Betsi Cadwaladr University Health Board Third Sector Strategy

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1 Introduction The third sector is diverse in the range of population groups it serves and types of services it provides. This diversity is at the heart of the strength and value of the sector. The depth and breadth of the populations served. The sector s ability to reach, engage and innovate is a significant factor in contributing to effective partnership working and contributing to service planning and delivery. Betsi Cadwaladr University Health Board (the Health Board) recognise these strengths and values the role and independence of the sector, and through this strategy intends to put in place arrangements and mechanisms that will maximise the benefits of the relationship between itself and the sector for the people of North Wales. Purpose of Strategy This strategy sets out the Health Board s ambition to develop and strengthen its relationship with the third sector together with and the operational arrangements to be put in place for effective collaborative working, so as to enhance the lives of and improve outcomes for individuals, communities and the population of North Wales. To this end, the strategy aims to be is relevant to all third sector organisations whose purpose, aims and objectives support the health board to achieve its stated purpose. This includes organisations who receive funding from the health board as well as those who do not. The development of this strategy is in line with, and is intended to support the implementation of the Health Board s three year plan The Health Board s Three Year Plan The Health Board is required to develop and agree a three year plan by March 2015 which will set out how it will improve health and well-being for the population of North Wales. The Health Board recognises its clear leadership role to influence changes and to address inequalities in health and close the relative gap in health and well-being of our communities. Our vision is to create a healthier and fairer North Wales, that maximises opportunities for everyone to realise their full potential by; Changing the Health and Well-being model so that it places people and communities at the centre of what we do, with safe services tailored to their needs, provided as close to home as possible. Recognising the wealth of assets which all individuals and communities have. Through remodelling the way we plan and deliver public services we will create more equal relationships between those who use services and those who deliver them. Supporting the model of public services shared with our partners which creates more resilient people and communities with fairer access to all the resources, benefits and opportunities available. Supporting citizens to self-care with appropriate access to a range of planned, emergency and specialist services delivered in a network across North Wales. Shifting services away from hospital to become more preventative and community focussed. In order to achieve our vision the Health Board recognises the third sector as a key partner. 1 P a g e

2 The key health challenges facing North Wales are summarised below. The health of the North Wales population varies significantly by geography. This variation is strongly associated with the substantial variation in relative deprivation Socio-economic deprivation has significant impact on how healthy our lives will be. Across North Wales, 22,275 (19%) of children live in poverty The overall health status and healthy life expectancy of some groups remains particularly poor, including those who are homeless, traveller populations, people with mental health problems, those with physical and learning disabilities Our population is both growing in total number and ageing; the population of North Wales is predicted to grow from the current level of just under 700,000 to over 711,000 by 2020 Chronic and Long term conditions: data indicates that 5 of the most prevalent conditions in BCUHB are Hypertension, Obesity, Asthma, Coronary Heart Disease (CHD) and Diabetes. The above cannot be addressed by the Health Board in isolation and will require partners and individuals to recognise their role and contribution. In order to respond to the above, this will mean: Shifting our focus towards Prevention & Health Improvement and ensure a progressive realignment of services in this way. Strengthening Primary and Community Care with particular emphasis upon new models of care outside hospitals that move care and intervention close to peoples home Providing more-integrated care with our partners in Local Authority social services, with voluntary sector and working with Carers. Delivering planned changes to hospital based services over the next 3 years to ensure that the services that we provide are sustainable for the future. This information will inform the development of the priorities for working with the third sector over the next three years. Key Priorities for Working with the Sector To be completed What is the Third Sector? The third sector refers to community associations, self-help groups, charities, faith groups, voluntary organisations, social enterprises and housing associations. It is also sometimes referred to as the voluntary sector. The third sector is a key component of a fair and strong society, working with the public sector to create opportunities to work together to tackle issues in communities and provide a channel for groups to get their voice heard. The NHS in North Wales has a long history of working in partnership with voluntary and community organisations who make a major contribution to the shared agenda of prevention 2 P a g e

