What is the issue?
Our health and social services are under extreme pressure, due mainly to budget cuts, but additional pressures include more elderly people, high expectations around care and medicine provision, with a lack of well-paid secure jobs and affordable housing creating related social pressures – all likely to have the greatest impact on the most vulnerable. Clearly our national and local services face an extraordinary set of challenges and it appears that solely relying on a government and market approach to deliver what people need is failing us. However, our health is at the heart of our personal resilience, on which our community’s economic resilience rests.
Caring Town Totnes is a local network of 70+ public, voluntary and private organisations and groups that care about our community. We’ve come together to pool our resources, our skills and our ideas to try to make sure that we all have the health and social care we need, across all stages of our lives.
One issue is that Commissioning bodies tend to contract with larger organisations which are often primarily profit driven, and offer a limited range of options albeit at scale. While there are some advantages of this model, it excludes the participation of smaller, more flexible, socially-oriented, locally embedded organisations that are finely attuned to actual needs. The organisations behind this bid believe there’s a huge opportunity to provide some services in a far better way by using the local community – while defining the appropriate roles of statutory, private and voluntary sectors – and collectively we have the ideas and likely solutions for many of the issues we face.
What will the project try to achieve?
The project will bring together some key local commissioners and delivery organisations and their users, to co-design new models of commissioning and delivering 2-3 key community priority health/welfare services, which can reduce overall costs; improve on health outcomes; and help stimulate a more vibrant, independent marketplace, including new procurement processes that better enable local enterprises to compete for contracts. These new service models will underpin the business plan for a new community-led enterprise that can be commissioned, then in turn commission local service delivery; it will model new economy principles, and be the cornerstone of the development of a more local marketplace. Thus the project intends to provide a viable alternative to the current model, one that commissioners feel able to engage with, and is itself cost effective as an enterprise with access to a variety of funding and income streams, with lower overheads and being not for profit. Wider integration with other place based activity – food, housing, education, creativity etc. – will help ensure complex needs are met, and that root causes are better understood and addressed more systemically. There will be a review at the conclusion of this stage to decide whether to implement the business plan or not.
Who might be interested in this project?
This project will be most relevant for those who are interesting in new models of community-led commissioning and delivery for health and welfare/social services.