Health and wellbeing in the Harrogate District –
what is the future role of the voluntary and community sector?
Report of event held
Tuesday 27 March 2012
at the Cairn Hotel, Harrogate
Hosted by Harrogate and Area Council for Voluntary Service
and funded by the National Association for Voluntary and Community Action
Purpose of the event:
 To bring together VCS and health organisations to explore how they can work
together in the new health framework to achieve positive health outcomes in the
Harrogate District
Objectives for the event:
 For everyone – to receive an up to date briefing on the current position on NHS
reorganisation in the Harrogate District and the opportunities this brings
 For voluntary and community sector representatives - to learn more about the key
players in the future commissioning and provision of local heath care
 For health and local government sector representatives - to learn more about the
current and potential role of the voluntary and community sector in health care
Intended outcomes for the event
 A shared understanding of the NHS re-organisation in the Harrogate District and
how this will affect roles, responsibilities and commitments in the future
 Recognition of the voluntary and community sector as a key player in the health
and wellbeing of the local population
 Identified next steps for developing a effective working relationship which results in
improved health outcomes in the Harrogate District
Tony Collins, Janet Probert, Alistair Ingham and Jon Burke
2
The delegates at the Cairn Hotel
ATTENDANCE
60 people participated in the event. 43 VCS and 10 statutory organisations were represented,
with 2 private sector colleagues and a number of service users & carers also in attendance.
See Appendix 1 for full attendance list.
The event was chaired by Harrogate and Area CVS Chair Tony Collins (also Chief Executive
of St Michael’s Hospice) and 6 members of the Harrogate and Rural Clinical Commissioning
Board were present (Drs Sarah Hay, Alistair Ingram, Chris Preece, Gareth Roberts and Rick
Sweeney and Locality Director Amanda Bloor).
PROGRAMME
Tony Collins, HACVS Chair and Jon Burke, NAVCA Development Adviser (Health and Social
Care) welcomed everyone to the event and explained why it had been organised by HACVS
and funded by the National Association for Voluntary and Community Action.
The first part of the programme involved presentations from representatives from the health
and voluntary and community sectors to set the scene:
Alistair Ingram, Chair of the Harrogate& Rural Clinical Commissioning Board
P:\Events And
Meetings\NAVCA Health Event March 2012\H
Janet Probert, Director of Partnerships and Innovation, Harrogate and District NHS
Foundation Trust
P:\Events And
Meetings\NAVCA Health Event March 2012\E
Kate Tayler, Chief Executive, North Yorkshire and York Forum
P:\Events And
Meetings\NAVCA Health Event March 2012\H
Karen Weaver, Harrogate & Area Council for Voluntary Services
P:\Events And
Meetings\NAVCA Health Event March 2012\H
Alex Bird, Sadie Davy and Nora from Age UK North Yorkshire
P:\Events And
Meetings\NAVCA Health Event March 2012\H
April Baskind, Care in the Home Service Manager Yorkshire, British Red Cross
P:\Forums\Hgt
District Chief Officers & Chairs Forum\2012-0
WORKSHOP SESSIONS
After the break workshop sessions were held, with 6 groups each led by a GP or NHS North
Yorkshire and York representative and supported by a note taker. There was then a final
round of key points from each of the 6 groups, fed back by the group leader
PROVIDING INTEGRATED CARE AND SUPPORTING LONG TERM CONDITIONS
Table 1 (Dr Chris Preece/Angela Jones)

Integrated Care needs to happen everywhere with everything.

Some long term conditions likely to increase (e.g. dementia) but others may decease e.g.
respiratory conditions due to smoking trends

VCS and social care to work together – more of willingness than before, positive

Added benefits of VCS

GP’s know people in a locality /patients – do PCT’s? This is an opportunity

But GP’s don’t know who doesn’t come through their doors and now have a responsibility for the
community

Challenge for all people heard – role for VCS

People registered out of area (e.g. Henshaws students) – part of community “invisible people”

Obstacles for integrated working in past – used to be a feeling – perceived VCS provided “inferior”
services and didn’t appreciate preventative work

Improved communication & co-ordination – electronic/ paper / for people with learning difficulties

Resources needed to support process

£ didn’t go into preventative services – went to people in crisis

Now beginning to work better

Integration health and social care and also many VCS orgs – local services (not cross county) –
value in local services

Connection with communities, hidden voice – through VCS, role of CVS

Issues with knowing what is available in VCS for GP’s. “Where to Turn”

