Third Sector Research Forum - Scottish Government, devolved 第三部门研究论坛-苏格兰政府，权力下放

Third Sector Research Forum - Scottish Government, devolved 第三部门研究论坛-苏格兰政府，权力下放 Third Sector Research Forum MinutesthMonday 30 January 2012 St Andrews House Present Geoff Pope, SG Kay Barclay, SG Jenny Long, SG Dave Cruickshank, SG Stephen Osborne, Edinburgh University Ruchir Shah, SCVO Sandy Watson, SE Duncan Thorp, SES Gillian Miller, Big Lottery Fund John Lee, VDS Jonathan Coburn, Social Value Lab Mike Woolvin, SAC Patricia Lozano- Casal, ESS Apologies George Eckton, COSLA Carolyn Sawers, Big Lottery Steven Marwick, ESS Linda Boyes, ACOSVO Jane Holligan, OSCR 1) Welcome and Introductions Geoff welcomed the group and noted the change in direction of the forum to a policy theme approach whilst still functioning as forum that will meet to share research activity and findings. 2) Summation of the health and social care briefing paper Feedback from Laura Major on production process (Kay Barclay) Kay highlighted the excellent job that Laura had done to a very tight timescale; involving intensive reading and analysis of a vast amount of data and evidence; covering an area that was entirely new to her and writing up a high quality paper in an appropriate style.She noted the risk in taking on an intern with limited knowledge of the third sector area but that Laura had got quickly up to speed. The main challenges to consider in future are time and capacity required to do a paper due to the volume of literature that must be read and analysed. She also noted that the forum’s role in the exercise had been quite limited and their input was largely through a) identifying some literature and b) through their discussion of the issues in the workshop. However, the bulk of the work had been done by Laura (with input and support from Kay). 1 It was generally agreed that Laura had also produced a useful paper summarising the state of the evidence base and highlighting the most robust evaluative examples. The forum as a whole was extremely positive and felt that it had been a useful exercise and one that could be repeated in future. Key factors in the success of the work were: •Ensuring that the work was linked to an outcomes focus •Linking the work to timely policy events to ensure that it would have an audience •Having an analytical and critical approach •Offered a balanced perspective: although promoting the benefits of working with the third sector it also noted some of the challenges and the barriers •Was also honest about the limitations of the evidence base. Areas for improvement •Tighter focus of the brief (very broad topic area and not clear where the boundaries lie) Policy Feedback from Jenny Long (Health and Social Care Directorates) Jenny Long gave very positive feedback on the paper and noted that it had been very well received by the Quality Alliance Board (QAB). She explained how the paper fed into policy work in the Health and Social Care Directorates. The paper had been used to support the work of the QAB in delivery of the NHS Quality Strategy. This included work that Jenny was doing to review how Government can improve engagement with the third sector to enhance health outcomes. Following on from this the QAB endorsed three short-term actions to support longer-term change : 1. Develop and implement an accessible resource to improve mutual understanding of public and third sectors, and promote the benefits from working with the third sector.2.Increase engagement between key NHS Board members, including Chief Executives, Chairs and Non-Executive Directors, and the third sector beginning with facilitated dedicated sessions throughout the year. 3.Develop, test and spread use of Community Benefit Clauses within the NHS.The full recommendation report from the Quality Alliance Board Working Group to which the Evidence Briefing Paper was annexed is attached below. Jenny also emphasised the importance of the larger context of Christie Commission which identifies an increasingly important role for the third sector around the four pillars of reform 1(people, prevention, partnership and performance). The following points were made: •The style, layout and content of the document was appropriate for the audience: the Quality Alliance Board and health policy officials, and well received by it (Derek 1 See Renewing Scotland's Public Services - Priorities for reform in response to the Christie Commission 2 Feeley, DG Health and Social Care and Chief Executive NHSScotland, was particularly positive and drew attention to the importance of different types of evidence not just economic impact data) •Covered both quantitative and qualitative research and critically evaluated it. •Drew attention to the importance of analytical approach •Lay out was good, especially the clear links to the Quality Outcomes •Length – perhaps a little long (the shorter the better for a policy audience) Jenny suggested there could now be scope to build on this work for example by focussing on one particular aspect in greater depth and this could be of use to Chief Execs in Health Boards. Dissemination Jenny highlighted importance of getting the paper disseminated to the right people to ensure that it falls into their hands and they pay attention to it. A big challenge is getting Chief Execs of Health Boards. Kay noted that there may be an opportunity to attach to another briefing that Gareth Allen is circulating to Health Boards. Update The paper has been published on Third Sector Division’s website ;s website. 3) Research Forum: Forward planning There was discussion around whether the Forum would do a second paper covering another policy area or theme. The following suggestions for future papers were made: •Prevention/ preventative spend (to address what evidence says in relation to the assumptions around prevention and challenges associated, how to measure and evaluate it) •Co-production •Innovation in service delivery •Low Carbon Economy – and how the third sector fits in •Rural third sector •Personalisation •Role of third sector in culture, sport and health •Employability •Developing markets •Social Finance •Reducing Reoffending Change Fund Clearly, there is no shortage of ideas however the challenge is in finding the time and resources to take these forward (see later). 3 In relation to the Reducing Reoffending Change Fund, a briefing paper would help to support work in this area with colleagues in Justice to be produced by May. Kay and Geoff will take this forward with support from forum members, Patricia from ESS, Gillian from Big Lottery and Ruchir from SCVO. It was also suggested that it would be helpful to look at cross governmental agendas (Public Service Reform Board). Action point- Kay and Geoff to take forward the Community Justice work; Kay and Geoff to follow up on cross governmental priorities with Gareth Allen and Cross Directorate Group Update: Kay and Geoff are working with the Robertson Trust, ESS and Big Lottery to thtake this forward. First meeting to take place on 13 March. 4) Resources The forum discussed how best to resource doing more of this type of work given work loads and time limitations. Research interns / research students hosted by forum members’ organisations over the next year might be a possible solution. Members identified their existing plans that might be helpful: 1) SCVO (Ruchir Shah) is hosting a post MSc internship student (in conjunction with a Norwegian University) to do some research on the contribution of third sector to the economy. The exact focus is yet to be finalised but there would be scope for linking in with this work and it’s output. 2) Scottish Enterprise also host interns throughout the year. Sandy Watson has advertised for a third sector project without success. Any theme here would need to have a business element to it. 2) Stephen Osborne can apply for funds from The Knowledge Exchange Transfer Team at Edinburgh University for small research projects (to be conducted by a researcher at the University that Stephen would nominate) so long as the topic is relevant to university research interests. Stephen will pursue this to fund a paper on co-production.Action point: Members to pursue internship possibilities and feedback to the forum.Update: Stephen is exploring some money for a paper on “co-production”; Gillian Miller is exploring the option of getting an intern into Big Lottery. 5) Collaborative approach to developing a Strategic Research ProgrammeKay introduced the SG proposal to take forward a collaborative approach to research planning and delivery. The Local Governance and Reform Analytical Unit in SG (where Kay is based) are aware of potential in developing stronger partnerships with key third sector stakeholders, researchers and academics to work together to identify research questions and priorities and identify collaborative solutions to conducting and resourcing research projects. She asked the forum if they felt there would be merit in developing collaborative approaches over and above what is already happening within the forum, and if members were interested in being involved. She explained that the approach would involve making links with the right people and then inviting them to a workshop (or series of workshops) at some point this year. 4 The forum were broadly supportive of the principle. The following points were raised in the discussion: •Important to be aware of the difference between research that covers generic third sector issues and research on specific themes in which third sector plays a role but where it is not the specific focus of study. Danger of the work slipping into the latter area •Would prefer to keep the forum as it is now and not increasing the membership so not something that members could see the current forum developing into as felt it would be too unwieldy. •Understood the desire to make linkages with academia but doubted academics would want to attend research forum meetings. •A number of existing collaborations were identified (listed below) and it was evident that there is scope to embed and align with existing work rather than starting anew. •Another suggestion would be to use the research forum as a “core” and make links to a broader group of stakeholders and researchers. Existing / developing collaborations: 1) CEiS and Hunter Centre for Social Innovation (Jonathan Coburn) are establishing a research collaboration to bring together research expertise in order to tackle intractable social problems in Scotland, and address the big public service challenges; and to use a stronger evidence base to kick start new approaches. This is currently in the design phase; the aim is develop the evidence base in a collaborative way through Knowledge Exchange and by bringing partners in on a project by project basis (both researchers based in universities and others with direct links into the third sector). There is scope for SG to link in with this work. Action point: Kay and Geoff to follow up with Jonathan 2) TSRC- SCVO research conference (Stephen Osborne and Ruchir Shah) is planned for autumn 2012 could provide an opportunity to develop or launch SG involvement and provide a venue for an initial workshop as many researchers and academics with Scottish third sector interests will be present. Action point: Kay to link in with Stephen and Ruchir 3) It was noted that some developing research papers in line with joint interests via research interns and students as noted above were in the spirit of this type of collaboration.6) Third Sector Employment in Scotland (Dave Cruickshank) Dave Cruickshank, statistician from Local Governance and Reform Analytical Unit presented some new data (from the Annual Population Survey) on third sector employment figures ndwhich were published on the SG website on 22 February. This data will also start to be published in the regular August update of APS data. It is planned that the workforce data will also be included in the proposed SG Quantitative Data on the Third Sector Briefing paper (see later). 5 The APS boosts the sample of the Labour Force Survey sample in Scotland and brings the sample up to 21,000 therefore increasing the reliability of the data. The data shows that there has been an increase in third sector employment of 31% to 79,400 in 2010 from 60,700 in 2004. The increase has been constant year on year (apart from in 2009 when there was a slight reduction) Dave highlighted the fact that the data only goes up to 2010 and therefore does not capture the latest trends. UK figures are however showing a reduction in third sector employment in the year to the end of June 2011 and it is anticipated that the Scottish statistics will start to demonstrate a reversal in the next There was discussion around the differences between the APS survey and the findings from SCVO panel survey which quotes a considerably higher figure (137,000 paid staff). It was highlighted that the two figures cannot be directly compared as they relate to different things. The APS survey provides a robust estimate of the number of people employed in the third sector. SCVO use the panel survey to estimate the number of jobs available in the sector. As workers may have more than one job in the sector this will include a degree of double counting regarding workforce statistics. The differences in data sources and methodology will also account for some of the differences in the figures. Further details on the APS data and methodology are available in the ‘Local Area Labour Markets in Scotland’ publication: Link to the third sector employment statistics: ) Research Updates Members provided a summary of their research updates Big Lottery Fund (Gillian Miller) 1) BLF are looking into thematic areas of our funding to identify the impact of the projects they have funded in these areas. Currently they are looking at employability projects and will be looking at parenting in the near future. 2) BLF are also looking into particular investment areas in more depth: Investing in Communities Life Transitions programme – to explore what works well in helping people move past challenging times and to identify interventions that have high potential in terms of both impact and scale and outline what is needed to enable this potential to be realised. They are also hoping to identify ‘best practice’ interventions and seeking to investigate the potential scalability of the projects identified as ‘best practice’. 