3 of ill health, provision of health, social care and well-being services and support for carers, vulnerable individuals and communities, bringing expertise and knowledge that is often unique. E.g. advocacy, carer support, service user involvement, supporting discharge from hospital. Each third sector organisation has its own aims, distinctive culture, set of values and way of doing things, but they all have important characteristics in common: Independent, non-governmental bodies Established voluntarily by people who chose to organise themselves Value driven and motivated by the desire to further social, cultural or environmental objectives, rather than simply make a profit and Committed to reinvesting their surpluses to further their social, cultural or environmental objectives The structures, forms, and legal identities of third sector organisations also vary considerably. They include unincorporated organisation, registered and unregistered charities, companies limited by guarantee (which may also be registered charities), and community interest companies, charitable incorporated organisations and Industrial and Provident Societies. The Third Sector in North Wales The WCVA third sector database suggests there are between 900 and 1200 third sector organisations providing health and social care services in each county of North Wales. The range of services include those for families, children and young people; older people; general health; specific health conditions, physical, sensory, learning disability; mental health; addictions; homelessness; black and ethnic minorities; carers. Many third sector organisations providing health and social care services do not receive public funding while for those that do it is of key importance as it may provide the core funding to enable them to function. In 2013/14 the Health Board spent 7.2 with the third sector across some 100 Individual organisations. A number of organisations exist in Wales to support the third sector: County Voluntary Councils (CVCs) There are six county voluntary councils across North Wales, each co-terminus with its local authority boundary. The CVC is an umbrella infrastructure organisation for the local third sector. Its key role is to provide comprehensive advice, information and support in relation to governance, effective management, funding and training for local third sector organisations. CVCs also facilitate the sector s relationship with local public sector organisations and are the mechanism for influencing the planning and delivery of local public services including representation to strategic partnerships and planning groups. 3 P a g e

4 Unllais Mental Health Agency Unllais is a development, information and training agency. It provides support to the voluntary sector, service users and carer organisations working in the field of mental health in North Wales. Through partnerships it seeks to promote good practice in the planning, provision and monitoring of mental health services. The Health Board currently provides funding to support this service across North Wales. Health and Social Care Facilitators The role of health and social care facilitators, based in each CVC was set out under the Welsh Government s Building Strong Bridges project in 2002 to strengthen partnership working between the third sector and other providers of health and social care services. The Health Board currently provides funding of 210,000 for 6 facilitator posts. They have a key role in supporting the delivery of strategic priorities with the sector and as a conduit for sharing information and knowledge between the sector and Health Board. Voluntary and Philanthropic Support Voluntary and Philanthropic Supporters are voluntary groups, external bodies and individuals which provide grants and donations to support the activities of the Health Board. Voluntary and Philanthropic Supporters often provide non-medical services to support the activities of the Health Board, examples of which include tea bars and shops on Health Board premises. In view of the fact that the demands on healthcare in North Wales are increasing, coupled with the reality that healthcare has long been supported by voluntary and philanthropic bodies, the Health Board recognises that it will not achieve its strategic aims without the valuable contribution made by: 1. The Leagues of Friends and other voluntary service groups 2. Supporters of the NHS charity in North Wales, Awyr Las Leagues of Friends and voluntary services have helped to support healthcare services for generations. Collectively these groups gave over 850,000 towards equipment, new facilities, special projects and patient comforts here in North Wales in 2013/14. NHS Charities have been in existence across the UK since the NHS was established in Fundraising groups, individuals and organisations together gave over 2,000,000 through Awyr Las, the NHS charity in North Wales in 2013/14. Development of the Strategy Five structured workshops with the sector were held to inform the development of the strategy as well as meetings with volunteers and the CVC facilitators. From the workshops there was agreement that the sector serves four key roles in its relationship with the health Board. 4 P a g e

