Budgets, Blunkett and getting old...

So, the Budget. And the missing £40m. It’s disgraceful that the Local Sustainability Fund still hasn’t been launched, more than a year after it was first announced. This idea - promoted by ACEVO and agreed by OCS under Nick Hurd - has been quietly dropped for now. They hoped quietly but I intend to ensure there is nothing quiet about this manoeuvre. Of course we suspect why this has happened. The idea that you need a ‘sustainability fund’ implies there are many charities in danger from funding cuts and rising demand for their services. This does not fit the current narrative of the ruling coalition. I suspect the hand of Lynton Crosby in excising this particular ‘barnacle’ from the budget speech ‘boat’.

So will Rob, our civil society minister, now stand up for the sector and insist on the fund going ahead? We have only a week before purdah. I’m hoping that Rob will set the record straight at our ACEVO and CAF hustings on Tuesday. He will certainly be asked what happened!

Whatever the good aspects of the budget - raising tax allowances, moves on savers, etc., it is deeply worrying for our sector what might happen on cuts. The IFS comment about a “rollercoaster of cuts to come” will have been greeted with dismay in our sector as we and our beneficiaries will undoubtedly bear the brunt.

In fact I was in the Commons after the Budget. I was having a late lunch with Nick Hurd MP, for a catch-up and an opportunity to reflect back on the 6 years he spent in the job of civil society minister or spokesman. 

As you can imagine it was a wide-ranging discussion. But with a particular emphasis on social finance and how we promote it. And then onto a reception to mark the contribution that David Blunkett MP has made to society generally and to youth charities in particular. A great and emotional occasion as he is a towering giant of a politician and a friend for over three decades. Indeed there was a gaggle of us former local government types from the 80s reminiscing in the corner - led by the brilliant Margaret Hodge MP.

Of course the danger of getting older is the huge temptation to reminisce about the good old days. But more importantly, as the population ages, as the working life extends, as many of us get older and live longer with long-term conditions we need to look carefully at the role of our sector in working and supporting older people. 

Often this subject is approached from a negative and unhelpful position. Us oldies are a burden. We soak up resources. We get too many free perks. So it’s good that today we get the report Decision Time: will the voluntary embrace the age of opportunity? It’s the final report of the Commission on the Voluntary Sector and Ageing Ably led by Lynne Berry, former active ACEVO member when she ran WRVS. 

As they say, “longer life expectancy is opening up new possibilities for individuals and communities”. It offers the potential of an age of opportunity in which the third sector could thrive. Worth reading. Worth taking up the challenge. 

This is a good approach, and certainly for those of us in our seventh decade (me and Stuart Etherington to name but two!) this age of opportunity is something to be welcomed.

Charities and A&E – quiz the ministers!

Well today’s been good for drawing attention to charities’ work in A&E. We’ve announced a new programme with Red Cross, Age UK and RVS, funded by the Cabinet Office. 700 charity volunteers to work in the 29 most under-pressure A&E departments around the country, and help reduce demand on A&E over the next 12 weeks. See today’s Telegraph for an excellent roundup by Chris Hope.

Naturally, this is the precursor to bigger things. I’m making sure that government collect evidence of how charities can reduce the load on A&E. It’ll be a good evidence base for a wider national intervention in future years. Charities need to be integral to A&E strategic planning in future. This programme will help make that happen.

But what of the parties’ thoughts on the third sector’s role across social care + health? At election time this is the important question.

On 3 March ACEVO’s Health and Social Care Conference is the biggest such third sector event. In central London (and in front of the BBC + other cameras!) we’ll have not only Jeremy Hunt but also Labour’s Andy Burnham and the Lib Dems’ Paul Burstow to put their respective pitches to third sector leaders. With lots of time for questions. And in the morning we have a session with Simon Stevens of NHS England – an excellent chance to discuss progress on his five year forward view.

I highly recommend you come along, whether you’re third sector leader or anyone else. Tickets here: https://www.acevo.org.uk/event/spring-health-social-care-conference-2015. See you there!

Recognise what charities can do in A+E

On the sofa at 6.45 this morning! That is, on the sofa for ITV’s ‘Good Morning Britain’, where I was talking about how charities and social enterprises can work with the NHS to relieve pressure on A+E.

Of course we often forget charities have been working in hospitals for centuries. Indeed we used to run them. Not that I want to see a return to those days, but I do think people in the NHS increasingly see the value of our sector – professional staff  and trained volunteers – working alongside medical staff to ensure the right care and treatment for the frail elderly.

It’s scandalous that so many hospital beds are occupied by people who are not sick but cannot get back to home because of social conditions. It’s scandalous that older people who attend casualty are signed off by medical staff but end up in hospital because of a transport breakdown or worries there is no one back at home and it’s bitterly cold. Hospitals are bad places for people who are not sick. And it’s a senseless use of scarce hospital resources.

Addenbrookes, a hospital ACEVO has been working with on this issue, says 20% of their beds are occupied by older people who don’t need medical care. This is not a clever way to run our NHS. And charities can help solve that problem.

Last year I worked with my CEO colleagues in 3 big national charities whose mission is to support older people in the community: the Red Cross, RVS and Age UK. We worked up a proposal for Government that would ramp up the role of our sector in hospitals and in the community. We wrote to the PM setting this out. Letter is here.

We have been working on this since and discussing with hospital CEOs etc. There is great interest, but also, frankly, huge barriers in the system to implementing this.

Yesterday, along with a range of colleagues from the sector, I went to a meeting with the Cabinet Secretary and the Department of Health Permanent Secretary to talk about how to mobilise support for the most stretched A+E departments. It was productive and helpful. I was tasked with providing a report to indicate what we might do in the short term for the highest-priority hospitals and I'm now busy talking with my CEO members on what this might mean. I have until Monday to report back. I have a round table with some of the charities most involved tomorrow morning to discuss practicalities.

Longer-term we need to grip this issue and sort it. The point I made at yesterday’s meeting was that there are 3 main barriers to change:

• Culture – the NHS doesn't generally understand the modern third sector and too often thinks of ‘do gooders’ not professionals.

• Systems – the third sector is not embedded inside hospitals at A+E, or on the wards, in planning or in early discharge teams.

• Commissioning – this is done on transactions not outcomes. There are no incentives for hospitals to work with the third sector and the current commissioning process generally ignores it.

Now we need both to help in target areas, to secure better care for our elderly citizens, and to seek organisation reform. Ultimately we need radical approaches to health and care that galvanise the third sector. Systems that move us from the margins to a partnership approach in the NHS and in councils, that does the best for the individual’s well being.

One of the earliest tasks for our charity sector, a millennium ago, was securing good health and care for the sick and old. It’s time the nation rediscovered the genius of charity.