2) Ongoing evaluation of our Our Place programme. This programme is still in progress but we are keen to capture learning along the way as this is a new approach to investing lottery funding based on priorities set by local need. Scottish Agricultural College (Mike Woolvin) 1) Mapping charities in urban and rural Scotland The project, undertaken in partnership with VDS, has used OSCR data to map the distribution of charities across Scotland, and the ways in which their purposes and scale of 6 operation might vary across urban and rural areas. It also explores the influence of deprivation on charity distribution. Results will be published in the form of the ‘Rural Scotland in Focus 2012’ report, associated Rural Policy Centre briefings, and through events and publications led by VDS. 2) The Benefits and Challenges of the Coproduction of Health and Social Care Services in a Rural Context This workshop was hosted by SAC with the JIT towards the end of 2011. It drew together representatives from research, policy and practice to examine the role of the third sector in the co-production of health and social care services in rural areas. A summary report, published via the Rural Policy Centre, can be found here. 3) Governance and decision making for community empowerment in rural communities.As a Main Research Provider, SAC has been commissioned by the Scottish Government to deliver a five year programme of work exploring governance and decision making for community empowerment in rural communities in collaboration with the James Hutton Instutue (JHI). Now nearing the end of the first full year of work, a two page summary of the project can be found here. Research includes work in Dumfries and Galloway (in collaboration with Dumfries and Galloway LEADER) to explore the changing nature of community resilience. 4) Low carbon rural economy. Similarly funded to the above, SAC has also been commissioned to undertake research into the ‘low carbon rural economy’ (two page summary available here). This will also run for five years and is nearing the end of its first year. As part of this, members of Rural Society Research are involved with undertaking a ‘governance assessment’ which will explore new and existing ways governance and institutional frameworks of relevance for transition a low carbon rural economy. This will include examining the role of communities and third sector organisations (two page summary available here). 5) Does place matter? Exploring drivers for volunteer participation SAC jointly supported a Research Workshop ‘Visualising Volunteering: Does place matter? Exploring drivers for volunteer participation’ with VDS, AQMeN and the University of Stirling ndwhich was held on 22 February at VDS, Stirling (see VDS entry below). Social Enterprise Scotland (Duncan Thorp) Social Enterprise Scotland is planning to commission a large-scale mapping research study of social enterprises in Scotland this year, in partnership with Social Firms Scotland and Senscot. HiE have commissioned GEN to conduct a mapping exercise of social enterprises across the Highlands and Islands and SES is waiting until these results are produced before they commission a study for the whole country. ESS (Patty Lozano-Casal) 1) Reversing the Trend is a partnership programme between Evaluation Support Scotland and the Lloyds TSB Foundation for Scotland’s Partnership Drugs Initiative, with the support of the Scottish Government. The aim of the programme is to identify the outcomes and evaluation tools for preventative and diversionary approaches in community based youth 7 organisations in relation to substance misuse. ESS is working with a group of youth organisations to draw from ‘on the ground’ practice and taking a ‘learning set’ approach. This means they harness the expertise of practitioners (and young people), and test it, make sense of it and write it down simply so that others can also learn. They want to help policy makers and funders better understand the purpose and outcomes of diversionary projects – and to help this sector get to grips with evaluation. 2) ESS has established a Reference Group to: 1.Help ESS and PDI review the emerging learning about outcomes and evaluation and provide a critical ‘sense checking’. 2.Provide views on the extent to which our emerging learning reinforces, adds to or contradicts other evidence. 3.Advise on good ways to share our learning with all stakeholders with an interest in this area including the wider third sector, Alcohol and Drug Partnerships and commissioners. VDS ( John Lee) Recent & current projects 1.Third Sector Internship Scheme project: Case studies with 10 volunteer involving organisations looking at their use of information to help achieve outcomes through improving day to day management and support of volunteers 2.Case studies: exploring volunteers experiences of different group/organisational contexts and motivations for getting involved. 3.Volunteering in Scottish Charities Survey 2011. Representative sample (location, local geographic spread of operation, income) of 1000 charities taken from OSCR charities register. Emphasis was on local charities who carry out activities. Received 60% response rate. Survey seeks to understand whether there are challenges on the ‘opportunity’ side of volunteering within charities, asking about challenges currently faced in relation to capacity to engage and support volunteers, views on challenges for the future. Keen to understand whether there is a pattern regards type of challenges and location or area of activity. Analysis of data will begin in February. 4.TNS Omnibus survey (representative sample 10000) aims to fill in some gaps from the SHS, seeking to identify: a.Willingness to volunteer amongst those who volunteered in the past but stopped, or who’ve never volunteered b.Willingness of those currently volunteering to contribute more time c.Shifts in commitment in terms of hours given 8 d.Number of organisations or groups people volunteer for e.What sector (public/private/voluntary) people volunteer for Analysis of data will begin in February. Future projects 5.Extending Charities survey to groups and organisations who involve volunteers but are not registered charities, in particular ‘under the radar’ volunteer led groups.6.Volunteer Scotland User Survey (Feb/March) – with 2000 + registered site users. Seeking to understand what sparks people’s motivation to search for opportunities via website or VC/Interface, rather than going through ‘word of mouth’/existing networks, the ease of accessing opportunities via an ‘intermediary’ channel such as Vol Scotland.Events VDS hosted an event: ‘Visualising Volunteering: Does place matter? Exploring drivers for ndvolunteer participation’ on Wednesday 22 February. Funded by the Applied Quantitative Methods Network (AQMeN), the workshop was organised by Volunteer Development Scotland (VDS), the University of Stirling, and the Scottish Agricultural College (SAC).The workshop explored what analysis of existing quantitative data can tell us about spatial variations in volunteering, supported by short ‘response’ presentations and afternoon workshops identifying the implications of this and what further research would be beneficial to policy and practice. A summary of the day can be found here, and additional outputs will follow shortly. Edinburgh University Business School (Stephen Osborne) 1) Third Sector Longitudinal Study Opportunities and Challenges of the Changing Public Services Landscape for the Third Sector in Scotland: A Longitudinal Study: Year Two Report ndfor the Scottish Government (publication date 22 Feb) 2) Stephen has research students covering the following areas: •Community resilience •Co production through asylum seekers •Social networking and the changing nature of philanthropy •Innovative capacity of philanthropy. Social Value Lab (Jonathan Coburn) Developing Markets - Survey of Public Service Commissioners exploring attitudes to buying from the third sector, the use of Community benefit clauses and Public Social Partnerships, support needs and opportunities to build better relationships with the third sector.SCVO (Ruchir Shah) 9 Financial panel survey is under review following OSCR’s recent analysis. SCVO will be collaborating with NCVO to share tools and software enabling SCVO’s data to be synchronised with UK data. Scottish Enterprise (Sandy Watson) Scottish Enterprise continues with its established approach to research which covers a wide range of economic development issues including - enterprise and innovation; investment and infrastructure; industry sectors; rural research; cities and place; economy updates and evaluations. Reports in the public domain are available, under these headings, at: (Fiona Robb by email) 1) Impact on Orkney of a Generation of Cultural Focus Commissioned by Highlands and Islands Enterprise (HIE) and written by social researcher François Matarasso the report highlights how Orcadians have developed a unique cultural lifestyle which is a major draw for international tourists to the islands. Its findings show how community leadership, a strong ethos of volunteering and working together have combined with the natural archaeological and historical assets of the islands to develop a cohesive cultural identity. The report is available on the HIE website at www.hie.co.uk/economicreports . 2) Social Enterprise Sector Profile: Study to profile sector, identify growth opportunities, key sectors and support needs.Field work progressing well. Draft findings due to be presented to HIE Strengthening Communities Leaders Forum on 22 February 2012. Report complete by end Feb 2012.3) Fragile Areas Statistical Review 2011 HIE’s purpose is to generate economic growth in every part of the Highlands and Islands. HIE’s operating plan recognises that there are areas on the Highlands and Islands classified as ‘fragile’ which continue to suffer from population loss, limited employment opportunities, poor infrastructure and remoteness. In order to refine HIE’s resource prioritisation for the future, it is important to have the most up to date statistical evidence base for classification of such areas in the Highlands and Islands. Completion by end Feb 2012 Scottish Government (Kay Barclay) 1) Third Sector Longitudinal Study as detailed above 2) Third Sector Quantitative Data Briefing The Local Governance and Reform Analytical Unit are proposing to produce a briefing paper that will pull together key sources of robust quantitative data on the third sector from a variety of sources. 6) Date and location of next meeting 10 Duncan Thorp from Social Enterprise Scotland kindly agreed to host the next meeting as ththeir offices in Thorn House on Rose Street. The date agreed is 24 April 10:00-12:00. All to update diaries accordingly. An agenda will be circulated nearer the time and the plan is to hold a workshop session on the evidence of the third sector contribution to community justice. More details will follow shortly. 11 Annex 1: QUALITY ALLIANCE BOARD PAPER STRATEGIC REVIEW OF ENGAGEMENT BETWEEN SCOTTISH GOVERNMENT HEALTH AND SOCIAL CARE DIRECTORATES AND THE THIRD SECTOR – OUTLINE RECOMMENDATIONS Meeting date23 November 2011 Agenda ItemThird Sector Engagement Presented ByJill Vickerman, Acting Director Health and Healthcare Improvement Audrey Birt, Chair LTCAS and Director for Scotland, Breakthrough Breast Cancer PurposeThe Quality Alliance Board agreed in November 2010 to consider how non-NHS partners who deliver healthcare services are engaged in the implementation of the Quality Strategy. As part of this a short-life working group was established over Summer 2011 to undertake a review of engagement between the Scottish Government Health and Social Care Directorates and the third sector, and to recommend where this could be improved in order to maximise the contribution of the third sector to improving the health and wellbeing of the residents of Scotland. The short-life working group has met three times and their outline recommendations are described in the attached paper.ActionThe QAB is invited to note the report and endorse the outline recommendations. 