By Warren Escadale, Acting Chief Executive, Voluntary Sector North West
This is a momentous time for Greater Manchester. The details about control over £6bn of current health & social care spend are about to be announced. What happens in Greater Manchester could set the tone for devolution in England and should act as a clear signal to the voluntary and community sector in England to take this agenda seriously.
The emphasis on health and social care – in many ways our sector’s core business – could be very good news. Rather than the loss of this agenda, this could be where health and social care connects to and influences a growth agenda. Growth with a wellbeing focus, attuned to population health and population approaches, determined to tackle health inequality, with a sophisticated understanding of the connections between life expectancy, confidence, career and happiness, could represent something far beyond the simple integration of services.
My hope is that this model of devolution means that ‘wellbeing’ (individual and collective) is given a central role. So, for example, when there are conversations about how the Work Programme works, there should be a focus on wellbeing and jobs: wellbeing creates the confidence and journey that gets a job, gets a career, that creates happiness, and that builds community. I also hope that key tenets, like those outlined in NHS England’s Five Year Forward View about “a new relationship with patients and communities”, are cherished and championed.
However, greater thought needs to be given to how the voluntary and community sector operates across these new emerging territories – apparently there are 40 Combined Authorities in the pipeline, including many counties. We need to make effective, collective strategic offers connected to and influencing emerging models and structures. While I’m not sure I’m advocating a series of mini-constitutional conventions in every devolved patch, democracy, accountability and genuine consultation do need serious consideration. Obviously, I want more community involvement, a fuller role and broader partnership with the voluntary and community sector, a greater emphasis on social action and investment in the right VCS infrastructure.
In the immediate future, I think local HealthWatch CEOs and Chairs, VCS reps on local Health and Wellbeing structures, leading local and specialist VCS infrastructure agencies and lay representatives on CCGs need to think about how the people and communities they work for are more intrinsically involved in the future of their local devolved world.
Let’s not wait for devolution to come to us. That could well be the wrong kind of devolution!