Due North: A Voluntary, Community and
Social Enterprise Sector Perspective
Briefing Aims:
- Summarise the findings of Due North, as relevant to the voluntary, community
and social enterprise sector (VCSE).
- Highlight ways the VCSE can promote health equity in the North.
- Identify way public sector partners can enable VCSE action on health equity.
Jo Whaley, January 2015
About Due North
Due North was produced by an independent review panel, commissioned by
Public Health England (PHE). It aimed to bring a Northern perspective to action
on a nationwide problem - growing health inequalities. It aims to enable
collaboratives (local authorities, city and county regions, health and wellbeing
boards and others) across the North to advocate for, develop and apply policies
and actions that will reduce inequalities between (and within) the North and the
rest of England. The report builds on three elements of the Marmot Review:
economy and welfare; a fair start for children; and democratic and community
empowerment. It provides additional evidence on what actions are needed to
tackle the underlying determinants of health on the scale needed to make
a difference.
Due North details the main causes of the health inequalities including differences
in:
 poverty, power and resources needed for health;
 exposure to health damaging environments, such as poorer living and
working conditions and unemployment;
 chronic disease and disability left by the historical legacy of heavy industry
and its decline;
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opportunities to enjoy positive health factors and protective conditions that
help maintain health, such as good quality early years education;
economic and food security, control over decisions that impact your life;
social support and feeling part of the society in which you live.
Due North notes that health inequality has been further exacerbated by cuts in
public spending and there is a grave danger that steps towards economic
recovery continue to widen health inequalities, especially along the North-South
divide.
The report sets out a series of recommendations, aimed separately at northern
agencies (including the VCSE) and central government. The four high level
recommendations are:
1. tackle poverty and economic inequality within the North and between the
North and the rest of England
2. promote healthy development in early childhood
3. share power over resources and increase the influence that the public has
on how resources are used to improve the determinants of health
4. strengthen the role of the health sector in promoting health equity
The aim of this briefing is to pull out key aspects of how the VCSE can support
the recommendations and how public sector partners can enable VCSE action
against health inequalities.
Potential actions for the VCSE sector to address health inequity
Many of the practical solutions proposed in Due North are bread and butter to the
VCSE sector (e.g. promoting credit unions, giving benefit advice, supporting
healthy child development, empowering involvement in democratic processes
such as participatory budgeting). Much of the sector's work is with the poorest
communities - those experiencing the worst health outcomes. The next section
outlines possible actions VCSE organisations could take to impact on health
inequalities, particularly between the North and South. Some are taken directly
from the Due North report, others are extrapolations based on Regional Voices'
intelligence from the VCSE sector.
As service providers
1. Deliver place-based services which communities can shape.
2. Re-energise VCSE sector involvement in delivering holistic employment
support with an emphasis on the person and on building confidence,
wellbeing and opportunities.
3. Share and scale up good practice which makes a difference - work with public
health partners to demonstrate impact.
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As local partners
4. Contribute to local intelligence about health inequity, and how this intelligence
can be 'translated' into local action.
5. Co-design place-based services, and support communities to work with policy
makers and funders to shape change.
6. Support the development of intelligent local investment strategies which build
connections (networks) and community capacity (knowledge, opportunities,
motivation) especially with regard to early years' public service delivery
outcomes.
7. When involved in local enterprise partnerships and combined authority
governance ensure that reducing economic and health inequalities and
promoting health and wellbeing are central objectives in economic
development strategies.
8. Provide expertise on working and make links with specific communities and
equalities groups - make sure no-one gets left behind.
As employers
9. Become Living Wage employers.
10. Ensure that volunteering is not used as a form of job substitution.
11. Support the development of an effective VCSE sector workforce strategy e.g.
in a developing early years' delivery landscape and around Making Every
Contact Count.
As lobbyers/campaigners
12. Use the Social Value Act to lobby for maximum social value from public
sector spend, including funding of local VCSE organisations and investing in
local services.
13. Advocate on behalf of communities and equalities groups to make sure noone gets left behind as economy begins to grow.
For Healthwatch organisations
Due North made several recommendations specifically for Healthwatch, aiming
to increase its role in monitoring progress against health inequality:
14. Government should invest in and expand the role of Healthwatch as an
independent community led advocate that can hold government and public
services to account for action and progress on health inequalities.
15. PHE could work with Healthwatch and health and wellbeing boards across
the North of England to develop community-led systems for health equity
monitoring and accountability.
16. Healthwatch could be positioned to work with community groups and PHE to
develop measures of progress on health inequalities at the national and local
authority levels. They could involve communities in tracking progress both in
terms of the community as a whole and inequalities within and between
communities.
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National organisations may also wish to
17. Use Due North findings to influence national bodies (grant makers, policy
makers etc) to address structural causes of health inequalities.
18. Apportion activity relevant to geographic need.
Support for VCSE to impact on health inequalities
19. Enable development of relationships between VCSE organisations and public
sector partners (public health teams, centres and PHE nationally, CCGs, NHS
England area teams, local authorities, health and wellbeing boards etc) to codesign solutions to health inequalities.
20. Support VCSE organisations to use intelligence, including that held by public
health and NHS partners, to help make the case for interventions (to enable
commissioning and input into JSNAs) and support with measuring impact
(see Comparing Apples with Oranges - How to make better use of voluntary
and community sector evidence to improve health outcomes).
21. Invest in the local VCSE organisations. "Spot purchasing" rather than "core
funding" leaves organisations financially vulnerable; particularly smaller,
trusted, organisations, which are most able to address specific inequalities (in
geographic communities and communities of interest).
22. Invest in VCSE infrastructure organisations (also called umbrella
organisations or support and development organisations) which enable
smaller organisations to work more strategically and can help public health
and the NHS to engage with the VCSE sector and the communities
they serve.
23. Commissioners should be aware of barriers to VCSE involvement in
commissioning and work with the sector (locally, regionally and nationally) to
help to overcome the barriers (see "The Voluntary and Community Sector
and Localised Health Commissioning")
24. Local enterprise partnerships and combined authorities governance could
benefit from working closely with, and investing in, the VCSE sector to ensure
that reducing economic and health inequalities, and promoting health and
wellbeing, are central objectives in economic development strategies (see the
Local Enterprise Partnership Engagement Project).
What do you think?
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Are the recommendations right?
What would help your organisation address health inequalities?
Let Jo.Whaley@regionalvoices.org know if you have anything to add.
Links to further information
Due North report (links to full report and executive summary)
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PHE interim response to Due North and slide set on Health Equity North
Local action on health inequalities: evidence papers (Public Health England and
Institute of Health Equity). These resources translate the Marmot Review
recommendations into practical, evidence based actions.
PHE Longer Lives website data which demonstrates the scale of the health
issues and health inequalities impacting on the population of the North of
England.
Comparing Apples with Oranges- How to make better use of voluntary and
community sector evidence to improve health outcomes (NHS Confederation,
Regional Voices and LGA).
Regional Voices connects voluntary and community organisations with
government, through nine regional networks, to inform and influence policy at
local, regional and national levels. Regional Voices is a Strategic Partner to the
Department of Health, NHS England and Public Health England. To find out
more about Regional Voices' work in health, wellbeing and care go to Regional
Voices' website.
Follow us on twitter @regionalvoice
If you require this information in an alternative format or
further information email or call: contact@regionalvoices.org
0113 394 2300
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