12 Strategic review of engagement between the Scottish Government Health and Social Care Directorates and the Third Sector Aim A short-life working group, with representatives from third sector organisations and the Scottish Government, took forward a strategic review of engagement between the Scottish Government Health and Social Care Directorates and the Third Sector (review proposal attached at Annex A). The group developed the recommendations detailed below in order to achieve the following high level aim, and ultimately improve the health and wellbeing of residents of Scotland. •By working in partnership, develop an enhanced mutual understanding and enable both sectors (public and third) to engage more effectively with each other, in order to increase the coordination and impact of third sector organisations on health and social care policy, improvement, planning and delivery. Context The Government’s Programme for Scotland 2011-12 sets out a vision for Scotland where people collaborate; creating a new social partnership, with Scots empowered to take responsibility for improving their own lives. This requires nurturing a renewed sense of community and personal responsibility, maximising the opportunities presented by our greatest asset – our people. The third sector provide support and services to some of the most vulnerable people in Scotland and therefore have an increasingly important role in delivering better outcomes for our communities, including improved health and wellbeing, and improvements in the quality of care and support. The working group recognises this role and seeks to strengthen the contribution of third sector organisations to our Quality Ambitions and providing opportunities for all of Scotland to flourish. It will not be appropriate for all third sector bodies to engage with the statutory sector, nor will all third sector organisations wish to do so. However, we believe the recommendations and actions listed below will create the conditions for effective engagement and impact. Recommendations The short-life working group recommends that strategic engagement between the public sector and the third sector should build on existing successful partnerships and collaborations, such as the Change Fund planning arrangements, to ensure the third sector is a core participant in the planning, development, delivery and improvement of health and social care services. The required partnerships will be both strategic, focusing on areas where there is most to gain from collaboration, and solution focused providing practical actions at the operational level. This longer-term work would be led for the third sector by LTCAS and VHS (the Boards of VHS and LTCAS have recommended that they work towards a merger to provide a single coordinating focus and build a stronger voice for the third sector across health and social care), and would closely involve the wider sector. This would draw together, and build on, existing activity, for example: SCVO's 'Route Map for Older People' work; LTCAS/VAS' proposal to enhance strategic third sector contribution to the Change Fund; and explore 13 further development of the Change Fund 'joint sign off' model as part of emerging plans on integration of health and social care. We would welcome development of clear points of engagement between sectors, both at strategic and operational levels. This may require a more comprehensive overview of engagement and a degree of redesign across both sectors, in order to maximise the input and impact of the third sector. This aspiration is in line with the recommendations of the Christie Commission to overhaul relationships within and between those institutions and agencies responsible for designing and delivering public services. As an important catalyst for transforming relationships, and aligned with the Government’s priorities for reform, we recommend increased shared training opportunities across the public and third sectors in order to develop the skills, confidence and capability of those working in both sectors. Professional partnerships across the sectors could facilitate shared ownership of challenges, enable collaborative problem-solving, promote creative solutions and increase understanding between organisations. Greater mutual understanding and closer working towards a shared vision will in itself further strategic engagement. However, we recognise this needs to be developed through strong leadership and continued support for implementation in order to achieve long-term cultural, behavioural and systems change. This short-life working group represents the beginning of the dialogue between Government and the third sector to achieve these longer-term strategic outcomes. As a first step towards these outcomes, the working group recommends that the following immediate, specific, tangible and transformative actions are implemented. These seek to achieve cultural change through practical actions that build strategic relationships across the public and third sectors.Short-term actions to support longer-term change 1. Develop and implement an accessible resource to improve mutual understanding of public and third sectors, and promote the benefits from working with the third sector. This resource will aim to enhance the understanding of: •the third sector for government (national and local) •the third sector for the NHS •government (national and local) and the NHS for the third sector It will succinctly describe the landscape of the public and third sectors, and begin to map strategic contact points therefore providing a useful starting point for those looking to navigate the sectors (see Annex B for example). Additionally, the resource will highlight information and good practice in relation to third sector engagement, including principles that can be adopted by emerging partnerships to establish, support and nurture relationships. This resource will be jointly developed and owned by both sectors. This will include a shared responsibility to maintain, update and disseminate the information in a manner that maximises the value of the resource. Details of how the resource will be developed and implemented will be progressed pending agreement from the QAB to this paper.2.Increase engagement between key NHS Board members, including Chief Executives, Chairs and Non-Executive Directors, and the third sector beginning with facilitated dedicated sessions throughout the year. These would be a starting point for dialogue, on equal terms, between senior leaders from the NHS and the third sector. The 14 intention would be to start a structured process through which deeper partnership working could be developed, for example through joint leadership and organisational change activities, secondments between sectors and collaborative problem solving.This will build upon the recent identification of named leads at Board level for strategic links with the third sector across NHS Scotland. NHS Boards will be accountable for their engagement with the third sector as part of the Annual Review process. This will underline the added value and contributions to the Quality Outcomes that the third sector can bring (see Annex C) and promote the benefits of the public and third sectors working together to present shared solutions to challenges in delivery of health and social care. Successful models of engagement and partnership working would also be shared across Scotland. 3.Develop, test and spread use of Community Benefit Clauses within the NHS. A Community Benefit Clause (CBC) is one of a range of social considerations that can be included in public contracts and can help to deliver wider economic and social benefits, through buying goods and services (see Annex D for more details). A range of supportive measures will be put in place to support NHS Boards to use CBCs as part of standard procurement processes. This could include measures to raise awareness within NHS Board procurement departments about the contribution of the enterprising third sector and supply chain development; opportunities to increase awareness and skills with regard to CBCs (for example, social procurement training); mechanisms to promote good management of contracts and CBC conditions; sharing good practice examples of incorporation of CBCs into procurement for mainstream contracts. NHS Boards would be accountable for their use of CBCs through the Annual Review process and monitoring would be incorporated into the Procurement Capability Assessment. Short-life working group – strategic review of engagement between Scottish Government Health and Social Care Directorates and the Third Sector 15 November 2011 15 ANNEX A Strategic review of engagement between the Scottish Government Health and Social Care Directorates and the third sector Aim 1.This discussion paper outlines a proposal for a review of engagement between the Scottish Government Health and Social Care Directorates and the third sector, with the aim to enhance this relationship at a strategic level, in order to improve the health and wellbeing of the people of Scotland. The development of a strategic relationship should underpin both the contribution of third sector organisations to influencing and achieving the outcomes of the Quality Ambitions and increased participation and engagement of service-users. Background 2.The third sector is an important partner of Government at all levels, and the importance of this relationship is recognised in a number of Scottish Government policy documents (Better Health, Better Care (2007), Enterprising Third Sector Action Plan (2008), Equally Well (2008), Joint Statement on the Relationship at Local level between Government and the Third Sector (2009), Shifting the Balance of Care Improvement Framework (2009) and The Healthcare Quality Strategy for NHSScotland (2010)). 3.The ‘third sector’ is an informal term and not well defined. Its meaning was considered by the Scottish Parliament during a meeting of the Subordinate Legislation Committee in November 2007, when the following was stated; ‘The “Third Sector” is a commonly used term that denotes bodies not in the public or private commercial sector, and principally encompasses both incorporated and ad-hoc voluntary and community organisations, volunteering bodies, charities, social enterprises, cooperatives and mutuals, driven by a particular cause or set of social values and which principally reinvest any financial surpluses to further these objectives.’ 4.Each year SCVO produce an annual report on the size, shape and finances of the Scottish voluntary sector. The most recent report covers the financial year 2008-09, and details there are approximately 45,000 voluntary organisations (including social enterprises and community volunteers) in Scotland employing 137,000 staff (93,000 FTE). Over this period, the sector’s income was ?4.4bn, an increase of 7.3% compared with 2007-08. It was also reported that 4% of organisations have annual incomes of more than ?1m, accounting for 78% of overall share, whereas 65% of organisations have incomes of less than ?25,000 contributing collectively to less than 2% of the overall share. 1.2 million adults (28%) in Scotland volunteered in 2008-09, which equates to an estimated economic value of ?2.1bn.5.The Third Sector Division within Scottish Government acts as a champion for the third sector, and has the objective to effectively support its development; embedding awareness across Government and ensuring strategic engagement between local and national Government and the sector. The Health and Social Care Directorates continue to link closely with the Third Sector Division, and echo its commitment to supporting the growth and development of the sector, and helping to embed the sector in Scotland. 6.The Quality Strategy is the overarching strategy for NHSScotland and sets out our aim of becoming a world leader in healthcare quality, through the pursuit of 3 Quality Ambitions: person-centred care; no avoidable harm; and the appropriate treatment at the right time. The Quality Strategy was shaped and developed by consultation with NHSScotland, the public, third sector organisations and the wider public sector, and embedded throughout the strategy is the commitment to a partnership based approach to implementation; 16 ANNEX A ‘There will be a refreshed commitment to working closely with community planning partners in the delivery of the Quality Strategy vision and the wider Local and National Outcomes, recognising that public sector partners and the third sector have a major role to play in supporting people across Scotland in making the changes required to achieve the world-leading health and healthcare services to which we aspire.’ 7.Third sector organisations provide support and services to some of the most vulnerable people in Scotland and therefore have an increasingly important role in delivering better outcomes for our communities, including improvements to Scotland’s healthcare needs. For example, third sector organisations in the health and social care sector provide a range of information and support services, such as developing and running self-management programmes for people with long term conditions as well as a range of person-centred support that addresses the complexity of individuals’ needs. Others provide direct health-related, social care and employability services, including specialist nursing support and palliative care, as well as support for carers which is crucial as we seek to provide more care in the wider community environment. Others focus on developing and promoting community-generated and community-led health improvement initiatives. In addition they play an important role in service improvement and advocacy across the health, social care and employability communities. 8.It has been widely reported that the current spending on managing conditions and the demography of care is unsustainable and that approaches need to shift to better support quality of life, independent living and maximising the assets of individuals and communities. The third sector, with its diversity and responsiveness to communities (be they geographical or of interest) can provide services that are innovative, flexible and targeted to the needs of local communities, and are therefore vital to achieving the right balance between early years, healthy lives, good care in the community and acute services. 9.The recent report from the Commission on the Future Delivery of Public Services (June 2011) emphasises that a core principle informing any future reform process is that ‘public service providers must be required to work much more closely in partnership to integrate service provision and thus improve the outcomes they achieve.’ It also states that ‘addressing these systemic defects (in the public service system) will require a fundamental overhaul of the relationships within and between those institutions and agencies – public, third sector and private – responsible for designing and delivering public services.’10.Currently, there are a number of relationships between the Health and Social Care Directorates, third sector intermediaries and individual third sector organisations. Amongst these are the intermediaries Long Term Conditions Alliance Scotland (LTCAS), Voluntary Health Scotland (VHS), Voluntary Action Scotland (VAS) and Community Food and Health Scotland (CFHS), a number of disease/condition specific organisations and the recipients of Section 16B grants (NHS Scotland 1978 Act), Section 10 (Social Work Scotland Act 1968) grants, the Change Fund and the Self Management Fund. Building on these positive relationships there is an opportunity to enhance the strategic engagement between the Health and Social Care Directorates, other statutory agencies and the third sector.11.The recent successful collaboration between the third sector and the Health and Social Care Directorates, for example, through the strategic partnership with LTCAS ensures that the views of people with long term conditions are central to shaping SGHD policies and 2priorities. The Alliance produced Gaun’ Yersel’, The Self Management Strategy for Scotland, and administered the Self Management Fund to support projects which aim to encourage self-management throughout Scotland. 