Suggested community hubs to connect and signpost – to liaise on delivery of care plan

Neighbourhood networks – people with similar conditions

Making sure services involved in pathways – issues for smaller organisations – collective VCS
response

Clarity on pathways – ‘cradle to grave’

Include needs of many older people in residential homes
4

GP knows value of VCS work – have to show outcomes and value

Licensing

Have to move forward now

Change – how to integrate change for all of us

How will different commissioning bodies work together for people who cross sectors – will they be
missed

Hope to commission with one voice to improve community care

Shared terms and language about what we mean will help us make progress – v important

Everyone on panel needs to be a decision maker

Integrated Care Teams – include VCS person to signpost

Single Point of Access
Summary – “positive with difficulty”
Table 4 (Alistair Ingram/Naomi Garbutt)
What works well?
What works less well?
Doing it better together
Demonstrating outcomes - how demonstrate “prevention” outcomes?
What works well?

Track record of good services – good relationships

But changes have led to unsettled working relationships

Risk of undermining good services

E.g. free counselling service support services for mothers working closely with health visitors
preventative re post natal depression

Many mental health services refer to the VCS services (easier to access than secondary mental
health services, but no statutory funding, feel unrecognised)

Outcomes – VCS more advanced in this than statutory commissioners – used to doing it for Big
Lottery etc

Culture of people wanting to work together

High level of volunteering (but may change owing to demographics)

Appropriate roles for volunteers – need to be defined by role descriptions – reasonable
expectations/boundaries

Lots of expertise in sector - volunteer centres & long established orgs
5

Volunteers need training and support – not “free” (Big Society model doesn’t recognise this)
What works not so well?

Commissioning – tends to be task based not outcome focussed/patient centred

(E.g. all about how much/how many etc not difference achieved)

Commissioners don’t define outcomes they want

May “count” wrong things e.g. throughput not improvement for individuals

Gaps in services – personality disorders, diversity/BME needs

Funding reductions – hence even more need to invest in preventative work
How work better together?
Common frameworks – outcomes measurement, volunteering good practice
Communications between health & VCS
Collaborations and consortia around different service areas:

leading to consistency and quality standards

Local networks e.g. Harrogate Chief Officers and Chairs
VCS increasingly working in partnerships – not necessary to compete. Also bring in funding
How to commission specific services for individuals?
Various models for integration/better join up:

Core pathways

Knowing who involved with a patient
GP’s need to know who working with a patient
Working relationships with VCS
More away from “clinical model” to wellbeing services
Key point: need new models for communication
6
HOW TO EMBRACE WHAT THE VCS HAS TO OFFER
Table 2 (Dr Sarah Hay/Mark Codman)

VCS mentioned on every pathway

Not coordinated, more thought (book etc) – directory of who is in the Harrogate District

Do not know where to start

People would use it

Where does patient go for help?

Not one person co-ordinating the care on person gets

Different people need info in different ways – GP’s, members of public, learning disabilities etc

Role of CVS – have membership and if member in directory of VCS organisations

Sometimes people prefer to go to VCS rather than GP

Need uniform way for VCS organisations to get info into GP’s – what do they want

Nobody takes charge of info in surgery

When visit surgeries take up is not consistent

Central point needed?

Providing activities etc in GP surgeries useful working towards

Mutual understanding of funding streams for GP and may be look at more partnership working

Community group in Harrogate hospital foyer and rules about selling things/raffle – rules limit what
they can do – VCS more flexible

Need to tie up referral and feedback to GP from VCS

Mechanism to share information between VCS and GP’s

Coordinate when is the best time to promote VCS groups – flu clinics etc

Does the VCS need spokespeople to represent all members – role for Your Consortium?
Summary of issues: better information, not one size fits all, role of NHS 111?
Table 5 (Dr Rick Sweeney/Kate Tayler)

Understanding of existing services and structures

Need to join up service knowledge/responses more

What do we do if there is a problem – signpost what “we think” is the right response

Encourage proactive response to VCS organisations
7

Community integrated teams – VCS co-ordinator could be pivotal in this

Need to be very local responses

“Quality” needs to be embedded throughout
ENSURING INCLUSIVITY AND ENGAGEMENT
Table 3 (Gareth Roberts/Jackie Snape)

What do we need to know more about?

How long will it take to gather information?

How often will information need to be reviewed?

