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Reframing how place-based health is commissioned for sustainability and impact

“Recent years have made three key things increasingly clear to those who work in health and social care. The first is that prevention is completely critical to achieving the shared objectives we have with the resources we have. The second is that healthcare is not something that happens in hospitals and GP surgeries: it needs to be part of our work lives, our leisure time, our environment, our eating and our community. The third is that the NHS system cannot do this on its own: we can only make the shifts and transformations required through working across sectors and using the skills, capacity and reach of a wide range of partners.”

– Nick Temple, Deputy CEO, Social Enterprise UK

Uscreates have recently collaborated with the Healthy London Partnership (HLP) to produce A Guide for Commissioners alongside a Sister Guide, which recommend how the commissioning process can be adapted to ‘level the playing field’ for voluntary, community and social enterprise (VCSE) organisations; as well as how commissioners can begin to provide proactive support – incubation – and activate the sector. This is not only critical to ensuring that public sector funding is used most effectively, but also to ensure that people and communities have access to a range of local services which are able to meet their needs, sustainably.

The guidance builds on the Healthy Communities work we did with HLP last year to kick-start and incubate place-based initiatives, led by local people including social entrepreneurs, and capable of delivering health outcomes without on-going public sector funding. It is also based on broad engagement, interviews and input from a wide range of thought leaders from across the system; including commissioners, funders, social enterprises, charities and other innovators. It includes case studies which demonstrate some of the potential opportunities for commissioners.

Make Kit is a case study featured in the guide. It is a social enterprise run by two local social entrepreneurs that we helped kick-start at Uscreates as part of the Healthy Communities programme commissioned by the Healthy London Partnership. Make Kit provides healthy and affordable recipe kits in Hackney to improve access to and knowledge of how to cook healthy food, with the aim of reducing health inequalities and combating the obesity crisis.  Central to their operational model is being able to access local space in the community,  that can be leveraged by commissioners, for free to act as pack assembly and distribution hubs.

The VCSE sector can play a particularly important role in helping to upscale prevention within the complex and financially challenged system. VCSE organisations often have a wealth of knowledge and connections within the local community and are able to narrow health inequalities by reaching people who would not usually engage with the public sector. They are also able to access and build-on local assets and attract funding toward health from outside of the public sector.

Areas of support to consider in commissioner-led incubation

The guide is intended to stimulate dialogue on the value of the VCSE sector, its ability to create additional capacity for improving health and care in the community and the role that commissioners should play in ensuring the sector remains diverse and sustainable.

We believe that by using limited public sector funds more effectively, at both a local and pan-London level, by working more closely with the VCSE sector to design services more sustainably, and by incentivising greater collaboration and the development of more diverse business models; more could be achieved for people and communities. By effectively activating and incubating VCSE organisations, commissioners would not only see their money going further, but would also start to see the increase in prevention and improvements in population health that is required to bring the health system into balance.

Joanna is Design Director at Uscreates. She is a social designer, author, speaker and lecturer with over 15 years of practical experience in the UK, the Middle East and the United States. She leads on the development and delivery of service design, user centred innovation, design research, business modelling, communication and digital design projects. Joanna has worked with over 50 public and third sector organisations – including Nesta, The Healthy London Partnership, the Health Foundation and South London and Maudsley NHS Foundation Trust – to help them better understand and address their challenges. She has expertise across a broad range of social challenges including health and wellbeing, social integration, social action, employment, education and social enterprise. Joanna has a Ph.D. in design for social integration and is an RSA fellow. She is an associate lecturer at the University of the Arts London, Kingston University and Ravensbourne University.