2 17 ANNEX A 12.Coupled with the opportunity to enhance strategic engagement between the Health and Social Care Directorates and the third sector, is the desire on behalf of Scottish Government to enhance engagement and participation with the public and service-users in general, in order that they may be more involved in discussions and influencing decisions about Government priorities and policy development. The third sector is one conduit, amongst a number of others, that can provide a platform to facilitate this engagement. 13.Improving the strategic engagement between the Health and Social Care Directorates and the third sector could allow a regular and early opportunity for the third sector to contribute to and influence policy development and wider planning, thereby leading to policies that are more responsive to peoples’ needs. This would require a two way flow of information and communication, with the third sector reaching back into their networks to obtain individuals’ views. 14.A partnership based approach to implementation of the Quality Strategy presents an opportunity to formalise this approach which is effective and sustainable in the present financial context, and which maximises our collective potential to achieve the Quality Ambitions. Through this opportunity we should develop a shared understanding of our respective roles and responsibilities and to understand and overcome any barriers that have prevented this from happening to date. Purpose and Scope of the Review 15.A review by the Scottish Government Health and Social Care Directorates and the third sector is proposed, which will consider the current engagement between the Health and Social Care Directorates and the third sector, and make recommendations on where this could be improved in order to maximise the contribution of the third sector to improving the health and wellbeing of residents of Scotland. 16.The work will review current arrangements and the issues which appear to hinder the impact of the third sector’s work (some initial areas to consider are outlined at Annex B). The approach should allow a shared understanding of the current challenges in order to produce informed recommendations for improvement. 17.The review will be taken forward by a short-life working group with representatives from key third sector organisations and the Scottish Government (membership at Annex A), and co-chaired by Jill Vickerman, Acting Director Health and Healthcare Improvement, SG, and Audrey Birt, Director for Scotland, Breakthrough Breast Cancer and Chair of LTCAS. 18.The short-life working group will meet three times over Summer 2011 and collectively develop a report and recommendations to be presented to the Quality Alliance Board in November 2011. Outcomes 19.The ultimate outcome the review seeks to achieve is to improve the health and wellbeing of the people of Scotland. The review will be set within this national strategic objective and linked to delivering the National Outcomes (‘We live longer, healthier lives’, and ‘Our public services are high quality, continually improving, efficient and responsive to local people’s needs’) and the Quality Outcomes (‘Everyone gets the best start in life, and is able to live a longer, healthier life’, ‘People are able to live well at home or in the community’ and ‘The best use is made of available resources’). 20.The high level aim that the recommendations of this review should seek to achieve is: 18 ANNEX A •By working in partnership, develop an enhanced mutual understanding and enable both sectors (statutory and third) to engage more effectively with each other. Therefore enhancing coordination and delivery and increasing the impact of third sector organisations on health and social care policy, improvement, planning and delivery at an early stage and together with Government. 21.The review will assume that increasing engagement between the government and the third sector is a beneficial relationship that will lead to improvements to health and social care outcomes, including that service users have a stronger role in shaping policies that affect them, and will detail the assumptions and define the benefits. It will recognise and build on the assets that exist amongst individuals and the wider community. The review will seek to outline and promote the benefits of engagement in this context, and will recognise that it will not be appropriate for all third sector bodies to engage with government on national policy. 22.National Standards for Community Engagement were produced by the Scottish Community Development Centre (SCDC) and published in 2005. These were commissioned by the Scottish Government, developed in consultation with over 500 community organisations, and endorsed by the Scottish Government. The standards are a practical tool to help improve the experience of all participants involved in community engagement to achieve the highest quality process and results. They have since been applied by a range of service providers and third sector organisations. 23.The standards (see below) should guide the recommendations that seek to enhance engagement between the statutory and third sectors. 1INVOLVEMENT. : we will identify and involve the people and organisations who have an interest in the focus of the engagement 2SUPPORT. : we will identify and overcome any barriers to involvement 3PLANNING. : we will gather evidence of the needs and available resources and use this evidence to agree the purpose, scope and timescale of the engagement and the actions to be taken 4METHODS. : we will agree and use methods of engagement that are fit for purpose 5. WORKINGTOGETHER : We will agree and use clear procedures that enable the participants to work with one another effectively and efficiently 6. SHARINGINFORMATION : we will ensure that necessary information is communicated between the participants 7. WORKINGWITHOTHERS : we will work effectively with others with an interest in the engagement 8. IMPROVEMENT: we will develop actively the skills, knowledge and confidence of all the participants 9FEEDBACK. : we will feed back the results of the engagement to the wider community and agencies affected 10. MONITORINGANDEVALUATION : we will monitor and evaluate whether the engagement achieves its purposes and meets the national standards for community engagement Next Steps 19 ANNEX A 24.The short-life working group will identify specific areas where practical actions could be taken to maximise the impact of the third sectors’ contribution to the health and wellbeing of the people of Scotland. The aim is to produce a report and recommendations for consideration by the Quality Alliance Board at their meeting on 23 November 2011, with a view to presenting the recommendations to NHS Board Chief Executives. Paper produced with input from Health and Social Care Directorates and the third sector 26 July 2011 (Updated 18 October 2011) 20 ANNEX A References A greater role for Voluntary Health Scotland and the third sector in Scotland’s health agenda (2011) Helen Tyrell Better Health, Better Care (2007) Scottish Government Commission on the Future Delivery of Public Services (2011) Public Services CommissionEngaging with Scotland’s health agenda: a survey of local intermediary bodies (2011) VHSEnterprising Third Sector Action Plan (2008) Scottish Government Equally Well (2008) Scottish Government Exploring the use of economic evidence to support the health improvement contribution of the third sector (2011) NHS Health Scotland, CHEX, CFHS, VHS Government and the Third Sector: relationships at local level (2010) VAS, SCVOHow can the third sector play a greater role in meeting health and social care needs in Scotland? (2010) SCVO Impact; an evaluation of the Self Management Fund for Scotland 2009-2011 (2011) LTCASJoint statement on the relationship at local level between Government and the Third Sector (2009) National Standards for Community Engagement (2005) Communities ScotlandPublic Services and Government Research Findings No. 10/2009: The Evidence Base for Third Sector Policy in Scotland: A Review of Selected Recent Literature (2009) Scottish Government Social Research Scoping study on the Third Sector in Scotland (2010) Centre for Public Services Research, University of Edinburgh Business School SCVO Scottish Voluntary Sector Statistics (2010) SCVO Shifting the Balance of Care Improvement Framework (2009) Scottish GovernmentThe Healthcare Quality Strategy for NHSScotland (2010) Scottish GovernmentThe Opportunities and Challenges of the Changing Public Services Landscape for the Third Sector in Scotland: A Longitudinal Study (2011) Scottish Government Social ResearchThe Third Sector – a key role in delivering a healthier Scotland. Making a greater contribution to meeting Scotland’s health and care needs in tough economic times (2010) SCVO, VHS The third sector delivering public services: an evidence review (2010) Rob Macmillan, University of Birmingham (Briefing Paper 20, Third Sector Research Centre)The third sector in a devolved Scotland: from policy to evidence (2006) Fyfe, Timbrell and Smith, University of Dundee Thistles, roses, thorns: some reflections on third sector/government relations and policy expectations in economic downturn (2009) Jenny Harrow (ESRC/SCVO) Annex A Short-life working group Remit: to consider current engagement between the Scottish Health and Social Care Directorates and the third sector, and to make recommendations to the Quality Alliance 21 ANNEX A Board on where this could be improved in order to maximise the contribution of the third sector to improving the health and wellbeing of Scottish residents.Membership Jill Vickerman – Acting Director Health and Healthcare Improvement, SG (Co-chair) Audrey Birt – Director for Scotland, Breakthrough Breast Cancer (Co-chair) Shelley Gray - LTCAS Helen Tyrell / Margery Naylor – VHS Martin Sime - SCVO Emma Witney – NHS Health Scotland Janet Muir – CHEX Bill Gray – CFHS Colin Campbell – Senscot Henry Simmons – Alzheimer Scotland Mark Hazelwood – Palliative Care Scotland Gareth Allen – Third Sector Division, SG Jenny Long – Healthcare Planning, SG Tim Warren – Healthcare Planning, SG John Davidson – Patient Support and Participation, SGAndrew Jackson – Joint Improvement Team, SG Anne Hendry – National Clinical Lead for QualityJamie Megaw – NHS Lothian 22 ANNEX A Annex B Points for the review to consider (in no particular order and not exhaustive) •Diversity of the third sector can result in a fragmented and uncoordinated approach across the sector with no overall strategic focus •However, diversity can be a significant strength – we do not want to lose the ability for the third sector to innovate, be creative and different, and more flexible in their approach than statutory bodies are able to be. •Policy, planning and consultative interface is underdeveloped between third sector organisations and SG, Health Boards, CHPs and local government with a lack of real commitment to a partnership approach •Service interface between third sector organisations and health services, e.g. GPs and primary healthcare bodies, is also underdeveloped •The priorities of third sector organisations – as driven by those they serve – often span across Scottish Government divisions and lack of connections within Scottish Government can make it more difficult for the third sector to engage and influence effectively •Insufficient investment is available to produce robust evidence of the impact of third sector organisations’ activities on the full range of health outcomes for people and related impact on peoples use of other services •Public sector regimes should better value qualitative outcomes and evidence•Funding is short-term, fragmented, marginal and vulnerable to withdrawal, with bureaucratic monitoring processes •Funding arrangements should not form the focus of the review, but forms part of the overall context •Longer-term funding and bottom-up, needs-based policy are important ingredients in any sustainable approach to delivering broad social outcomes •A consensus should be built about the respective strengths and weaknesses of current arrangements before appraising any future options •Mapping and analysis by third and statutory sectors of current engagements•Broad engagement – across different sizes/types of organisation, rural as well as urban etc – is essential. Therefore some form of consultation to the wider third sector is important. •Issues of engagement at board/local authority/CHP level should be addressed in order to have most impact nationally •Recommendations should be progressed in partnership with local authorities, NHS Boards and CHPs •Links should be made to related agendas – e.g. personalisation, self-directed support, independent living/disability, social care, employability, financial inclusion, physical activity and housing, all of which have potentially healthy outcomes for people. The review should ensure effective linkage between the Health and Social Care Directorates on an ongoing basis. 