 12-13:
93% increased independence
65% more in control
600 disabled people supported to volunteer
31. Results
● Reduction in number of isolated people:
from 700 to around 511 (759 without the scheme)
● •After five years, 426 people would have moved out of isolation
into a ‘connected’ state (including those still with a volunteer)
Average cost of:
● £1,012 per person who started the scheme
● £1,887 per reduction of one person in the “isolated” community
Next Steps –further work on cost effectiveness, including savings and
outcomes e.g. in context of existing tools, ASCOT, POET.
32. Our Learning – Health and Wellbeing
“Being a volunteer gives self esteem
and confidence – a sense of
purpose and makes me happy”
“I need to be included in
decisions; it’s about what I want”
“Help to build my skills up so I know
what I want to do and how to do it –
I want to do things properly and
well”
“My confidence has improved
and my social skills …without
CSV I would not have got
anywhere and would be sat at
home bored with nothing to do”
33. Our Learning – Impact and Outcomes
● Volunteering makes financial sense - DWP: Wellbeing
and Civil Society (2013) - social and economic benefits
of volunteering. Economic value of formal volunteering in
the UK 1.3% to 1.6% of GDP – around £23 billion.
● Strong link with Care Act 2014 and new prevention duty
this places on LA’s; community capacity; Better Care
Fund and integration.
● Business Model to influence commissioning practise
across health, care and beyond; provides a tool for
engaging with and convincing commissioners of impact
of volunteering as a cost effective intervention.
New commissioners include:
Clinical Commissioning Groups
Public Health now in local authorities
Police and Crime Commissioners
Private-sector providers - we’re coming on to this
ASK GROUP TO THINK ABOUT PROS AND CONS OF THE TWO MODELS – BUT FROM DIFFERENT PERSPECTIVES
What if the Prime was say Barnardo’s or Women’s Aid?
Cost of a lorry of waste
now
in 4 years
Cost of recyclables
% recycled now
Mechanisms to influence behaviour change
We applied the Business Model:
Isolated Older People in Tendring, Essex – 100 per annum
Local volunteer mentors - 35
1 staff member for support
5 year programme
10 month maximum timed intervention
Option to re-enter model as a volunteer
Volunteers and Beneficiaries will drop out
Beneficiaries may naturally become isolated again following an intervention
Assumptions made, but based on actual statistics on isolation from Essex County Council
Results – slide.
ASCOT=Adult Social Care Outcomes Tool; POET=Personal Budgets Outcomes Evaluation Tool