5 1. A Strategic Partner - bringing its expertise; strength and diversity to contribute on an equal basis to the planning, shaping, decision making, and implementation of agreed local priorities 2. A Service Provider improving Health and Wellbeing outcomes by responding to local and diverse health and wellbeing needs 3. An Enabler of the Citizens Voice and Community Representation by encouraging and supporting local service users and citizens to inform planning and decision making by the Health Board 4. A source and support for volunteering and fund raising Strategic Priorities Feedback from the workshops identified the key principles of an effective working relationship rather than agreeing priority areas. A number of key factors were identified that need to be in place to ensure that a good partnership and joint working can be developed, maintained and monitored were: The sector being recognised as an equal partner and being involved in the planning and delivery of services Improved communication and engagement with and from the Health Board A detailed Commissioning Framework recognising the need and value in providing longer term contracts and funding to support the sustainability of the third sector Support to build infrastructure and capacity within the sector Accountability, Transparency, Governance and Scrutiny underpinning all transactions between the Health Board and the sector Access to a range of Health Board resources 1. Equal Partner We recognise that the sector s independence and autonomy makes it ideally placed to support and inform the Health Board in supporting actions to prevent ill health, promote wellbeing and encourage individuals be as active as possible in protecting and developing their own health and well-being as well as contributing to the planning and delivery of services, providing a voice for local people and communities. There is a need for the Health Board to have a more co-ordinated and joined up approach to ensure that the sector is more central to its planning processes and to ensure that the sector has appropriate opportunities to actively influence and monitor the strategic direction of service delivery. We will therefore ensure that effective partnership arrangements are put in place that improves the planning, design and delivery of services responsive to local needs. This will include embedding engagement of the third sector in key health board structural and process arrangements, actively promoting and maintaining the role of the third sector within the Health Board as an equal strategic partner to enable it to contribute to the design and 5 P a g e

6 delivery of services and supporting the sector in delivering the preventative and well-being agenda. We will develop and publish forward work plans to inform, secure and ensure engagement of the sector in the Health Board s operational and strategic planning. 2. Communication and Engagement We will engender a better understanding within the Health Board of the role; scope and potential of the sector to support it deliver its priorities for the area. We will ensure timely and improved communication with the sector and also identify ways to make it easier for the sector to communicate with us by having a clear communication plan in place, identifying and publicising the names and contact information of leads within the health board and generally raise awareness of the sector with our staff and managers. 3. Commissioning and Funding We recognise the added value of commissioned services from third sector Organisations and will actively consider the option, wherever practical, of using the sector as a means of delivering services supported by longer term agreements and funding where appropriate. We will develop clear processes for communicating timely, local priorities and processes for commissioning and grant funding of services. Wherever possible and practical we will develop our commissioning and grant funding intentions jointly with our Local Authority partners. Where the Health Board decides to de-commission services provided by the third sector it will be in line with an agreed de-commissioning procedure. We will develop and publish a commissioning and grant funding framework, based on best practice and Welsh Government guidance that, with our Funding Code of Practice, will clearly set out the arrangements the Health Board will follow in grant funding and tendering for services. Where we commission or grant fund services, performance monitoring will be based on proportionality and risk and the requirements will be clear and up front. 4. Infrastructure and Capacity We recognise the need to maintain and enhance the capacity of the sector to support the partnership working and to maximise the benefits of the relationship. We will work with the CVCs, Unllais and individual organisations, to identify and address development and support needs and consider how the Health Board s internal resources and expertise can be harnessed to meet these needs. We will continue funding for the 6 CVC based Health and Social Care Facilitators until March 2016, and evaluate their role as the key links between the Health Board and the sector and consult on the preferred model for these posts during Governance and Scrutiny We will ensure that appropriate governance and scrutiny arrangements to oversee the implementation of this strategy and associated actions are established, so that the board is sighted on the partnership with the sector and can oversee and scrutinise operational and 6 P a g e