23 ANNEX A •Health provision is implicit on the outcomes associated with housing, employability, advice, debt support and many of these organisations sit beyond the current role of the Health and Social Care Directorates. •The third sector must retain the important principle of being driven by those they seek to serve •The impact of health and social care integration •The authority of selected third sector representatives on key committees/boards•How any intermediary organisation can represent the totality of work undertaken by voluntary groups, and how some peripheral organisations can be recognised•Work on developing a ‘road map’ for achieving an effective contribution from the third sector to Scotland’s health has been commissioned by SCVO and being carried forward by Alan Sinclair •SCVO is progressing a total place initiative across all sectors •The recommendations should improve understanding and connectivity across the public sector so the role of the third sector is enhanced •The potential for third sector champions within local authority and Health Board senior management teams •Importance of Community Benefit Clauses and Public Social Partnerships•There are three distinct areas of the third sector; voluntary, community and social enterprise, which need to be taken into account to ensure appropriate and effective engagement •Need for a clear and single mechanism to allow the successful relationship between the Health and Social Care Directorates and the third sector to advance•There are a number of existing intermediaries – a further body could add further complexity. Therefore it may be better to find a way of effective communication within the current framework than add another layer. •Preventative measures are an important focus in achieving better health outcomes. Sports based social enterprises are already engaged with the Scottish Government on this area. •Work on using economic evidence in demonstrating the impact of community-led approaches to health should be considered (work has been carried forward jointly by NHS Health Scotland, the University of Glasgow, CHEX, CFHS and VHS) 24 Third Sector and Health – a basic topography The purpose of this note is to provide an elementary picture of the third sector and its connections with health in Scotland in order to facilitate the work of the Review of Engagement between Scottish Government Health and Care Directorates and the Third Sector. About the third sector SCVO defines voluntary organisations as organisations which operate on a non-profit distribution basis, are non-statutory and volunteer-led. In practical terms this includes voluntary organisations, charities and social enterprises with a variety of legal forms including Companies Limited by Guarantee, Industrial and Provident Societies, Associations and Incorporated Charities (SCIO’s), and some co-ops and other mutuals. Normally included in the definition of the Third Sector are volunteers, including people who volunteer through voluntary organisations. There are some 45,000 voluntary organisations in Scotland with a combined annual income of c?4.5bn and a workforce of around 140,000 and land, building and capital assets of c?9.2bn. It is estimated that 1.2 million adults regularly engage in volunteering.About the third sector and health When asked about their principal area of interest, 44% of voluntary organisations cite social care and development as their main field of work. A further 6% cite healthcare. These figures probably underestimate the overall proportion of the sector that have an interest or involvement – for example, some housing associations have a significant health locus. Also, the number of organisations is only one dimension of what is a diverse and complex picture – there are many thousands of small community groups included in the overall numbers; a high concentration of resources and staff (78%) are accounted for in a relatively small number of organisations (4%) The different roles that the third sector plays -campaigning and policy work in the public domain -lobbying -individual advocacy -fundraising, for example for research -information and advice, for example on specific conditions -service delivery for public bodies -provision of services like community transport or Care and Repair -community action How the third sector is organised The most common type of organisation is based around purpose. New groups are established to achieve particular objectives, whether they are broad (improving public health in Scotland) or narrow (to help people affected by diabetes in Arbroath) although some are established around wider themes such as the promotion of volunteering.The geographic dimension is important in a wider context. Many local groups are autonomous and indigenous to a particular locality; others are part of wider networks, federations or legal structures which variously cover Scotland, the UK or even international organisations. Arthritis UK recently consolidated all of its branches into a single legal entity; the MS Society is a (fluid) mix of Scottish, UK and local organisations. Whilst the principal affiliation is most likely based on mission, the third sector is also organised around its common interests. Locally, there are Third Sector Interfaces, supported by the Scottish Government to develop and represent third sector interests, for example in Community Planning. Nationally, SCVO and others promote the interests of the third sector to Scottish Government. A number of intermediaries operate at a national level to promote particular interests, for example, the Federation of Housing Associations or Scottish Environment Link. How the third sector is organised in health At the national level:- -Voluntary Health Scotland (VHS) is a national intermediary body for voluntary health organisations which provides information and support services for the sector. The Long Term Conditions Alliance Scotland (LTCAS) aims to provide a voice for people affected by long term conditions, supports members through a Self Management Fund and acts as a conduit between members and government. Community Health Exchange (CHEX), Palliative Care Scotland, Community Food and Health Scotland and the Coalition of Carers all perform some intermediary functions. Some national organisations also have a network of local branches as well as some direct services such as Alzheimer’s Scotland, WRVS or Age Scotland. The principal national intermediary in the social care field is the Coalition of Care and Support Providers Scotland (CCPS), an association of the major social care organisations. There are a plethora of individual organisations, organised around particular conditions like the Scottish Association for Mental Health (SAMH), the British Heart Foundation (BHF), Enable, Capability and so on. Many will be members of SCVO, VDS, LTCAS and CCPS; each will have a distinct set of roles that have evolved to meet the ambitions of those involved – some are fundraising based, others primarily about advocacy, whilst many deliver services on behalf of local government or Health Boards, The work of some national organisations and intermediaries is supported by an SG funding Scheme, commonly known as “16b”. The third sector is recognised and represented at a number of levels, including the NHS Quality Board, the Ministerial Strategy Group, the Health and Care Delivery Group and so on. At the local level- The major intermediary for the Third Sector at local authority level is the Third Sector Interface (TSI), an SG supported umbrella which represents sector views in Community Planning, promotes social enterprise and volunteering and helps organisations to develop. Beyond that there is a patchwork of local forums and some individual relationships with Health Boards and Community Health Partnerships. Martin Simeth24 August, 2011 26 Why?Involve?the?Third?Sector?in?Health?and?Social? Care?Delivery? An evidence paper produced by the Scottish Government in collaboration with the Scottish Third Sector Research Forum December 2011 27 Why?Involve?the?Third?Sector?in?Health?and? Social?Care?Delivery? Q&A Need-To-Know for Policy Makers The?challenge •How?can?we?reduce?demand?for?acute?services? •How?can?we?support?people?to?take?control?of?their?own?health?and?social?care?outcomes? •How?can?we?ensure?that?people?and?communities?are?involved?in?the?design?and?delivery?of?services? •How?do?we?effectively?integrate?health?with?social?care? For?policy?officials?making?critical?decisions?about?health?and?social?care?spend,?these?are?increasingly?pertinent?questions.??The?Healthcare?Quality?Strategy? aims?to?make?Scotland’s?health?care?services?world?leading.??How?can?better?partnership?with?the?third?sector?help?to?achieve?this?ambitious?objective?The?Scottish?Government?has?acknowledged?the?positive?role?of?the?third? sector?in?delivering?better?and?more?equal?public?services.?Now?as?Ministers?attempt?to?address?the?perennial?challenges?facing?Scottish?society,?with?even?less?money?available,?preventative?approaches?have?been?prioritised,?and?there?is?an? 1urgent?need?to?identify?how?the?third?sector?can?be?engaged?more?effectively?. This?briefing?paper?is?a?collaborative?piece?of?work?by?the?Scottish?Third?Sector? 2Research?Forum?.??Drawing?on?available?evidence?we’ve?demonstrated?where? and?how?the?third?sector?is?contributing?to?health?and?social?care?services?delivery?in?Scotland.??Tapping?into?the?most?robust?evaluations?we?could?find?we’ve?provided?examples?of?the?third?sector’s?contribution?towards?the?healthcare? 3Quality?Outcomes?ambitions?for?Scotland?.??We’ve?also?looked?to?this?selected? evidence?for?key?messages?concerning?the?hurdles?to?overcome?in?reaching?a?better?engagement.? The?Evidence?Base? Our?rapid?review?indicates?that?evaluative?evidence?demonstrating?the?impact?of?the?third?sector?(especially?economic?impact)?is?limited?and?much?of?the?available?documentation?consists?of?case?studies.?Our?ability?to?build?a?more?in?depth?narrative?around?efficacy?is?limited?by?this?evidence?base?and?as?such,?we?are?not?able?to?provide?all?of?the?answers.?For?example,?whilst?the?nature?of?the?available?evidence?dictates?the?focus?of?this?paper?on?more?positive?examples,?we?are?also?interested?in?learning?lessons?from?approaches?that?don’t?work?so?well.?This?paper?represents?a?starting?point,?drawing?upon?those?projects?that?have?undergone?robust?review?to?make?some?general?conclusions?about?third?sector?activity?in?this? 28 area.?Routing?out?more?examples?from?organisations?and?facilitating?more?evaluation?to?support?the?development?of?this?evidence?base?is?a?key?objective?for?the?Third?Sector?Research?Forum?moving?forward.? Key?messages?and?recommendations?as?identified?by?our?review: There?are?often?distinct?features?of?third?sector?service?delivery?which? complement?and?enhance?public?sector?services.?These?differences?are?not?just?tendencies?towards?particular?characteristics?(such?as?a?holistic?view?of?service?users?wellbeing)?but?are?also?shaped?by?localised?features???the?involvement?of?volunteers?or?the?passionate?drive?to?deliver?outcomes?appropriate?to?the?community?within?which?the?organisation?is?embedded.??Approaches?to? engagement?need?to?be?mindful?of?differences?and?both?the?challenges?and? opportunities?these?lend?to?collaborations.?We?need?to?build?an?evidence?base? which?assists?further?understanding?of?the?mechanisms?which?have?allowed? third?sector?organisations,?acting?alone?and?in?partnership,?to?facilitate?improvements?in?the?health?of?individuals?and?communities.?Continued?work?is?also?needed?towards?developing?forums?for?communicating?and?developing? ideas?around?services?and?their?delivery?which?are?user?friendly?for?all? What?is?being?done?by?the?third?sector? •There?are?a?vast?number?of?third?sector?organisations?(TSOs)?working?in? prevention,?particularly?in?the?area?of?food?and?healthy?eating?initiatives,?active? living?projects?and?support?for?early?years?and?older?people.?? 4•The?third?sector?is?collaborating?with?service?users??to?provide?self?directed? support,?personalised?service?packages?and?training?in?self?management? techniques. 4•Working?closely?with?communities??is?a?key?tenet?of?the?third?sector? approach.?In?many?cases?organisational?structure?and?aims?have?been? generated?by?members?of?a?particular?community?in?order?to?fill?gaps?they?have? identified?in?service?provision.? •Third?sector?projects?are?frequently?produced?with?the?aim?of?developing? social?networks,?building?social?capital?and?reducing?isolation?amongst? vulnerable?people.?These?positively?target?health?through?improvements?in? general?wellbeing?and?the?better?dissemination?of?healthcare?messages.Why?does?it?work?? The?available?evidence?suggests •Close?ties?with?geographical?and?service?user?communities?has?enabled?TSOs? to?gain?an?expert?knowledge?of?local?needs?and?preferences,?allowing?them? the?potential?to?develop?more?effective?and?relevant?initiatives.•Volunteers?drawn?from?within?third?sector?organisations?target?communities,? contribute?to?this?expertise?and?provide?a?flexible?and?economically?efficient? organisational?structure. 29 •There?is?now?consensus?that?health?and?social?care?services?within?Scottish? 5.??Knowledge?of?and?ability?to?react?to?calls?communities?need?urgent?attention? for?change?can?be?hampered?by?complicated?communication?pathways.?As?organisations?frequently?embedded?within?geographical?and?service?user?communities,?TSOs?are?often?free?of?this?additional?information?filter.?As?this?paper?will?attempt?to?demonstrate?TSOs?have?already?moved?to?meet?these? demands?and?are?making?positive?contributions?to?improving?services.? Guide?to?reading?this?paper We’ve?selected?case?studies?from?our?wider?review?and?linked?these?to?a?general?analysis?of?third?sector?activities?as?they?relate?to?each?question.?A?table?with?more?of?the?case?evaluations?is?provided?on?page?7?and?these?are?referenced?in?the?text?by?letter?(A,?B,?C?etc).??References?to?general?literature?throughout?the?paper?are?numbered?(1,?2,?3?etc)?with?full?detail?provided?in?the?Bibliography. 30 How?can?the?third?sector?help?us?to?reduce?demand?for?acute?services? Quality?Outcomes?Link:?Everyone?gets?the?best? start?in?life,?and?is?able?to?live?longer?healthier?Evidence?Review?lives Findings A?sizeable?portion?of?third?sector?action?in?health?and?social?care?is?directed? 6towards?preventative?work,?as?a?broad?assessment?of?literature?makes?evident?.? This?activity?encompasses?multiple?delivery?areas.?Supporting?older?people?to?live? 7?well?in?their?own?homes?for?example,?offers?that?‘little?bit?of?help’?that?delays?the? need?for?additional?support?from?hospital?services,?significantly?reducing? 8,?Aexpensive?unplanned?admissions?.?Providing?healthier?green?environments?for? exercise?is?a?motivation?for?activity?which?creates?positive?impacts?on?longer?term? 9,?B?Chealth?.?Working?with?families?to?enable?better?care?for?children?in?their?early? 