Is there a voice for hard to reach groups/people with mental ill health to be heard?

Needs to be clear and transparent who is funding what

What are the channels of communication with the social care professionals and providers?

How to providers get “known”?

Will the process for obtaining funding for services be too formal?

Will CCG have access to online information about vol sector providers?

Will providers need an approved quality standard?

How will providers demonstrate outcomes and value?

What do providers need to do and by when?

Will there be a conflict between the needs of CCG to report to Health and Wellbeing Board and the
needs of patients

How is the Borough Council going to feed into the H & WB Board?

Will there be formal links from all forums to the H & WB Board?

Will there be financial help for providers to reach the community?
Summary of issues:: communications, linking things up
Table 6 (Amanda Bloor/Nina Muir)
How to engage (and meaningfully) so it is a two-way process – key factors to consider:

Opportunities

Gaps

Concerns

Involvement in change
8

Quality outcomes

Financial outcomes
Issues:
How do we convey information to the RIGHT people? It is a ‘market’ but don’t want to disadvantage
smaller organisations.
Streamlining - integration includes clarifying pathways versus piecemeal services.
How do we communicate?
Managing shared outcomes i.e. working together to a specification; VCS has expertise on outcomes
Residential/Nursing Care:
Empowering seldom heard. Recognition that service users in residential sector need empowering to
engage:

Barriers

Isolation

Limited communication with providers – non engaged, seemingly by choice

Difficult to influence as not health commissioned

Not transparent

Significant quality concerns
Homecare

Meeting needs of carer and cared for; carer often forgotten

Addressing information need, “whole life approach”

Navigating information that is available – informs pathway options
Additional note:

Suggestions to streamline information via HUBs and categories including Health and Social Care

Joining up social care and health interventions

Current issues related to funding of each
9
Overview of workshops feedback
Based on combined notes of Karen Weaver & Tony Collins

Linking together – how to find out what’s out there and who represents those not currently
engaged

Coordination and information – no accident that NAVCA has funded HACVS to run this event – it
is part of our local support and development role and what we have traditionally been funded by
NHS NYY and NYCC to do. In place for 12/13 and for a further 2 years by HBC

GP’s being told to commission on outcomes by organisations who don’t know how to do this – a
shared experience with the VCS!

Potential for VCS to be involved in integrated care plans

Issue of quality and competition – we don’t want a supermarket system. This area is known for
smaller local shops – we want to have “artisan bakeries” for health – this is refreshing to hear

Not obvious how to engage – how do we engage meaningfully and get cleverer at this

Need to develop separate intelligence on residential homes

Surprise at the range and quantity of voluntary sector services in the area; very positive

Some concern over how to access information about the services as needed – make it easy for the
CCG – there is a lot out there

Apprehensive about a journey with a long way to go but also one with a positive feel about it and
an air of excitement

Need to keep the conversation going
Norah and Sady Davey from Age UK North Yorkshire
10
EVENT FEEDBACK SUMMARY
26 feedback forms were returned and overall satisfaction with the event was good. See Appendix 2 for
full details.
Some additional feedback from 3 participants:
Andy Wilkinson • Thank you Karen and to all your staff for a first class event (fire alarms excepted!).
Having the new commissioners there was very useful and signalled that we really need to streamline
our offerings so that they can be commissioned. For my charity, it gave me food for thought about
where we should concentrate. Andy
Jackie Snape • Really good event, it was interesting to hear from the GP's their perspective on how
the CCG's will work and slightly disturbing to find out about their lack of knowledge of what the
voluntary sector has to offer. Very encouraging though that they were interested in what we do and
keen to know more.
Geoffrey Raspin • Thanks from us at Advocacy too. It was an excellent event - instructive and useful.
Worth every bit of all HACVS's hard work.
CASE STUDIES
Each of the GP’s was presented with a case studies document which had been prepared with
contributions from various VCS providers as an experiment in providing information on the VCS role in
providing health related services. Feedback from the Clinical Commissioning Board on this was
invited.
P:\Events And
Meetings\NAVCA Health Event March 2012\Combined case studies doc.doc
NEXT STEPS
Copies of the final event report to be circulated to all attending and to the HRD CCB
Next steps to be developed by HACVS in conjunction with the Board, NHS NYY (Amanda Bloor) and
the Harrogate District Chief Officers and Chairs Group, but likely to include:
•
•
Keeping the VCS / CCG conversation going – HACVS has secured a small amount of
external finance secured to help make this happen
VCS leadership and forum in place to keep the conversation going – Harrogate District
Chief Officers & Chairs Group
Continuing to bring things together and to develop a shared mechanism to realise VCS
commissioning based on collaboration not competition
Connecting up with NY Health & Wellbeing Board via NY VCS representative
Connecting up with the lay representation on the CCG Board
•
Further case studies from the VCS to be developed
•
•
•
11
Grateful thanks to:

