How can the contribution of small community-led agencies and associations be recognised and maximised in the new local systems of health and care?
This was part of a series of events to explore what can be done to reduce health inequalities and improve social care, in our communities, and nationwide.
Lara Rufus-Fayemi, our thought leader on the theme of ‘joining forces’, opened the discussion by pointing out that many organisations claim that they bring about positive social change, but the truth is that most social change is complex and challenging and cannot be achieved by a single organisation on its own. We need to build a practice that goes beyond organisational self-interest, she said, combining with others to make a real and enduring impact.
She gave the example of Tower Hamlets Together, a coalition of statutory and voluntary organisations in East London, which is setting up a new health inequalities fund, aiming to bring about a culture change with a focus on preventative activity by voluntary and community organisations able to operate on the ground, with better integration into the wider system.
Anne Bowers, Newham Council’s strategic lead on community engagement in public health, then spoke about the critical importance of continuing to build mutually respectful and open partnerships and relationships, of the kind that happened early in the Covid pandemic. The pressures we now face, with cost of living for example, are unequally distributed, and are already creating challenges for health outcomes.
To address the ‘social determinants of health’ we need to support communities, which we are all part of, to be health-promoting and health-enabling. And when people are not healthy, they need services which are accessible, relevant and trusted. For all this to happen, the relationships with voluntary organisations and with community associations are critical, she believes.
In some cases, where the voluntary sector organisations really understand the problems and hold the relationships, e.g. with people with no recourse to public funds, the council needs to respect this, and its role may be convene and to channel resources, and advocate for policy or practice change, but not to try to control everything itself.
Anne gave an example of commissioning some insight-gathering via a local organisation, which works with new mothers from Black and Asian backgrounds. Here the council has taken care not to be prescriptive about the method or set targets for number and types of people to be contacted. All this has been left to the organisation, on the basis that they know best how to approach the task, they are best placed to cultivate the relationships that are needed to produce the real insights.
Anne explained that the council’s overall aim is to encourage, enable and enhance ways in which residents can take action to promote their health. Methods include small grants and a participatory budgeting programme. The council is also able to use its convening power, bringing people together, understanding that in doing so it can’t always predict what will happen. It is reviewing its strategy, including how best to build internal and external capacity, and how to establish shared governance and oversight, and make it possible to better assess whether the various activities are achieving the outcomes which are collectively wanted.
When is enough, enough? she asked. Statutory services, more and more, are relying on community champions, those able to convince others in their communities of the value of a particular health intervention, e.g. the Covid vaccine. But the failure to engage lies with the statutory system. Are we putting our problem on other people to solve? It is implicit in the language we use, she suggested, that it’s the responsibility of communities to keep themselves healthy, or heal themselves, yet often the responsibility truly lies with decisions taken in the statutory system, often at national level. It's hard to create partnerships and trusted relationships when people feel that a huge burden of responsibility has been placed, unfairly, on them.
Sometimes the council needs to share a problem, in an open way. For example, cost of living and access to food is a shared problem, which belongs to everyone in a community. The council has some capabilities, but so too do communities and community groups. We need to let go of the idea that the council is fully responsible for the solution, and act on the basis of shared responsibility and mutual respect.
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Here are some of the points that emerged from the subsequent breakout and plenary discussion:
Many of the policy statements from the NHS and local councils are excellent, it was felt. But practice is lagging far behind.
Budgets are not being devolved in a significant way. Attempts to do things differently, for example through social prescribing, are undermined by under-investment in community organisations.
Where there is funding for small community organisations and associations, a much lighter-touch approach is needed from statutory agencies and large charities. There are good examples of this, e.g. in place-based work in Cambridgeshire.
People are tired of being asked for their expertise with no financial recompense – ‘we are not here to service large organisations and make them look good,’ one said. But we know it is possible to work with people in a more positive way. We heard about a university/voluntary sector collaboration in Bristol, where a research project is using arts and community development methods to establish a respectful, not exploitative set of relationships with people from a local community.
If the formal institutions want to engage well with people in their communities they need to establish a reciprocal relationship, with reward and recognition - offering something of value in the here and now: money, or support, or a change of practice.
Fundamentally, we need to shift the perspective that the leadership that’s is needed to bring about a more healthy society comes from above, ‘it can come from all around you’ as someone pointed out.
Joining forces across sectors, including with the private sector
Summary of key points
The theme of the discussion was ‘joining forces across sectors, including with the private sector’.
The main points which emerged from the discussion were:
The business sector has resources at its disposal that are far greater than anything the charity sector could ever hope to deploy.
