Exploring the difference made by Support at home 13 In 2011, three pieces of research (two in England In 2007, the National Strategic Partnerships and one covering Scotland) were carried out Forum highlighted that the voluntary sector’s role on behalf of the British Red Cross to capture in health and social care is distinct from other commissioners’ experiences, views and current providers in the commercial or statutory sector. commissioning practices for services offering The “added value” that voluntary organisations low-level support at home.5 In line with the can offer is suggested to include community policy priorities set out above, three specific engagement, access to “hard-to-reach” groups, commissioner objectives were evident across innovation, cost-efficiency, strong user and the board: carer involvement, volunteers and absence of > Developing prevention strategies and stigma and threat. However, a review carried avoidance of unnecessary admissions into out by Dickinson et al. (2013) for the National hospital. Initiatives supporting this are a major Institute for Health Research (NIHR) School priority. For example, exploring better options for Social Care Research suggests caution in for falls response and prevention. attributing these common values across all voluntary sector organisations delivering social > Expanding the provision of time-limited re- care. They highlighted that the nature of the ablement services. This is viewed as critical relationship between state commissioners and to help people “get back on their feet again”, voluntary organisations is critical in achieving either when they have been discharged from the greatest impacts. While there is evidence of hospital or when there is a risk of them strong partnerships between trusts and voluntary needing to be admitted to hospital. However, sector providers in achieving high-quality, patient- a pressure on resources was also acknowledged centred care, there remain some barriers to as a barrier to expanding this provision. effective partnership working, including a lack of mutual understanding and clarity of roles > Ensuring flexible, personalised care. The and responsibilities. personalisation agenda is a big influence on commissioners and is driving a shift in the In addition, the current economic context emphasis of care from fixed, condition-centred of restricted financial resources presents a care to flexible, person-centred care. challenging environment for volunteering. Naylor et al. (2013) highlight the importance of Further priority areas mentioned by having a strategic approach, a clear vision and a commissioners included: minimising delayed focus on volunteering as a means of improving discharges; dementia care provision; relief support quality rather than cutting costs. These factors for carers; re-ablement services for people with are described as key enablers for seizing the chronic conditions; and emphasising choice and opportunities that exist in health and social care control in social care support, including more now and in the future. people using personalised budgets. the role of the voluntary sector in delivering social care Voluntary sector organisations have been involved in the delivery of social care for a very long time. In a recent King’s Fund report, Naylor et al. (2013) highlighted that around 3 million people volunteer in health and social care, making an important contribution to people’s experience of care. 5 A survey was carried out with 169 Local Authority and NHS commissioners in England and 3 in-depth interviews with GP Consortia commissioners (in Care in the Home Commissioners, IFF Research, 2011); 14 in-depth interviews with LA and NHS commissioners were also carried out in England (in the Study of Care in the Home Commissioning, IFF Research 2011); In Scotland 8 interviews were carried out with Red Cross staff and 11 interviews with LA and NHS commissioners (in Care in the Home Commissioning Environment Scotland, Emma Naismith 2011). All studies included commissioners who do currently commission Red Cross services and those who don’t.