NAVCA for providing financial support for the event

The chair and speakers for giving up their time and making such valuable contributions,
especially Nora from Age UK Knaresborough who offered inspiration and practical advice
in equal measures

Amanda Bloor (NHS NYY) for all her help and support in developing the programme and
bringing along 5 GP’s on the day

All the facilitators & note takers, particularly Jackie Snape for bringing her own flipchart
board!

The Cairn Hotel and HBC for help with setting up and loan of equipment

Bev Richardson for efficient behind the scenes admin and front of house on the day

Everyone who attended and helped to make the event such a positive morning
12
Appendix 1: Attendance List
NAME
April
Alex
Amanda
Christine
Jean
Helen
Jon
Alison
Clair
Denis
Mark
Tony
Samantha
Margaret
Nanci
Nicki
Mark
Pet
Councillor Ian
Naomi
Wendy
Catharine
Hazel
Dr. Sarah
Dr. Alistair
Angela
Sue
Rachel
Rosemary
Cllr Stuart
Heather
Val
Lindsay
Nina
Dr. Chris
Janet
Jill
Geoffrey
Sally
Sue
Dr. Gareth
Lizzie
Jackie
Rachel
Margo
Dr. Rick
Kate
Helen
Andrew
Chris
Karen
Andrew
Liz
Sadie
Nora
Alan
SURNAME
Baskind
Bird
Bloor
Boxall
Broadbent
Brown
Burke
Carter
Challenor-Chadwick
Cleaver
Codman
Collins
Craggs
Douglas
Downey
Eyre
Flood
Fowler Watts
Galloway
Garbutt
Green
Green
Griffiths
Hay
Ingram
Jones
Lamb
MacKenzie
Marsh
Martin
McGuinness
Michie
Mitchell
Muir
Preece
Probert
Quinn
Raspin
Read
Rees
Roberts
Rosewood
Snape
Souter
Swales
Sweeney
Tayler
Todd
Van Parys
Watt
Weaver
Wilkinson
Winship
Davy
Rawson
ORGANISATION
British Red Cross
Age UK North Yorkshire
NHS NYY
Carers' Time Off
Harrogate Branch of Arthritis Care
Carers' Resource
NAVCA
Harrogate Advocacy
Age UK North Yorkshire
Harrogate & District LINk
HBC Dept of Corporate Policy and Improvement
St Michaels Hospice
CRI Services Manager with her GP Sally Read
With Sue Lambert
Harrogate Branch of Arthritis Care
Henshaws
Orb community Enterprise
Home Instead Senior Care
Chairman Voluntary Sector Forum
NYCC Health and adult services
Your Consortium Ltd
Age UK North Yorkshire
Harrogate and Rural District CCG
Harrogate and Rural District CCG
HACVS
With Margaret Douglas
Opening Doors
Patient Voice Group
Ripon CVS
Time Together
Patient Voice Group
Harrogate Branch of Arthritis Care
HACVS
Harrogate and Rural District CCG.
Harrogate and District NHS Foundation Trust
Alzheimers Society
Harrogate Advocacy
CRI Harrogate
N Y Link
Harrogate and Rural District CCG
Talking Space Counselling Service
Disability Action yorkshire
British Red Cross
Age UK North Yorkshire
Harrogate and Rural District CCG
NYYF
Harrogate District Community Transport (Little Red Bus)
Home Instead Senior Care
Harrogate and District NHS Foundation Trust
HACVS
Harrogate Hospital and Community Friends
Crossroads Care Harrogate Craven and York
Age UK North Yorkshire
Age UK North Yorkshire - Service user
Cancer Action Partnership
13
Appendix 2: EVENT FEEDBACK
26 feedback forms were completed:
Local Authority
Health
Private Sector
Voluntary & Community
2
3
3
18
Quality of Event
Good
Adequate
Poor
19
3
0
Skills/Knowledge of Speakers
Feedback from 26 respondents based on a score of 1 - Good 2 - Adequate 3 Poor
Therefore best possible score is 26
All respondents marked speakers good or adequate from all respondents who gave a score
(not all respondents scored all speakers and the case study score was for all 3 case studies combined)
Alistair Ingham
Janet Probert
Kate Tayler
Karen Weaver
Case studies (3)
29
28
31
25
25
Key Implications of changes for your organisation?