10,?D?Eyears?will?result?in?benefits?for?health?and?educational?attainment?later?in?life?. The?reports?and?reviews?we?examined?attributed?the?particular?success?of?the?third?sector?in?this?area?to?the?holistic?and?person?centred?nature?of?the?service?models.?Locating?communities?and?individuals?at?the?centre?of?design?inspired?a?wide? 11range?innovative?program?designs?that?met?varying?community?needs?.?? Healthy?eating?has?become?one?of?the?primary?areas?for?attention?in?encouraging?lifestyles?which?prevent?ill?health?and?reduce?demands?on?Scottish?health?services?12.??We?found?that?this?area?of?preventative?intervention?is?also?particularly?well?represented?within?the?evidence?base.?It?was?also?an?area?in?which?there?was?the?most?visible?evidence?for?successful?public?sector?and?third?sector?partnerships.?The?Happy?Jack?initiative?and? Quality?Outcomes?Link:?People?are?able?to?live?evaluation?for?example,? well?and?home?and?in?the?communityoutlined?below,?was?funded? and?supported?by?local? authorities,?local?authority?intermediaries?and?community?groups.??This?funding?and?support?strategy?has?been?used?successfully?to?underpin?a?number?of?the?Edinburgh?Community?Food?Initiative’s?(ECFI)?projects?which?aim?to?tackle?health? inequalities?in?low?income?Edinburgh?communities?through?food?and?health? ?13.promotion?work?? Case?Study Description:?Happy?Jack?was?developed?by?ECFI?and?funded?by?SureStart.??The? project?provided?fruit?and?vegetables?to?children?attending?Children?and?Family?Centres?(C&F?Centres)?and?through?the?same?centres?coordinated?the?provision?of?cooking?classes,?tasting?sessions,?fruit?promotions?and?a?variety?of?paper?publications?and?packs.?Activities,?materials?and?staff?provided?information?and?assistance?in?motivating?service?users?towards?making?broader?changes?in?their? 14eating?habits?.? Findings:?A?comprehensive?evaluation?of?the?Happy?Jack?project?gathered?both?qualitative?and?quantitative?data?for?analysis,?concluding?that?Happy?Jack?provided? 31 good?value?for?money?and?achieved?positive?healthy?eating?outcomes?for?children?and?families.?The?initiative?also?helped?relieve?some?of?the?time?and?resource?pressures?experienced?by?C&F?Centre?staff.? How?can?the?third?sector?allow?service?users?to?take?control?of?their?own?health?and?social?care?outcomes?? Quality?Outcomes?Link:??Everyone?has?a?Evidence?Review?Findings positive?experience?of?healthcare Evidence?has?demonstrated?that? empowering?service?users?to?manage?their?own?health?and?social?care?provision? 15leads?to?greater?choice,?autonomy,?control?and?independence?.?Recent?reports? have?indicated?that?it?is?often?not?possible?to?implement?self?directed?support?without?an?active?local?third?sector?partly?because?the?sector?is?often?well?placed?to? 16advise?and?support?self?directed?support?users?. As?the?case?study?below?demonstrates,?proximity?to?service?users?is?frequently?the?key?to?encouraging?participation?in?self?management.?The?extent?to?which?service?users?form?the?organisational?structure?of?the?service?and?the?often?specific?expertise?of?staff?within?third?sector?organisations?provides?a?good?foundation? upon?which?service?users?can?build?a?Quality?Outcomes?Link:??People?are?17,?Fself?directed?support?system?.able?to?live?well?at?home?and?in?the? community?The?Long?Term?Conditions?Alliance? (LTCAS)?provided?support?and?guidance?for?Momentum’s?development?of?the?self?management?programme.?LTCAS’s?support?was?provided?through?The?Self?Management?Fund,?a?resource?available?to?voluntary?organisations?and?community?groups?in?Scotland.?The?fund?is?aimed?at?work?which?encourages?people?living?with?long?term?conditions?to?learn?more?about?the?management?of? 18their?conditions,?and?to?become?partners?in?their?own?care?.? Case?Study???? Description:?Momentum?Care?provides?personalised?packages?of?support?for? adults?with?an?acquired?brain?injury.?In?order?to?advance?this?support?package,?Momentum?recently?piloted?an?Acquired?Brain?Injury?(ABI)?self?management? 19programme?for?young?men?in?Grampian?.?The?project?recruited?two?young?men? living?with?ABI?as?peer?leaders.?The?aim?of?the?course?was?to?provide?the?opportunity?for?the?service?users?to?share?information?informally?and?talk?about?their?experiences?of?living?with?the?condition?as?well?as?sharing?strategies?and?techniques?for?successful?self?management. ‘Now?there?is?going?to?be?a? Findings:?In?developing?the?course?Momentum?course?run?by?local?guys?my? realised?that?many?young?men?were?finding?it?age?telling?me?what?I?want?to? difficult?to?engage?with?their?programmes?because?know?and?giving?me?tips?that?I? their?views?on?what?they?needed?to?self?manage?will?actually?use’??Course? Participant?were?very?different?to?the?organisations’.?As?a? 32 result?the?peer?leaders?worked?with?communities?to?incorporate?information?that?the?young?men?felt?was?important?into?the?course?content.?They?also?designed?the?course?to?be?adaptable?and?interchangeable,?ensuring?it?could?respond?to?individual?needs?in?different?rural?areas.?Feedback?from?service?users?has?been?very?positive?and?Momentum?are?hoping?that?they?might?be?able?to?replicate?the?program?in?more?areas.? How?can?the?third?sector?help?to?ensure?that?health?services?involve?people?and?communities?in?their?design?and?delivery? Quality?Outcomes?Link:??The?best?use?is?made?Evidence?Review?of?available?resources;?People?are?able?to?live? Findingswell?at?home?and?in?the?community? There?is?a?long?tradition?in?rural?areas?of?Scotland?of?services?being?provided?by?volunteers?and?attention?has?been?drawn?to?this?by?a?number?of?qualitative?and? 20quantitative?data?reviews?.??We?also?know?that?the?co?production?of?services?with?a?volunteer?workforce?can?be?a?highly?effective?method?of?addressing?health?and?social?care?service?needs.?With?this?in?mind?a?number?of?projects?have?been?developed?recently?which?aim?to?investigate?how?and?where?volunteers?could?contribute?more?effectively,?particularly?given?the?positive?moves?towards?better?community?involvement?and?the?co?production?of?essential?services?such?as? 21health?and?social?care.? Third?sector?organisations?frequently?draw?upon?volunteers?from?within?the? G?H.?community?in?which?the?organisation?is?placed?This?means?that?they?are?often? ideally?situated?to?communicate?information?concerning?local?issues?to?public?sector?service?providers?and?to?guide?the?process?of?engaging?communities?in? 22designing?and?delivery?services?.? Despite?this?access?to?community?knowledge?and?resources,?engagement?with?public?sector?services?has?sometimes?stalled.?Third?sector?organisations?have?reported?that?they?are?not?engaged?with?enough?frequency?at?an?early?stage?in?service?planning?forums,?or?that?where?efforts?have?been?made?to?include?third? 23sector?the?organisation?still?did?not?have?the?power?to?influence?decisions?.? Quality?Outcomes?Link:?Everyone?gets?the? best?start?in?life,?and?is?able?to?live?longer?Case?Study? healthier?lives 24Description:?The?Healthy?Communities?Collaborative??is?a?Perth?and?Kinross? project?which?involves?groups?of?older?people?working?in?partnership?with?a?small?team?of?staff.?The?initial?aim?of?the?project?was?the?prevention?of?falls?in?over?65’s?with?broader?objectives?for?improving?health,?wellbeing?and?quality?of?life?for?older? 25people?.? 33 Older?volunteers?were?recruited?by?the?project?management?teams?attending?local?community?groups?and?extending?invitations?to?orientation?events.?Locality?teams?were?then?established?each?comprising?5?or?6?older?people?supported?by?6?support?staff.?Training?and?team?time?discussion?sessions?were?organised?so?that?the?groups?could?work?out?what?they?wanted?to?implement?in?their?communities?and?how?work?would?be?carried?out.??Each?year?the?teams?focus?on?a?different?area?of?health.?In?2006?for?example,?‘Physical?Activity’?resulted?in?team?members?being?trained?as?Chair?Based?Exercise?Instructors?and?Walk?Leaders.Findings:??Benefits?identified?by?the?ongoing?project?evaluation?included?increased?opportunities?for?social?contact,?physical?activity?and?improvements?to?mental?health.?The?success?of?the?programme?was?such?that?there?are?now?ten?teams?operating?across?the?Perth?and?Kinross?area.?This?programme?was? conducted?by?local?authorities?in?partnership?with?volunteers?and?is?a?useful?example?of?the?potential?for?partnership?programmes?to?deliver?positive?outcomes.?How?can?the?third?sector?help?us?to?integrate?health?with?social?care? Quality?Outcomes?Link:?People?are?able?to? live?well?at?home?and?in?the?communityEvidence?Review?Findings 26There?are?many?third?sector?organisations?working?in?social?care?,?organisations? which?are?heavily?involved?in?providing?support?for?vulnerable?and?marginalised?groups?who?frequently?face?poverty,?social?care?needs?and?poor?health?(those?facing?homelessness?and?drug?addiction?for?example).??Evidence?has?demonstrated?that?many?TSOs?have?been?able?to?build?trusting?and?productive? 27working?relationships?with?these?otherwise?socially?fragile?user?groups?.?TSOs? have?succeeded?in?overcoming?barriers?to?communication?for?instance,?with?direct?improvement?in?the?ability?of?services?to?convey?health?promotion?messages?and? Iarrange?suitable?access?to?healthcare?support?.?Indirect?benefits?include? improvements?in?the?capacity?of?service?users?to?develop?healthy?stable?relationships?with?the?communities?in?which?the?are?resident,?resulting?in? Jimprovements?to?general?wellbeing?and?social?cohesion.?? As?the?Nari?Kallyan?Sangho?evaluation?highlights?(for?example),?staff?have?identified?struggles?to?engage?further?with?public?sector?services?given?the?increasing?calls?for?assistance?that?their?service?users?are?placing?on?time?and? 28resources?.??This?increasing?pressure?on?resources?has?been?reflected?across?many?areas?of?third?sector,?mirroring?the?pressure?that?the?public?sector?is?also?facing.?? Quality?Outcomes?Link:?Everyone?gets?Case?Study? the?best?start?in?life,?and?is?able?to?live? longer?healthier?livesDescription:?The?Edinburgh? based?organisation?Nari?Kallyan? 29?Shangho?(NKS)?addresses?women’s?welfare?issues,?particularly?women?from?a?Bangladeshi?background?who?are?living?in?Scotland.?Group?work?and?other? 34 activities?take?place?at?venues?all?over?the?city,?according?to?the?most?convenient?and?practical?location?for?the?women?concerned.??NKS’s?purpose?is?to?provide?a? common?platform?for?South?Asian?women?to?act?together?to?improve?the?quality?of?their?lives.?Its?primary?aim?is?to?promote?physical,?mental?and?social?well?being?by?alleviating?isolation?and?deprivation?using?a?community?development?approach?of?user?participation?and?collective?action.?The?responsibilities?of?the?twelve?staff?vary?from?administration?to?childcare,?cleaning,?sewing,?tuition,?health?and?family?support.?The?project?uses?a?combination?of?one?to?one?workers,?community?support?staff?and?health?care?professionals?to?lead?work?across?their?target?areas.?Findings:?The?project?has?produced?some?useful?and?informative?evaluations?of?their?project?work?which?have?highlighted?the?improvements?that?the?project?has?been?able?to?achieve?in?reducing?social?isolation?and?enhancing?social?networks?for?these?particular?groups?of?people.?Their?work?has?allowed?them?to?raise?health?awareness?amongst?female?participants,?as?well?as?improve?local?health?professionals’?understanding?of?particular?cultural?sensitivities.?Conclusions The?evidence?base:?contributions?and?limitations? As?we?have?noted,?the?evidence?base?is?limited.??There?is?a?lack?of?robust?evaluative?data?that?demonstrates?the?impact?of?third?sector?involvement?and?only?a?handful?of?evaluations?that?demonstrate?the?economic?benefits?of?working?with?the?third?sector.??Instead?we?are?largely?dependent?on?a?body?of?case?study?data?which?illustrates?broadly?what?third?sector?services?are?aiming?to?do?but?not?necessarily?providing?detailed?feedback?on?the?mechanisms?of?the?service?or?the?overall?outcomes?for?health.?That?said,?we?also?believe?that?there?is??evaluative?data?“out?there”?which?is?more?difficult?to?access,?perhaps?because?organisations?do?not?wish?to?share?or?do?not?see?the?value?or?relevance?in?making?their?evaluations?publicly?available.?? Key?messages?and?recommendations Third?sector?services?are?already?heavily?involved?with?initiatives?that?aim?to?encourage?healthier?lifestyles?within?Scotland?and?prevent?future?demand?on? healthcare?services.?We?have?located?evidence?and?reviews?(see?tables?and?case?studies)?which?suggest?that?the?success?of?third?sector?work?in?this?area?is?frequently?due?to?a?flexible?structure,?often?attributable?to?the?involvement?of? volunteers?in?organising?services?delivery.?The?ability?to?change?and?innovate?to?meet?local?needs?and?preferences?is?also?essential?in?encouraging?communities?to?see?the?benefits?of?healthier?living.?There?is?a?lack?of?uniformity?in?TSO?activity?and?an?informality?of?organisation?which?allows?these?particular?characteristics?to?be?embedded?successfully?within?initiatives. Discussions?of?partnership?working?between?the?third?sector?and?public?sector?needs?to?be?mindful?of?this?often?more?informal?working?model.?New?strategies?would?be?welcome?which?help?to?align?these?ways?of?working?alongside?more? 30.business?like?models?of?delivery?that?often?characterise?public?sector?services? 35 There?is?an?evidence?base?which?demonstrates?that?volunteers?are?making?a? significant?contribution?towards?services?delivery?in?Scotland.?Close?ties? between?third?sector?organisations,?communities?and?volunteers?have?facilitated?the?initiation?and?organisation?of?this?informal?service?provision.?Reviews?of? partnership?engagement?forums?have?demonstrated?frustration?amongst?third?sector?organisations?when?confronted?with?a?limited?ability?to?influence?real?change.?Moving?forward?with?service?reform?could?be?assisted?by?better?mutual?knowledge?and?understanding?of?the?evidence?which?demonstrates?that?the?third?sector?can?be?a?great?benefit?and?of?the?evidence?which?discusses?where?and?how?partnership?approaches?work?best.? The?third?sector?is?in?some?ways?better?equipped?to?overcome?challenges?facing? public?sector?health?and?social?care?services.?It?is?also?important?to?note?that?many?of?the?pressures?facing?the?public?sector?are?also?affecting?third?sector.?Calls?for?engagement?need?to?be?sensitive?to?the?increasing?draw?upon?resources?and?time?that?many?organisations?are?facing. As?the?pool?of?evidence?featured?within?this?paper?demonstrates,?there?are?areas?in?which?third?sector?activities?complement?and?directly?support?work?towards?meeting?the?healthcare?Quality?Outcomes?ambitions?for?Scotland.?Building?on?this?hard?work?will?be?essential?in?moving?forward?with?the?ambitions?for?better?services?for?Scotland.??? 