7 relationship issues as necessary. The establishment of the Health Board s Strategy, Planning and Partnership Committee will ensure that implementing this strategy is supported by the Health Board at the highest level. We will review and update as necessary the Compact agreed with the six CVCs in 2011, during 2015, and seek to enter into tri-partite county based compact agreements with local authorities where practical. 6. Resources We will maintain the current level of funding invested in the sector and aim to increase this as we are able to over time from the 7.2 million in Working together we will seek to access alternative sources of funding (big lottery/comic relief) to support priority areas. We will also work with Awyr Las charity to fund identified projects and initiatives that the sector can deliver, and explore opportunities to provide support in kind through access to training accommodation and specialist advice and support where required to meet our needs. Awyr Las will take the lead role in working with and supporting the various Leagues of Friends and other fund raising groups that support the Health Board. 7. Voluntary and Philanthropic Supporters The financial support from these groups and supporters makes a significant impact on healthcare services, but these groups and individuals activities also present many more benefits. Members of the Leagues of Friends and other groups voluntarily invest a great deal of time and energy in providing additional services and organising fundraising initiatives and events. The Health Board greatly values the significant financial and non-financial support that these groups provide. Through this strand of its third sector strategy, the Health Board aims to formalise its commitment to: Recognise this support Develop existing partnerships with voluntary and philanthropic Supporters Safeguard this support The objectives of this strand of the strategy are to: 1. Ensure members of groups and those who provide support individually feel appreciated, respected, supported and involved 2. Make sure staff and the general public are aware of the valuable contribution that these groups make 3. Ensure that the impact of these groups continues to be felt by patients and their families, both through the provision of a high standard of service provided by these volunteers and also through the grants that these groups make 8. Health Board Volunteering and Fundraising Activities 7 P a g e

8 We will increase the number of volunteers we have and ensure we have the necessary capacity in place to support safe recruitment, training and development and have effective communication in place to support current and future volunteers. 9. Implementation The Assistant Director-Community Partnership Development, working with the Health and Social Care Facilitators, will be responsible for developing an action plan to ensure the strategy is implemented. The action plan will be developed in consultation with the third sector, and progress will be monitored by the Health Board s Strategy, Planning and Partnership Sub-Committee and reported to the sector periodically. 8 P a g e

9 Appendix 1 Action Plan Strategic Priorities Equal Partner We recognise that the sector s independence and autonomy makes it ideally placed to support and inform the Health Board in supporting actions to prevent ill health, promote well-being and encourage individuals to take responsibility for their own health as well as contributing to the planning and delivery of services, providing a voice for local people and communities. There is a need for the Health Board to have a more co-ordinated and joined up approach to ensure that the sector is more central to the planning processes and to ensure that the sector has appropriate opportunities to actively influence and monitor the strategic direction of service delivery. We will therefore ensure that effective partnership arrangements are put in place that improves the planning, design and delivery of services responsive to local needs. This will include embedding engagement of the third sector in key health board structural and process arrangements, actively promoting and maintaining the role of the third sector within the Health Board as an equal strategic partner to enable it to contribute to the design and delivery of services and supporting the sector in delivering the preventative and well-being agenda. We will develop and publish forward work plans to inform, secure and ensure engagement of the sector in the Health Board s operational and strategic planning. Action Lead Timescale Status (RAG) 1 Actively promote the third sector within the Health Board as an equal partner 2 Develop a generic representative job description, defining the role and responsibility requirements ensuring equal status and accountability 3 Develop a 2 way process to disseminate and receive information/feedback 4 Develop and publish a forward work programme to inform the sector and ensure 9 P a g e

