LTCAS

Once there has been time for the Christie Commission report to be digested and debated it will be time for the hard work of breathing life into its ambitious vision.

The third sector has a significant contribution to make, both in helping drive cultural change and innovation, and in ensuring the voices of people who use services are at the heart of the agenda.

LTCAS’ recent conference Long Term Conditions and Public Service Reform, Working with people; building communities gave a focal point for this debate in relation to the two million people who live with long term conditions in Scotland.  The event, unsurprisingly, revealed concern that provision does not keep pace with rising need and that already many people and organisations are experiencing substantial cuts.  However there was also cautious optimism that we now have a real opportunity for radical change.

The shift in approach advocated by the Christie Commission echoes much of what LTCAS and our members have been advocating since coming into being in 2006.  People who live with long term conditions want to be in control of their lives, treated as equal and active citizens and supported in ways that recognise their human rights and enable them to live well.  It is clear that within individuals and communities (whether of geography or interest) there exists a wealth of assets that must represent the key to facing the demographic and economic challenges ahead.

LTCAS’ conference report (link to report) identifies a number of issues that must be addressed in taking forward the public service reform agenda.  One theme to emerge is that of power and the need for people to have genuine voice and influence in their own lives and in the policy and services that affect them.  Related to that is the need for a major cultural shift towards approaches that recognise the complexities of people’s lives – not viewing their needs in separate silos – and that work with the capacity of individuals, families and communities.

The conference reinforced the energy that the third sector brings to developing approaches based on co-production, a holistic response and the delivery of high quality, personalised outcomes that result in savings for higher-cost statutory services.  However, the potential of the third sector to help realise the Christie Commission’s vision is contingent upon improved strategic – and funding – relationships between the sector and local statutory agencies.  There is strong support for an increased role for the sector, and recognition of the need to shift resources to preventative, community based provision.  However the vast bulk of resources remain tied up in acute and crisis end statutory provision and funding for the third sector is rarely made on a longer term, strategic basis.

The Self Management Fund has already begun to demonstrate the potential of a relatively modest investment in the third sector.  The 81 projects supported so far have all been founded on the type of approach that Scotland now needs to embrace as the rule, not the exception.  People themselves have been at the heart of the projects and there has been a strong focus on unlocking, and developing assets and capacity.  This theme is described in more detail in the latest in LTCAS’ series of Self Management Fund Special Reports Building Capacity (link to report), published in partnership with Voluntary Action Scotland.

LTCAS has secured political commitments to the future of the Self Management Fund but the risk is that the Christie Report, whilst lauded nationally, fails to penetrate the local structures that impact so greatly on people’s lives.

Health boards and local authorities are already responding to the economic climate by retrenching and reducing the type of activity that would support the Christie vision.  LTCAS, with our members, will be working hard to secure improved partnership arrangements between health boards, local authorities and the third sector organisations that provide high value, low cost, preventative support across Scotland’s communities.

That medium to longer-term resource shift from public sector to third sector and community facing activity is not pain-free. Neither is it a panacea to the huge demographic challenges. It is an approach that needs to manage party allegiance, electoral considerations and the entrenched bureaucracies of the public sector to make a reality of the vision set out by the Christie Commission.

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