Prevention needs brave leadership and a thriving VCSE

At Bradford District and Craven place-based partnership, our vision is to ‘Act as One’ to help keep people happy and healthy at home.

Our partnership is committed to ensuring a vibrant and diverse VCSE is an equal partner in our work and has invested in VCSE leadership to ensure effective VCSE sector contribution and influence on key decision-making bodies, as well as in other parts of our system.

Supporting our ambitions

And we have many great examples locally of how the VCSE sector is helping support our ambitions. One of these is our nationally recognised and award-winning multi-agency support team (MAST), which provides support at Bradford Royal Infirmary and Airedale Hospital and in the community on discharge. In the past year, the MAST team has screened and assessed a total of 3,656 patients and has conducted 2,253 support sessions for individuals. After three months, less than 15 per cent of patients who provided feedback had returned to the hospital with the same issue for which they originally sought treatment.

"...over 11 per cent of our partnership’s mental health budget is now used to commission VCSE services"

Our partnership has another long-standing ambition: to innovate and change the way budgets are allocated. We specifically aim to be the first in the country to establish a community health investment standard, which would allocate 1 per cent of the total budget to VCSE services.  Significant progress has happened in some areas: over 11 per cent of our partnership’s mental health budget is now used to commission VCSE services.  This is a shift from our position in 2017 when this was around 2 per cent. This has been achieved not with extra resource, but rather through repurposing existing resource in a way that better meets the needs of people who need it most. 

Ambitions on hold

However, as we look to close the financial gap, this ambition is now on hold. I can understand why this has happened, but it’s frustrating to our VCSE sector when we know the services we do and could deliver will keep people healthier for longer and direct people into the support they need, which in turn reduces pressures on frontline health and care services. 

When finances are squeezed, we’ve seen people’s focus shift to ensuring all statutory services are kept running and that the focus of performance management is on statutory targets. Locally, difficult decisions have been made resulting in a reduction or cessation of funding for VCSE services that that have demonstrated a positive impact. This goes against the ambition of shifting resource into the VCSE sector, and it makes our VCSE sector feel anything but equal partners. 

As VCSE sector lead in the partnership, I’m a big advocate for getting commitment from local places to continue to invest in VCSE services and for national changes that would make it easier for local places to do this. I know, however, that in the current financial climate this requires brave leadership both locally and nationally. 

"The announcements in October’s Budget present a significant risk to the VCSE sector"

The announcements in October’s Budget present a significant risk to the VCSE sector through the increase in employer National Insurance contributions and real living wage requirements. Some VCSE organisations across our place are reporting increased expenditure of up to £100,000 from April 2025. These amounts cannot simply be subsumed within existing budgets. An urgent conversation is needed about how we can mitigate these risks.

Some local places are managing to maintain investment in VCSE services despite working within these unprecedented financial constraints and I intend to talk to these places about how they are managing it. I also know that national conditions are hindering ability to act in line with ambitions. So, how we can work with national partners, agencies and policy makers to get this right?

Shifting funding and measurement

I read with interest both Lord Darzi’s review into the NHS and the government’s focus on three shifts from analogue to digital, from secondary to community care and from cure to prevention. While the focus has understandably been on the NHS, the role of a strong and stable VCSE is key to achieving these ambitions.

I firmly believe that we need the government and wider policy makers to show brave leadership, which, to me, means:

• a rethinking on funding formulas, to look at inequalities data to ensure areas like Bradford District and Craven are not left further behind (the Carr-Hill formula needs to be revisited)
• ensuring decision-making is devolved to places so they can decide how they can invest locally and ensure VCSE partners are part of this process
• reviewing how we measure improvements in people’s wellbeing, especially when working with VCSE partners, because access and performance data alone does not work when dealing with complex issues and lives
• a national drive to set up a community health investment standard, with enough financial headroom set aside for this and focusing on communities that are among the most economically challenged
• ensuring any national policy designed to shift care into community settings includes a period of co-production and design involving VCSE partners as well as those within the statutory health and care sector. 

This brave leadership isn’t just based on funding alone, it needs a rethink in how we measure the impact of VCSE services and wider partners that contribute to healthy communities and can help us locally work towards our vision of people living happily and healthily at home. 

Sam Keighley is VCSE sector lead for Bradford District and Craven Health and Care Partnership and chief executive of the VCS Alliance. You can follow Sam on LinkedIn