36 Referenced?Evidence? NameSourceEvidence?BaseDescriptionOutcomes The?Food?TrainCommunity?Food?Cost?Benefit?Grocery?shopping,?befriending?and?support?service?A?well?targeted,?effective?and?A and?Health?Analysisfor?older?people?living?within?Dumfries?and?flexible?service.?Generates?high? ScotlandGalloway.value?outcomes?for?customers? and?fulfils?a?critical?role?in? supporting?them?to?remain? independent?at?home.?High? economic?value?in?delaying?the? onset?to?higher?cost?packages?of? care.? BCTV?Green?Gyms?National?Evaluation?Quantitative?and?Participants?are?guided?through?a?range?of?practical?Evaluation?noted?improvements?in?B ProjectsReport?conducted?qualitative?analyses?outdoor?projects.?The?activities?are?intended?to?health,?confidence?and?the? by?Oxford?Brooks?of?service?user?improve?health?and?the?environment.?There?are?25?acquisition?of?new?skills?in? Universityquestionnaires?green?gyms?located?within?Scotland.environmental?management? techniques.? Cairngorms?Upper?Deeside?Quantitative?and?Offers?regular,?short,?safe?and?sociable?walks?that?Reported?improvements?in?health?C Outdoor?Access?Walking?to?Health?qualitative?analyses?are?aimed?at?people?who?would?benefit?from?an?and?wellbeing?for?the?participants?Trust?Project?Evaluation?of?data?gathered?increase?in?their?physical?activity.?A?weekly?walk?and?the?volunteers.?Participants? Report.?from?interviews?with?lasts?30?60?minutes?and?is?led?by?trained?health?walk?reporting?an?increase?in?activity? WalkDeeside?Ltd.?service?users?volunteers.?Within?Deeside?there?are?9?walking?levels?and?increased?attendance? groups.?With?a?number?of?other?groups?operating?at?other?community?events?as?a? across?Scotland.?direct?result?of?participation?in?the? walks.? Little?Leithers?Edinburgh?Case?study?report?The?aim?of?the?scheme?is?to?encourage?families?Over?4000?vouchers?and?2000?D Voucher?SchemeCommunity?Food?indicating?from?low?socio?economic?backgrounds?to?use?local?recipes?were?distributed?over?an? Initiative?(ECFI)?qualitative?and?shops?and?cook?using?fresh?ingredients.?Each?family?evaluation?period?of?2?years.? and?Evaluation?quantitative?data?was?supplied?with?vouchers?for?use?in?local?Case?studies?of?shops?issuing? Support?Scotland?sources?fishmongers,?butchers,?greengrocers?etc,?and?vouchers?demonstrated?increased? (ESS)?reportingprovided?with?easy?recipe?suggestions.?use?of?outlets?by?voucher?families? with?a?total?expenditure?was?often? greater?than?the?value?of? vouchers?issued. 37 Blackburn?Early?Farechoice:?Self?evaluation?Weaning?support?project?for?parents?with?babies?in?Parents?who?had?completed?the?E Years?Action?GroupNewsletter?of?report?findings?the?West?Lothian?area.?Delivered?three?sets?of?workshops?reported?improved? Community?Food?published?as?a?weaning?courses?which?included?guidance?on?parenting?skills?and?greater? and?Health?case?study?blending?foods?for?healthy?meals.confidence?in?preparing?their?own? (Scotland)baby?foods.? The?Sunrise?Project?The?Big?Lottery?Case?Study?Integrated?Drug?Service?(IDS)?which?offers?There?has?been?a?substantial?(Galloway?Alcohol?Fund:?Better?Off?Summary?of?a?assessment?for?people?who?have?a?drug?misuse?increase?in?the?number?of?people?Fand?Drugs?Action?Evaluation?wider?evaluation?problem.?Statutory?and?voluntary?support?is?offered?entering?and?staying?in?Team?[ADAT])Summary?submitted?to?The?at?the?same?time?and?a?co?ordinated?care?and?rehabilitation?since?the?project? Big?Lottery?Fundsupport?plan?is?organised?in?collaboration?with?the?was?launched.? client.?This?support?plan?draws?together?direct?action? to?tread?addiction?and?additional?services?such?as? housing?and?employment?support.? Healthy?ValleysReport?from?the?Qualitative?Aims?to?preserve?and?protect?the?mental?and?Conclusions?of?the?evaluation?G (Lanarkshire)University?of?evaluation?drawing?physical?health?of?residents?and?to?assist?in?the?relief?found?very?positive?outcomes?for? Strathclydeupon?interviews?of?ill?health?and?the?provision?of?health?education.?health?and?wellbeing?of?service? and?focus?group?The?project?includes?a?wide?variety?of?activities?users.?Including?the?provision?of? sessions?with?including?sports?activities,?health?walks?and?useful?support?for?those?suffering? service?users.?counselling?support.?Community?volunteers?provide?from?ill?health?and?improvements? most?of?the?staffing?support.?in?partnership?working?across?the? community.? The?Handyperson?Community?First?Social?Return?on?Service?works?with?local?volunteers?to?provide?SROI?found?that?the?project?had?H Service?for?Moray(Moray)Investment?support?for?older?people,?people?with?disabilities?or?overall?positive?outcomes?for? Analysis?(SROI)other?long?term?illnesses?and?other?vulnerable?service?users.?Service?users?felt? individuals?who?need?support?in?their?homes?safer?and?better?able?to?manage? the?care?of?their?homes.? IAberdeen?Foyer?NHS?Health?Detailed?Case?Aims?to?enable?homeless?and?disadvantaged?young?This?case?study?and?associated? Scotland?–?‘Insight’?Study?Reportpeople?to?gain?social?and?economic?independence.?reports?by?the?Community?Health? Case?Studies?in?The?Foyer?provides?access?to?information,?training?Exchange?(CHEX)?for?example,? Community?and?social?support.?Accommodation?is?also?have?illustrated?the?essential? Development?and?available.?A?key?objective?is?the?improvement?of?resources?that?this?service? Health?Scotlandhealth?and?wellbeing?of?those?in?contact?with?the?provides?for?vulnerable?young? service.?people JDundee?Families?The?University?of?Qualitative?Projects?aims?to?assist?families?who?are?homeless?or?Project?provides?considerable?Project?Glasgow?(Centre?evaluation?with?at?severe?risk?of?homelessness?as?a?result?of?anti?cost?savings?in?preventing?the? 38 for?the?Child?quantitative?data?social?behaviour.?Offers?a?range?of?services?from?need?for?contact?with?public?sector?&Society?and?output?including?counselling?to?after?school?activities,?parenting?skills?agencies.?Frequently,?the?threat?Department?of?cost?benefit?guidance?and?support?for?anger?management?of?eviction?was?lifted.?Service?Urban?Studies)analysisissues.?users?reported?additional?benefits? to?general?wellbeing?as?a?result?of? the?service. 39 Bibliography?and?Footnotes 1.??Scotland,?The?Scottish?Government?(2011)???Scottish?Spending?Review?2011?and?Draft?Budget? ??2012?13.???The?Scottish?Government:?Edinburgh;???Scotland,?the?Scottish?Government?(2011)???The? ??Government?Economic?Strategy?2011??.?The?Scottish?Government:?Edinburgh;??Scotland,?The? ??Scottish?Government?(2011)???Renewing?Scotland:??The?Government’s?Programme?for?Scotland? ??2011?2012??.?The?Scottish?Government:?Edinburgh;?Scotland,?The?Scottish?Government?(2011)? ??Report?on?the?Future?Delivery?of?Public?Services?by?the?Commission?????chaired?by?Dr?Campbell? ??Christie??.?The?Scottish?Government:?Edinburgh.? 2.Consisting?of?The?Scottish?Government?and?key?third?sector?stakeholders:?Association?of?Chief? Executives?of?Scottish?Voluntary?Organisations,?Convention?of?Scottish?Local?Authorities,?CEiS,? Evaluation?Support?Scotland,?The?Funders?Forum,?Highlands?and?Islands?Enterprise,?Office?of?the? Scottish?Charity?Register,?Scottish?Agricultural?College,?Scottish?Council?for?Voluntary? Organisations,?Scottish?Enterprise,?Scottish?Social?Enterprise?Coalition,?Volunteer?Development? Scotland,?Voluntary?Health?Scotland,? 3.Six?healthcare?Quality?Outcomes?were?developed?by?the?Quality?Alliance?Board?as?a?result?of? discussions?following?publication?of?The?Healthcare?Quality?Strategy?for?NHS?Scotland?[Scotland,? ??The?Scottish?Government,.?(2010)???The?Healthcare?Quality?Strategy?for?NHS?Scotland??.?The? Scottish?Government:?Edinburgh] 4.In?line?with?the?drive?towards?the?co?production?of?public?services:?Bunt,?L,.?Harris,?M,.?and?Puttick,? ??R,.?(2010)???Radical?Scotland???Confronting?the?Challenges?Facing?Scotland's?Public?Services??.? NESTA:?London;???Boyle,?D.,?Coote,?A.,?Sherwood,?C.?and?Slay,?J?(2010)???Right?Here,?Right?Now:? ??taking?co?production?into?the?mainstream??.?Nesta:?London;?see?also?the?forthcoming?addition?of? ‘‘Rural?Scotland?in?Focus’’?published?by?The?Scottish?Agricultural?College?and?available?from? 5.??Scotland,?The?Scottish?Government?(2011)???Report?on?the?Future?Delivery?of?Public?Services?by? ??the?Commission?chaired?by?Dr?Campbell?Christie??.?The?Scottish?Government:?Edinburgh 6.For?a?broad?summary?of?third?sector?services?and?a?similar?conclusion?with?regards?to?the? limitations?of?available?evidence?see:?Dacombe,?R.?and?Bach,?S,.?(King's?College?London)?(2009)? ??The?Evidence?Base?for?Third?Sector?Policy?in?Scotland:?A?Review?of?Selected?Recent?Literature??.? Scottish?Government?Social?Research:?Edinburgh? 7.‘That?Little?Bit?of?Help’?a?strategy?discussed?by?the?Joseph?Rowntree?Foundation?inquiry?report:? ??Raynes,?N.,?Clark,?H.?and?Beecham,?J,.?(eds)?(2006)???The?Report?of?the?Older?People’s?Inquiry? ??into?‘That?bit?of?Help’??.?Joseph?Rowntree?Foundation:?York?????? 8.As?discussed?by?Age?UK?in?their?campaign?‘’Preventing?Falls?in?Later?Life’’.?See?Age?UK?website? for?further?information,?[Last?accessed? October?2011] 9.For?example:????Scotland,?The?Scottish?Government,.?(2008)???Healthy?Eating,?Active?Living:?an? action?plan?to?improve?diet,?increase?physical?activity?and?tackle?obesity?2008?2011.?The?Scottish? Government:?Edinburgh 10.Noted?with?The?Scottish?Government’s?‘’Early?Years?Framework’’:??Scotland,?The?Scottish? ??Government,.?(2008)???The?Early?Years?Framework??.?The?Scottish?Government:?Edinburgh;??further? examples?of?third?sector?early?years?project?initiatives?can?be?found?within:?Community?Food?and? ??Health?Scotland?and?Evaluation?Support?Scotland?(2010)????Making?the?Case?–?Early?Years?Self? ??Evaluation?Framework??.?Community?Food?and?Health?Scotland:?Glasgow 40 11.For?example:??Scottish?Council?for?Voluntary?Organisations?(SCVO)?and?Voluntary?Health? Scotland?(VHS),.?(2010)?The?Third?Sector?–?a?key?role?in?delivering?a?healthier?Scotland.?Available? through?the?VHS?website?[www.vhscotland.org.uk]?[Last?Accessed?November?2011];?Phillimore,? ??J.,??McCase,?A,.?with?Soteri?Proctor,?A,.?and?Taylor,?R,.?(2010)???Understanding?the?distinctiveness? of?small?scale,?third?sector?activity:?the?role?of?local?knowledge?and?networks?in?shaping?below?the? ??radar?actions.???Working?Paper?33.?Third?Sector?Research?Centre:?Birmingham 12. ??Scotland.?The?Scottish?Government,.?(2004)???Eating?for?Health:?co?ordinated?action,?improved? ??communication?and?leadership?for?Scottish?food?and?health?policy??.?Scottish?Executive:?Edinburgh.? 13.See?Edinburgh?Community?Foods?Initiative?website?for?further?information:? www.edinburghcommunityfood.org.uk?[last?accessed?November?2011] 14.??Christie,?I,.?and?Simpson,?L,.?(Community?Food?and?Health?[Scotland]?in?partnership?with? ??Edinburgh?Community?Food?Initiative?and?City?of?Edinburgh?Council)?(2009)???An?Evaluation?of? ??Happy?Jack:?What?is?the?Economic?Value?of?the?Project???.?Blake?Stevenson:?Edinburgh 15.Equality?and?Human?Rights?Commission,.?(2011)?Personalisation?in?the?Reform?of?Social?Care.? Key?Messages.?Available?from?the?Equality?and?Human?Rights?Commission?website? www.equalityhumanrights.com?[Last?Accessed?November?2011] 16.See?Page?24?of:????Scotland,?Scottish?Government,.?(2011)???Self?Directed?Support:?A?Review?of?the? ??Barriers?and?Facilitators,?Health?and?Community?Care??.?The?Scottish?Government:?Edinburgh? 17.The?Self?Management?Fund?for?Scotland?administered?by?The?Long?Term?Conditions?Alliance? Scotland?(LTCAS)?has?published?a?number?of?interim?reports?and?an?initiative?impact?report?which? illustrate?this?point.?Reports?can?be?accessed?via?the?LTCAS?website:?www.ltcas.orf.uk?[last? accessed?November?2011];?for?instance?the?Scottish?third?sector?consultation?report?‘‘Tackling? health?inequalities?and?poverty’’?highlights?Scottish?TSO’s?various?expertise?in?providing?support? for?vulnerable?service?users?in?managing?their?own?recovery:?Voluntary?Health?Scotland?(VHS),.? (2008)?Tackling?Health?Inequalities?and?Poverty:?a?consultation?with?Scotland’s?third?sector.? Carried?out?for?the?Scottish?Public?Health?and?Wellbeing?Directorate.?Available?from?the?Voluntary? Health?Scotland?website:?www.vhscotland.org.uk?[last?accessed?November?2011] 18.??Long?Term?Conditions?Alliance,.?(2011)???Impact:?an?evaluation?of?the?Self?Management?Fund?for? ??Scotland?2009?2011??.?LTCAS:?Glasgow 19.Momentum?Care?ABI?Programme?Evaluation?published?within: Long?Term?Conditions?Alliance? ??Scotland?and?Neurological?Alliance?Scotland,.?(2011),???Neurological?Alliance?of?Scotland?Self? ??Management?Fund?–?Special?Report.?Neurological?Conditions??.?LTCAS:?Glasgow 20.For?example:?Timbrell,?H,.?(2006)?Scotland’s?volunteering?landscape:?The?nature?of?volunteering.? VDS?Research?Summaries.?Available?from?www.vds.org.uk?[last?accessed?November?2011];? Woolvin,?M,.?(In?Press),?Mapping?the?Third?Sector?in?Rural?Scotland:?an?initial?review?of?the? literature.?The?Scottish?Government:?Edinburgh.? 21.For?example:?The?Scottish?Government’s?‘Leader’?Programme.?Information?available?from:? ;?The?Big?Lottery?Fund?supported? Volunteering?Highlands?initiative.?Information?available?from:? 22.Third?sector?organisations?have?also?been?involved?in?reporting?this?finding?themselves.?For? example:?Queensferry?Churches?Care?in?the?Community?and?Communities?Scotland,.?(2009)? ??‘The?Long?and?Winding?Road??’.??Last?accessed?November?2011 41 23.See?for?example?the?findings?of:???Voluntary?Health?Scotland,.?(2011)???Engaging?with?Scotland’s? Health?Agenda:?A?survey?of?local?intermediary?bodies.?VHS.?Edinburgh.?Last?accessed?November? 2011;?Voluntary?Health?Scotland?&?Scottish?Council?for?Voluntary?Organisations,.?(2010)? ??Government?and?the?Third?Sector?Relationships?at?a?local?level??.?Available?from?www.vds.org.uk? [last?accessed?November?2011]? 24.??Miller,?E?