A combined approach to supporting older people

How can health and social care, and the third sector better support older people in Wales? Age Alliance Wales outlines the need for a combined approach.

By 2041, the population of Wales is projected to increase by 4.6%, to 3.26 million, with the number of those aged 65 and older projected to increase by 36.6%, to 232,000.

Support for Older People in Wales

In May 2017, the Welsh Institute for Health and Social Care (WIHSC), working in partnership with WCVA and Age Alliance Wales, issued a ‘Think Piece’ report, reflecting on the role of the third sector in supporting older people’s health and care needs, and how relationships need to develop in order to meet the rising challenge of ageing.

This was followed by a second phase of work, with the aim of further examining the issues emerging from the Think-Piece, resulting in a second report, Support for Older People in Wales – Health, Social Care and the Third Sector: A Discussion Paper (available here).

Funding overhaul

One of the key points raised in that second paper is that a major overhaul of the funding regime for the third sector is needed. The flat-lining of grants has had huge implications. The increasing commercialisation and professionalisation of the third sector, brought about through a growth in contract relationships and a need to show “value for money”, is placing it in danger of losing its original identity, not only as a sector which promotes volunteering, but also in terms of the other roles it often fulfils, like engagement, influencing and user voice.

Role of the third sector

The report clarifies that the Social Services and Well-being Act has been effective in moving people away from statutory services, on occasion even when they are entitled to them. This means that the third sector is often the only option for people in need – very often without associated funding. There needs to be a greater recognition that resources should follow responsibilities. Overall there is a need for the statutory sector to recognise and respect the role of the third sector so that sustainable strategic relationships can be built, without the public sector just looking for the ‘cheap’ option.

Identifying need

The report also raises the need for more input from service deliverers into identifying what people need, requiring better use of the ‘intelligence’ within the third sector. Local authorities should adopt an outcomes-based approach to commissioning and service delivery based on co-production (avoiding simply paying ‘lip-service’) and should avoid slipping into a ‘commissioner/provider’ relationship.

Responsibilities of board members

With regard to the new Regional Partnership Boards and Public Service Boards, the report notes that notions of ‘representation’ and ‘membership’ are continuing to evolve, as are the cultures and behaviours around board tables. However, the roles and responsibilities of board members need to be clarified so that all parties know what is expected of them. Of course, this raises the question as to whether the third sector has the capacity required to contribute to all of these groups, given their finite resources. At present the sector is responding to the challenge but may be considered to be struggling to keep pace with the changing landscape, requiring additional support to engage effectively with these new arrangements.

Collaborative working

So, where does this leave us and what might we conclude about the future? The report suggests that in many ways the circumstances facing the third sector in Wales could be described as reaching a “new normal” stage. Grant funding for the sector is set to continue to fall, but there is a growing level of contracted services in the huge and ambitious legislative agenda. However, this has resulted, in parts of Wales, in the third sector becoming less collaborative and more competitive.

The concept of reciprocity is crucial: working together within formal collaboration or informal partnerships is the best way to improve practice. Change will only come about if both the third sector and the public sector make a commitment to improve the current situation and move towards developing more sustainable strategic relationships.

Age Alliance Wales is an alliance of national voluntary organisations working together with, and for, older people in Wales.