10 involvement and engagement. 4 Enable third sector organisations to attend and contribute to local planning groups/fora 5 Provide support for representatives Communication and Engagement We will engender a better understanding within the Health Board of the role; scope and potential of the sector to support it deliver its priorities for the area. We will ensure timely and improved communication with the sector and also identify ways to make it easier for the sector to communicate with us by having a clear communication plan in place, identifying and publicising the names and contact information of leads within the health board and generally raise awareness of the sector with our staff and managers. Action Lead Timescale Status (RAG) 1 Work with the sector to understand what information they want, the frequency and preferred channel of communication 2 Develop a programme of actions to address the communication needs identified above 4 Publish a timetable of events (e.g. meetings with CVC Chief Officers) to ensure openness, transparency and access to individuals 5 Raise awareness within the Health Board of the different third sector organisations and services available in the area 6 Identify and communicate the names of lead officers and contact point for the third sector for Planning Commissioning Support (accommodation, training etc.) 10 P a g e

11 Volunteering and Fund Raising 11 P a g e

12 Commissioning and Funding We recognise the added value of commissioned services from third sector Organisations and will actively consider the option, wherever practical, of using the sector as a means of delivering services supported by longer term agreements and funding where appropriate. We will develop clear processes for communicating timely, local priorities and processes for commissioning and grant funding of services. Wherever possible and practical we will develop our commissioning and grant funding intentions jointly with our Local Authority partners. Where the Health Board decides to de-commission services provided by the third sector it will be in line with an agreed de-commissioning procedure. We will develop and publish a commissioning and grant funding framework, based on best practice and Welsh Government guidance that, with our Funding Code of Practice, will clearly set out the arrangements the Health Board will follow in grant funding and tendering for services. Where we commission or grant fund services, performance monitoring will be based on proportionality and risk and the requirements will be clear and up front Action Lead Timescale Status (RAG) Commissioning 1 Identify and adopt best practice guidelines for commissioning processes 2 Develop a clear process for agreeing the local priorities for commissioning services 3 Develop our commissioning intentions in partnership with our stakeholders and partners 4 Agree standard documentation to be used when commissioning in partnership Decommissioning 5 Adopt best practice guidance in relation to decommissioning services 6 Develop a clear process for the decommissioning of services 12 P a g e

13 Funding 7 Refresh the Health Board s Funding Code of Practice for third sector organisations in line with the Welsh Government Third Sector Strategy Recognise the value of investing in longer term agreement and funding arrangements with the third sector 10 Develop and publish a Funding Framework (grant funding, core funding, commissioned services) 11 Develop a decision making tool to support the Funding Framework to enable decision makers to use the appropriate funding mechanism 12 Refresh and publish the Health Board s grant funding process Performance Management 13 Develop a Performance Monitoring Framework based on of the following four areas 1. Service Delivery 2. Governance Adopt the Healthcare Standards as an audit tool 3. Quality Recognise the value of externally validated quality marks 4. Sustainability 14 Develop a standard contract compliance checklist 15 Develop a matrix of risk & proportionality to support to define the level of reporting required including the funding stream (contract/core funding/grant) Tendering 16 Identify and adopt the best practice principles for tendering of services 13 P a g e

14 Infrastructure and Capacity We recognise the need to maintain and enhance the capacity of the sector to support the partnership working and to maximise the benefits of the relationship. We will work with the CVCs, Unllais and individual organisations, to identify and address development and support needs and consider how the Health Board s internal resources and expertise can be harnessed to meet these needs. We will continue funding for the 6 CVC based Health and Social Care Facilitators until March 2016, and evaluate their role as the key links between the Health Board and sector and the preferred model going forward. Action Lead Timescale Status (RAG) 1 Work with the sector to understand what their infrastructure and capacity needs are 2 Develop a programme of actions to address the needs identified above 3 Develop in partnership with the third sector a relevant training/information awareness programme for contracted organisations 4 Promote the third sector within the Health Board as an equal partner 5 Support the third sector representative to feedback to the sector 6 Support third sector organisations to collaborate 7 Review the role and functions of the CVC Facilitator Health Board funded posts 8 Ensure the new structure in the Health Board recognises the need for local and regional lead officers to ensure implementation of the strategy and action plans. 14 P a g e