(Joint?Improvement?Team),.?and?Barrie,?K?(Better?Together?Project),.?(2010)???Perth?and? ??Kinross?Healthy?Communities?Collaborative.?Evaluation?Report??.?Available?from? www.jitscotland.org.uk?[last?accessed?November?2011]? 25.An?increasing?turn?towards?engaging?older?people?in?the?design?and?delivery?of?services?has? characterised?wider?thinking?around?better?health?services?provision?in?challenging?financial? climates.?See?for?example:????O4O:?Older?People?for?Older?People,.?(2010)???Final?Report??.?Available? from?www.O4Os.eu/final?report.asp?[last?accessed?November?2011].??Within?Scotland,?a?high? prevalence??of?isolated?rural?populations?of?older?people?has?given?these?initiatives?even?greater? urgency. 26.As?discussed?within:????Scotland,?The?Scottish?Government,.?(2011)???The?Opportunities?and? Challenges?of?the?Changing?Public?Services?Landscape?for?the?Third?Sector?in?Scotland:?a? ??longitudinal?study??.?The?Scottish?Government:?Edinburgh?? 27.As?discussed?by?The?Scottish?Government?report?‘’Equally?Well’’:??Scotland.?The?Scottish? ??Government,.?(2008)???Equally?Well:?Report?of?the?Ministerial?Task?Force?on?Health?Inequalities??.? The?Scottish?Government.?Edinburgh?and?‘’The?Christie?Report’’?Scotland,?The?Scottish? ??Government,.?(2011)???Report?on?the?Future?Delivery?of?Public?Services?by?the?Commission?chaired? ??by?Dr?Campbell?Christie??.?The?Scottish?Government:?Edinburgh) 28.For?example:???Rahman,?O?and?Munro,?A,.?(2005)???Moving?Further?Ahead.?Evaluation?Report?of? ??NKS?Services?from?April?2002?to?March?2005.???Nari?Kallyan?Shangho:?Edinburgh 29.See?Nari?Kallyan?Shangho?website?for?further?information:? [last?accessed?November?2011]? 30.The?Scottish?Government’s?Public?Social?Partnerships?(PSPs)?initiative?has?been?working?towards? building?appropriate?forums?in?this?area.?Between?2007?2009?a?number?of?PSP?partnership? projects?were?established?across?Scotland.?The?success?of?these?partnerships?varied?but?the? learning?experience?of?itself?was?valuable.?As?a?result?The?Scottish?Government?produced?a?guide? to?managing?PSP?work?with?the?aim?of?moving?forward?in?this?area:??Scotland,?The?Scottish? Government,.?(2011)?A?Practical?Guide?to?Forming?and?Operating?Public?Social?Partnerships.?The? Scottish?Government:?Edinburgh 42 Methodology This paper was based on a rapid review of evidence and literature. It drew upon a wide range of resources including online evidence libraries maintained by the SCVO, VHS, The Joseph Rowntree Foundation, The Big Lottery Fund and various other online academic and third sector sources. The evidence review identified documents containing evaluative data relating to third sector organisations in Scotland. A large number of anecdotal case studies were also reviewed. The review was not able to access evaluative data held at organisational level due to time and resource limitations. The literature review searched for documents which focused on the particular role of the third sector in providing health and social care services in Scotland. Policy documents which outline the recent proposals and implementation plans for service reform were also identified. Review and associated paper compiled by Laura Major, PhD Candidate (ESRC), Department of Social Anthropology, University of Edinburgh (as part of a broader three month internship with Scottish Government) and by Dr Kay Barclay, Third Sector Division, The Scottish Government. We would value your feedback Did you find the content of this paper useful? Comments on layout? Any suggestions for improvement? Other evaluations that you can point us towards? 43 Please?return?your?feedback?and?any?other?comments?or?queries?to:? Dr.?Kay?Barclay Third?Sector?Division,?Scottish?Government Kay.Barclay@scotland.gsi.gov.uk? 0131?244?7470 44 Review of engagement between Scottish Government Health and Social Care Directorates and the Third Sector. Purpose of this paper: To make recommendations to the Quality Alliance Board (through its short life working group on third sector engagement) about the use of Community Benefit Clauses (CBCs) in contracts and how these might be implemented initially in the NHS and eventually across Health and Social Care settings. Introduction The overarching strategy for healthcare in Scotland, the Quality Strategy (2010), emphasises the importance of the relationship between Scottish Government and the Third Sector in pursuing the Quality Ambitions, and embedded throughout the strategy is a commitment to a partnership based approach. Building on the relationship between the Scottish Government Health Directorates and the Third Sector at a strategic level, and in order to maximise the contribution of third sector organisations to action on the Quality Ambitions, a short-life working group has been established to review, develop and scope a number of options to progress this area. The short-life working group consists of representatives from third sector organisations, NHS Health Scotland and Scottish Government. This group will meet three times over Summer/Autumn 2011 and present a report and recommendations to the Quality Alliance Board at their November 2011 meeting. As part of the review of this group, NHS Health Scotland and Senscot have been tasked with exploring the potential place of Community Benefit Clauses in procurement processes, and make recommendations about how these can be implemented initially within the NHS and eventually across Health and Social Care settings. Engaging the Third Sector in service design/delivery The Scottish Government is committed to developing an enterprising Third Sector which can play a valuable role in putting service users at the heart of the design and delivery of public services and take advantage of market opportunities. This was further highlighted in the Christie report from the Commission on the Future Delivery of Public Services (June 2011) and the recent budget statement which placed an emphasis on the Third Sector’s role in developing programmes with a focus on preventative spend. Using CBCs in health and social care contracts offer important ways of achieving a greater role for the Third Sector and potentially offers efficiencies and innovation that can deliver better outcomes for service users. In order to encourage this shift in culture the Scottish Government have piloted a number of Public Social Partnerships (PSPs). PSPs have introduced new service delivery models, delivered in partnership with third sector organisations who play a key role in service design, will, it is envisaged, culminate in a procurement contract with CBCs in place. Community Benefit Clauses In February 2008, the Scottish Government published a report and guidance on the use of CBCs in public procurement. These clauses are now being used in a variety of projects across the public sector to deliver wider social benefits, including targeted recruitment and 45 training as well as opportunities for social enterprises and SMEs in the supply chain. The work and recommendations of the short life working group are an opportunity to build on this work by making CBCs the norm in NHS procurement with a view to their being central to all health and social care procurement in the future. A Community Benefit Clause is one of a range of social considerations that can be included in public contracts which can help deliver wider economic and social benefits, through buying goods and services. CBCs are contractual requirements which seek to deliver wider social benefit within a procurement contract that form part of the criteria on which contracts are assessed and evaluated. Four elements are fundamental for CBCs : -Employment – e.g. targeted recruitment and training (TR&T) -Reducing carbon footprint -The inclusion of the enterprising Third Sector -Community Consultation Benefits of CBCs Preventative spending is at the heart of the Scottish Government’s response both to the need to address inequalities and to do so in the context of reduced resources. Through helping preserve local jobs within communities most at risk, as well as helping to sustain an enterprising Third Sector focusing on the needs of the most vulnerable groups CBCs are a powerful means of promoting this agenda in action. In addition experience has shown that CBCs promote collaboration between private and third sector bodies as joint tendering becomes more widespread. CBCs have developed considerably over recent years. Historically, the focus has been on targeted training and recruitment but increasingly, as evidenced by Commonwealth Games construction contracts, the New South Glasgow Hospital construction contract, Green Academies in the Fuel Poverty Division’s Energy Assistance Programme and others, CBCs are being developed to encourage contractors to engage with SMEs and social enterprises in the supply chain. In addition, clauses are developing into other areas such as education and public realm (publicly owned streets, parks, publicly accessible open spaces and any public and civic building and facilities) initiatives. There are many examples from community transport to leisure, health and social care where CBCs have enabled social enterprises to successfully deliver high quality and user-focused services. CBCs are already in use in the NHS. NHS Health Scotland for instance has embraced them as part of its response to the sustainable procurement agenda and has proved a valuable tool in getting suppliers in line with the aims of this agenda. Sustainable procurement is ‘a process whereby organisations meet their needs for goods, services, works and utilities in a way that achieves value for money on a whole life basis in terms of generating benefits to society and the economy, whilst minimising damage to the environment.’ (Sustainable Procurement Task Force) A recent tender for a framework of film production suppliers served as a model for future tenders and involved auditing potential suppliers on their sustainability credentials. Questions included how economic, social and environmental sustainability implications were factored into the film production service. 46 Examples of CBC’s listed below: www.readyforbusiness.org/downloads/casestudies141011.doc : Key Drivers A recommendation from the short life working group to include CBCs in all NHS contracts as a first step in making their use a normal feature of all health and social care procurement is very much in line with Scottish Government policy and drivers. The Scottish Government already has in place a Sustainable Procurement Action Plan but is committed to delivering a Sustainable Procurement Bill which will require the inclusion of social, economic and environmental considerations when public bodies are buying goods and services. This will be a key driver for change. In addition, the Scottish Government has issued national contracts to support the Third Sector’s role in public service reform and delivery. Key to working with the public sector on PSPs developments and using CBCs in procurement is the Scottish Government’s ‘Developing Markets for the Third Sector’ which will provide support and promotion across the public sector. Progress is already being made in raising awareness about the need to include CBCs in service contracts which should have the effect of widening the opportunity for third sector organisations to participate in sectors such as health and social care.CBCs fit well with the Scottish Government’s ‘Procurement Journey’ approach which is intended to support all levels of procurement activities and to help manage the expectations of stakeholders, customers and suppliers). It facilitates best practice and consistency across the public sector by providing one source of documentation nationally which can be updated on a continual basis with any changes in legislation, policy and promotion of best practice. () Social value is regarded as the additional benefit to a wider community that comes from the direct purchasing of services .e.g. a befriending scheme has a wide range of community benefits as well as improving the health and wellbeing of individuals. The Scottish Government will promote the use of Social Value which will include the use of tools such as Social Return on Investment (SROI ), Social Auditing ( ) and others to support the public sector to measure the community benefits achieved through CBCs. Recommendations 1.Community Benefit Clauses It is recommended that Community Benefit Clauses (CBCs) are a standard component of procurement within the NHS. The key elements of CBCs are that they place a legal obligation on suppliers in respect of employment, carbon footprint and the involvement of social enterprise. NHS Boards should be accountable for their use of CBCs through the Annual Review process and monitoring should be incorporated into the Procurement Capability Assessment. All NHS procurement through the Public Contract Scotland portal should include CBCs. Each NHS Board needs to report on current use of CBCs by the end of March 2012. This should be seen as a first step in making the use of CBCs the norm within procurement across the Health and Social Care sectors. 47 2.Support for NHS Board procurement A range of supportive measures should be in place to support NHS Boards to comply with the requirement to include CBCs as the norm in procurement procedures. Some of these are already in place or planned but they could usefully include measures to raise awareness within NHS Board procurement departments about the contribution of the enterprising Third Sector and supply chain development; opportunities to increase awareness and skills with regard to CBCs (e.g. social procurement training); mechanisms to promote good management of contracts and CBC conditions such as the Balanced Score Card. 3.Good practice examples Working through the Social Enterprise Health Roundtable, NHS Health Scotland and Senscot are able to offer learning about the incorporation of CBCs into procurement for mainstream contracts and the development of exemplar NHS Board policy in this area. Sources of Help & Advice/Useful sites Community Benefits in Public Procurement Guidance Note Public Contracts Scotland: Ready for Business: Public Social Partnerships: 48