Voluntary, community and social enterprise mental health services

The voluntary, community and social enterprise (VCSE) sector is an important partner for health and social care agencies and makes up a significant part of the UK economy, with 153,000 registered charities and £53bn of income.

Alongside this, mental health provision has become more important than ever as people have struggled to cope with the pandemic – all at a time when the sector has had to cope with considerable change.

This week GGI and the Association of Mental Health Providers (AMHP) staged a joint event to engage senior sector leaders in a discussion about the impact of the health and social care white paper on the sector, equality and diversity and lived experience in the board room. Today we explore these key success factors for the sector.

Two white papers

The mental health VSCE community is reacting to two white papers at the same time: the health and social care white paper and the reform of the mental health act white paper, which is designed to give the individual more power in decision-making about their care.

The health and social care white paper has less of a guaranteed mechanism to involve the VCSE sector, so collectively there is work to be done to ensure membership. We need to think differently, starting from the perspective of the individual and the care delivery outcomes we desire. There is currently a focus on existing structures but if we really want to make a difference, this needs to be turned on its head.

Population health

Both white papers talk about communities but the focus on place has been underplayed. If we want a population approach to mental health and wellbeing it's critical to start with communities and the VCSE sector has the best connections and engagement there.

If information is knowledge and knowledge is power, we think there is also a real opportunity for VCSE to share population outcomes information with the health providers. The white papers remove some of these barriers and could be the levers for VCSE to harness the opportunity.

The challenge? VCSE organisations aren’t part of the proposed NHS board in the health and social care paper, only potentially in the ICS partnership boards, which may not be as influential. The answer? For VCSE organisations to work together to ensure the community voice is heard in local decision-making.

Collaboration

Organisations challenged each other to stop being so competitive, despite in some circumstances chasing the same money. Instead, they should collaborate and learn from each other to improve outcomes for individuals.

The health and social care white paper states that “the NHS and local authorities will be given a duty to collaborate with each other.” So, should the VCSE mental health sector be calling for a statutory duty to be included in collaboration within the sector to deliver the best results?

We should take a strategic and pragmatic approach to getting the voice of those the VCSE sector are involved with through the door. Enabling the voluntary sector in there, not just being around the table but with an aim, could bring huge benefits. For example, the VCSE sector has excellent links with lesser-heard voices, such as young people, and could bring these to the decision-making process.

Lived experience and diversity

The government and the NHS are prioritising equality diversity and inclusion across public services and this has become more apparent in the past year. The importance of having both lived experience and diversity among board members has been shown to improve results in both the private and public sectors. A principal concern during the pandemic is that trustees could be less engaged as they have been unable to visit services and meet staff.

A question raised was whether governance is the right place to think about lived experience and diversity. We believe it is. Why? Because boards are the collective minds of organisations and the decisions they take impact a diverse community of people.

The reform of the Mental Health Act white paper states: “Black people should not be treated less favourably than people from other groups – whether in mental health services, by the NHS or by public services as a whole. […] Although many of the changes set out in this White Paper will have a positive impact on people from black, Asian and minority ethnic groups, the scale of disparity that exists means that specific targeted interventions will also be vital.”

There is considerable change ahead for the sector, which presents opportunities to work more innovatively and flexibly, to collaborate more closely, and to build symbiotic relationships and boards with more diverse experience. Now is the time to reinvent mental health services with improved outcomes for every individual.

Illuminations

• The VCSE mental health sector is an important link to local community voices. For either white paper to succeed, the sector should be around the top table.
• Collaboration is key. More voices, collectively, are more likely to shift local and potentially national decisions that will benefit patients and communities.
• Leadership is at the heart of good governance and for VCSE mental health organisations to be successful, they must be representative both in terms of lived experience and diversity.
• Leaders must create routes to senior positions – mentoring could support this.

If you have any questions or comments about this briefing, please call us on 07732 681120 or email advice@good-governance.org.uk.