15 Governance and Scrutiny We will ensure that appropriate governance and scrutiny arrangements to oversee the implementation of this strategy and associated actions are established, so that the board is sighted on the partnership with the sector and can oversee and scrutinise operational and relationship issues as necessary. We will review and update as necessary the Compact agreed with the six CVCs in 2011 and seek to enter into tri-partite county based compact agreements with local authorities where practical. Action Lead Timescale Status (RAG) 1 Ensure that responsibility for third sector relationship management is clearly embedded within the new structure and the responsible Director has been identified 2 Create an open and transparent governance structure within the Health Board which will support and monitor the implementation of the third sector strategy and scrutinise other third sector issues. 3 Review the Compact to ensure it is fit for purpose 4 Strengthen the Health Board relationship with the County Voluntary Councils 5 Develop tri-partite county level compact arrangements where possible 6 Develop a process to for escalating concerns and risk management with Local Authority Partners 7 Agree a point of contact on all sites for agencies to apply to have a presence in Health Board premises, and the minimum standards required to receive endorsement (if they are seen on our premises then they are seen to be endorsed by the Health Board) 8 Develop a process and governance arrangements for agreeing to support third sector Agencies which are not directly commissioned/funded by the Health Board (Grant in Aid) 15 P a g e

16 Resources We will maintain the current level of funding invested in the sector and aim to increase this as we are able to over time from the 7.2 million in Working together we will seek to access new sources of sustainable funding (big lottery/comic relief) to support priority areas. We will also work with Awyr Las charity to fund identified projects and initiatives that the sector can deliver, and explore opportunities to provide support in kind through access to training accommodation and specialist advice and support where required to meet our needs. Awyr Las will take the lead role in working with and supporting the various Leagues of Friends and other fund raising groups that support the Health Board. Action Lead Timescale Status (RAG) 1 Over time to increase the amount of funding spent by the Health Board for commissioned and grant funded services from the sector 2 Explore opportunities to provide support through access to training and accommodation 3 Working together to access new sources of funding (big lottery/comic relief) 4 Agree the process for supporting externally funded opportunities (big lottery/comic relief) working with agencies to submit bids based on Health Board priorities etc. 5 Develop a third sector Glossary of Terms to ensure consistent use and understanding 6 Explore the potential to work more closely with Awyr Las charity 7 Work with Awyr Las charity to fund identified projects and initiatives that the sector can deliver. 8 Awyr Las will take the lead role in working with and supporting the various Leagues of Friends and other fund raising groups that support the Health Board 16 P a g e

17 Voluntary and Philanthropic Supporters The financial support from these groups and supporters makes a significant impact on healthcare services, but these groups and individuals activities also present many more benefits. Members of the Leagues of Friends and other groups voluntarily invest a great deal of time and energy in providing additional services and organising fundraising initiatives and events. The Health Board greatly values the significant financial and non-financial support that these groups provide. Through this strand of its third sector strategy, the Health Board aims to formalise its commitment to: Recognise this support Develop existing partnerships with voluntary and philanthropic Supporters Safeguard this support Action Lead Timescale Status (RAG) 1 Identify how different groups believe they can best be supported by the Health Board Improve working relationships between the groups and the Health Board and ensure more strategic planning for communications, support provided and volunteer recruitment. Identify how communication channels and support within the Health Board can be better managed, to ensure that the implementation of the strategy is effective and inclusive. Improve internal working relationships within the Health Board and ensure more strategic planning for communications, support provided and volunteer recruitment. Identify strengths and weaknesses of the plans and ensure support resources are effectively allocated. Identify how the Awyr Las Fundraising Strategy can complement the activities of the Voluntary and Philanthropic Supporters Ensure that the Awyr Las Fundraising Strategy complements the activities of the Voluntary and Philanthropic Supporters and underpins the strategic priorities of the Health Board 17 P a g e

18 Volunteering Action Lead Timescale Status (RAG) 1 We will increase the number of volunteers we have and ensure we have the necessary capacity in place to support safe recruitment, training and development and have effective communication in place to support current and future volunteers 18 P a g e