It is therefore potentially a huge force for positive change, especially if companies can make a shift to discover their core social purpose.
The charity and wider social sector can encourage that to happen, but that means going well beyond asking for money.
It means finding better ways to build alliances and join forces across sectors, inviting companies to help discover the solutions, and help to design new approaches.
On both sides we need to recognise and respect the ‘different worlds’.
There will be misunderstanding, disappointments, and bad experiences. But we shouldn’t allow that to become the barrier to trying again.
Social sector organisations will achieve most when they approach businesses with positive intent, and assume the same positive intent in them as well.
It is important to generate small wins, to keep the momentum. And to build on that with creativity and ambition.
In more detail
Steve Wyler, co-convenor introduced the model of change set out in the recent Better Way publication Time for a Change, which some have called the Better Way ‘beachball’:
In this cell we are exploring the ‘joining forces’ element of this model while noting that there are connections between all four elements, and indeed that applying them in combination makes each more effective.
Our focus this time was Joining Forces across sectors, including with the private sector: How can we build alliances not just between the voluntary and public sectors but also with the business sector?
As Cate Newnes Smith, thought-leader for this cell, pointed out, collaborations with businesses often work best where there is one clear theme where a difference can be made in people’s lives, rather than spreading efforts too thinly, and where the charities are not simply approaching companies with a begging bowl.
Presentations
We first heard from Tom Levitt, former MP and author of the Company Citizen.
He started by saying that Corporate Social Responsibility is insufficient. It is optional, short term, input led, and usually about fundraising and team-building rather than about making change.
Rather the focus should be on ‘purpose’, a reason for being which goes beyond, or even comes in front of, making money for a company’s owners. The very term company derives from the Latin meaning to ‘break bread with’ – a social not just economic purpose. Over a century ago the Lever brothers, W.H. Smith, Jessie Boot, and others founded companies which had a real social purpose.
The potential for businesses to make a difference is huge. The turnover of Oxfam is about £1m a day. This is equivalent to a single large Tesco store. If just 1% of the business sector’s revenue were to be applied to doing good that would dwarf what charities can achieve.
In recent years the funding provided to charities from private businesses has reduced. But in some cases this is because the businesses are taking on social projects themselves. For example the Wates company is training prisoners so that on release they can take up jobs in the construction industry. This is good for the business too, helping to create a skilled and potentially loyal workforce.
Tom pointed out that more companies are now addressing climate change, especially the FTSE 100 companies. 40% of all investment is now ‘climate sensitive’, according to the World Economic Forum.
Tom set up Fair4You as anti-poverty private company, to provide an alternative to high cost lenders. Capitalism, said Tom, is a toolbox, and the tools can be used to maximise profit, or to maximise good, or somewhere in between. It is in the interests of business to put things right. For example poverty is not good for business, if people can’t afford to buy their products. Climate change is not good for business, because it raises far too many unpredictable risks.
The social sector has its own unique role, Tom acknowledged. But in partnering with business, and acting as advocate, in raising the gaze of business from the short term to the long term, and in raising the moral and practical issues, it is possible to establish a win-win situation for business, the planet and society, and that he believes is the way to go.
We then heard from Mel Smith, Deputy CEO at Grapevine Coventry & Worcestershire.
Mel explained that Grapevine’s work is all about creating deeper relationships between people, sometimes by being playful, introducing the unusual, with elements of hope and joy and music.
During the pandemic Grapevine hosted a series of ‘Summits’ and learned a great deal about the process of gathering people together to bring about change. For example, who should be there, how should the discussion be framed to achieve the best possible outcome, how can the energy from the event be harnessed?
A Public Sector Summit came first, involving national as well as local contributors, and this addressed three questions:
How can we keep shared humanity as a motivator?
How can we model and normalise new ways of working around permission, risk, and shared purpose?
How can we continue to collaborate together on end goals and outcomes that meet everyone’s needs?
This was followed by a public sector ‘thinkers and doers’ group, which continues to meet.
The Business Summit built on this learning. Grapevine was able to draw on relationships which had been formed over time, before the pandemic, with businesses which had connection and belonging at their heart, and which seemed to be well placed to support the Grapevine mission to end marginalisation and isolation.
For example Grapevine had started to build a relationship with Drapers, a café/bar, and Drapers agreed to host Grapevine social living rooms. The management were willing to say ‘Yes’ to Simon who asked if he could buy a coke and blackcurrant cordial for the same price as their cheapest drink and sit there as long as he wanted. And as the relationship deepened, Drapers provided a Christmas meal for a group of people Grapevine was working with, and discussed their staff induction with Grapevine. They decided that they should position themselves as a community-facing business.