How we develop true integration


It has created an organisation! Hopefully giving us more opportunity to influence local
provision of services for our community
Integration of social care (Housing) with future health care issues

Links - health work - role/statutory. Obligations. What is in it for the individual

Funding - communications

Commission and tendering for services

Coordination / support for VCS and NYCC and health organisations
14





Impact on future commissioning and delivery of services. Identify needs to improve future
services
Funding - method/source of?
Funding for services has ceased. Engagement with new commissioners / CCGs is v
important
Licensing to meet commissioning requirements

Driving healthcare closer to the patient needs portable rugged equipment (as opposed to
large hospital based items). This will cost money
The group will now be monitoring HDFT’s community services

Engagement for vulnerable individuals

AC nationally under threat, branch need to function independently. Keeping abreast of
changes nationally and locally, "marketing group" and lack of volunteers
To provide co-ordinated access to funding for small VCS organisations and provide a one
stop shop to commissioners in accessing the wide range of VCS service on offer
It all seems very confusing at the moment




As a carer I am concerned about the changes in health and social care for my autistic son
and as myself as a carer
I don't know

How will they know who we are?


Commissioning body will change. Need to fund a way that CCG/VS/Private/statutory can
work together
Contracting our service

New commissioning/funding routes

Partnerships that are really effective
Have the implications become clearer?
YES
NO
20
3
What actions will you take as a result of this event?

Spread the word in own organisation
15

Further research into 'new world'. Communication with others in the sector

Brief my committee and watch developments closely

Keep up to date with progress and opportunities

Keep getting out there, got to put work in.

Raise the profile of Your Consortium Ltd to CCG and all 750 VCS orgs in Harrogate

Greater input into my deaf group. Research open aspects of what is going on

Think about it

have contact with more people to make clear what we do

Try to engage with new CCG

Network with similar organisations

Attend further events and follow up new contacts

Review how we can engage third sector in service provision
What further support do you need form your local support and development
organisation to prepare you for the changes?

Similar event with public health

Keeping me up to date

Opportunities for change, knowledge and having discussions with range of partners

Keep up providing information


Any training that would be available to ensure we are fit for commissioning
Opportunities for engagement/communication with other third sector organisations
We will support moving care to patients financially

Information and contact point

Keep carrying on with information, advice and networking events

Don't need any
16

Need to know more about monitoring and quality control under new regime?

We want to be involved
To what extent will the event improve the effectiveness of your organisation?
Not at All
Not Much
Some
A Lot
0
4
13
4
ADDITIONAL COMMENTS


Workshop was really good - GP presence demonstrated their willingness to engage.
Felt for the first time that partnership was possible
Really appreciated the fact that the GPs and commissioners had attended and
committed time to listen and hopefully learn and vice versa
A very good and useful morning

Very useful networking event

Would like involvement in future events as health and wellbeing continues to evolve

Keep holding events - terrific, good!


YCL and organisations like us have a role in championing the work of VCS and helping
commissioners to make sense of the vast array of services on offer. We also provide a
Workforce Development arm which supports smaller orgs to develop their internal
governance and quality to ensure they continue to be sustainable
Provision for the deaf needs to be better. No loop system. Sound system poor.
Missed a good deal of what was said.
As an ED nurse and carer I found session useful but hope this is not just a one off
event and communication
None at all

More of today



KW 25/4/12 P:\Events And Meetings\NAVCA Health Event March 2012\Event report\270312 Harrogate Health Event Report.doc
17
HARROGATE & AREA COUNCIL FOR
VOLUNTARY SERVICE
We support charities and volunteers to make our area
a great place to live and work.
How Can We Help You?
support your charity, community group or social enterprise
help you get involved in volunteering
signnpost you to local support organisations.
www.harrogatecvs.org.uk
Harrogate & Area Council for Voluntary Service Limited
Company limited by guarantee Registered in England and Wales
Registered Charity No. 1144758 Company No.7760477
Affiliated to the National Association for Voluntary and Community Action (NAVCA)