It was becoming clear, said Mel, that town centres need to be destinations that are more than just about shopping. They also need to develop as places for sociability and belonging. So the Business Summit explored two big questions:
How can we improve our recovery prospects by making sure that behind our shop fronts the door opens to a range of experiences for socialising and belonging?
How can we make sure that connection, sociability and belonging are hard-wired into re-imagining the future of our high streets, and suburban core?
It felt important to have many voices around the table, including for example speakers from local and national companies, and the Business Improvement District leads.
Grapevine had never before really thought about the business sector in such depth. Mel said, ‘It is hard, we are trying to understand each other’s world, and what change we can make together’.
A cross-sector working group, including Grapevine, the Local Enterprise Partnership (LEP) and Chamber of Commerce, has been formed. The Summit has led to a discussion with the Coventry Building Society, and they have decided to fund a community organiser post to work specifically with the business sector, able to connect with those at grass roots levels but also speak to those who hold power and make decisions in Coventry. Grapevine is also working with an artist to design resting spaces, and is in discussions to establish them with companies across the City.
It really feels like entering a different world, said Mel. It is important, she said, to gain a really deep understanding of each other, developing the local contacts and relationships, sharing tangible examples including local stories as well as things that are happening elsewhere in the country, which show the potential of what can be done together and which demonstrate the aspiration and inspiration for change. And also small wins that can keep the momentum and appetite for change going.
Discussion
Breakout sessions were then held to consider the question: ‘How can we build better alliances with the business sector?’ In the feedback and further discussion participants made the following points:
We need to understand better what is likely to attract a business into an alliance
We are likely to achieve most if we can discover the shared value, the mutual benefit. For example, the common ground might be the well-being of people in the community where the business operates, and where its employees and customers come from.
It is usually a good idea to approach the business as a prospective partner not just as a prospective funder. It is attractive for businesses to be positioned as leaders or pioneers, and ideally as a major part of the solution. Businesses can offer leverage, not just money or volunteering days
We need to remember that many businesses will need to be persuaded of a business case, and need to believe that there is potential for financial or reputational benefit, even if that is likely to come about indirectly.
Social sector organisations may be able to offer routes to customers or influence or funding. They may also have specific products such as disability awareness training which the company can benefit from.
It is helpful, some felt, to think about alliances and joining forces rather than partnerships.
Suspicion and prejudice exist on both sides and must be recognised and overcome
It is not easy to build good relationships across sectors. There are likely to be differences in motivation, in culture, even in world views. There are likely to be many misunderstandings and disappointment on both sides.
Charities can sometimes be viewed as a soft touch by unscrupulous businesses, and treated badly, especially if they are seen simply as a route to attracting public funds, or establishing a better public image. Equally, unscrupulous charities can treat businesses as a soft touch, telling them whatever they want to hear to attract money, and delivering very little in return.
It is not surprising then that the voluntary sector often has a prejudiced view of the business sector. But it is useful to remember that any large company can often be experienced as positive or negative by different charities at different times. And while a bad experience with a single company can easily generate a psychological barrier to future relationships with the business sector as a whole, that is not a sufficient reason to give up on the attempt. Keep trying, it was said.
Equally, it is not surprising that the business sector often has a jaundiced view of the ‘begging-bowl’ charity, and often underestimates or undervalues the skills in the social sector. But charities and other social sector organisations are experts in their field, and there is a more respect in the relationship if they can establish that from the start. And moreover many of the people working in the social sector have highly developed business skills – some, for example, are highly entrepreneurial and have expertise in managing complexity. The more contact businesses have with social sector organisations, the more likely they are to realise that.
Welcoming spaces to meet and positive intent are often the keys to success
It was felt that, to start with, we simply need to create better opportunities for the two sectors to meet, so that there are more opportunities to overcome misconceptions on both sides, and build relationships.
But the interactions need to be positive from the outset. Social sector organisations should offer a warm and welcoming space for businesses, to reach hearts and not just minds.
It is essential to set out with positive intent and assume that this positive intent is shared by others. When those in the social sector approach businesses with suspicion, and mistrust their motives, it is much less likely that something worthwhile will happen.
Future meetings
19th October, 3.00pm-4.30. Joining forces to inspire, rather than to control: If, in our collaborations, we seek to control the actions of others we may be preventing the growth of something bigger, a wider social movement. So, can we ‘let go’ when we collaborate, without losing our way?