Moving from rhetoric to reality

The health and social care sector faces six key challenges and opportunities, says Steve James, CEO of the Avenues Group, and it’s time we turned ideas into practice

On 17 October, I will be chairing a meeting of ACEVO’s health and social care special interest group in Manchester. This is an opportunity for leaders from a whole host of different health and care charities to come together and talk about the big issues we face.

More importantly for me, it’s a chance to make a practical difference to the work my organisation does. This can mean a chance to talk to decision makers about the way they’re going about their jobs. Or it can mean getting advice from experts in their field.

That’s why, in Manchester, we’re bringing together experts and practitioners to address the six areas that I believe represent some of the biggest challenges and opportunities facing the health and care sector.


Like it or not, Brexit is the big issue in the UK today. A year on from the referendum, we’re beginning to understand what the government’s position might look like, but we’re still some way from knowing what the future will hold. This matters to our beneficiaries – obviously – but it also matters to charities as organisations.

Everything from who we can hire to which medicines we distribute is influenced by the EU. The nature of our departure will have a huge impact on how we operate over the coming years and decades.

Workforce development

One of the challenges Brexit may bring is a reduction in our workforce. The health and care sector currently employs huge numbers of EU citizens – a number which may or may not have to fall when we leave the EU.

Leaving aside staff numbers, the skills of our workforce are increasingly important. Developments such as personalised care require a new skillset, and it is up to charities to help ensure their staff make the grade.

Digital transformation

I’ll hold my hand up to not being the most technologically savvy person – I don’t use Twitter, and don’t know my BitCoin from my blockchain. But I do know that technology has the potential to totally change the way my organisation works. I mean, 20 years ago emails were considered a bit forward-thinking. While there’s little to no chance of working out what everything will look like 20 years hence, it remains important to stay on top of this rapidly changing area.


One of the most positive trends of recent years has been the integration agenda. We’re moving away from a place where you had primary healthcare in one silo, social care in another, employment in a third and public health somewhere else entirely. Instead, integration allows all of these issues to be tackled in a more holistic way.

This is something the sector is still getting used to. Not all commissioners have yet acclimatised to the new way of doing things, and not all providers are working fluidly across boundaries yet. But, if we can get it right, it could change the way we deliver services to vulnerable people.


Tied in with the shift towards integrated services is the need for collaboration. Charities can’t get distracted by the competitive funding process, pursuing every contract regardless of their ability to fulfil it, to the detriment of the people we serve. Sometimes, I have to hold my hand up and say that my organisation isn’t best placed to do a certain job. At times like this, working with other organisations – whether they’re charities, social enterprises or the public sector – can help to deliver a higher standard of care.


Last but by no means least, is commissioning. The reality of the sector means that for many health and care charities – mine included – government funding is essential to carrying out our work. In principle, this shouldn’t be a problem. However, nearly a decade of budgets being tightened has left its mark.

Commissioners have fewer resources, but there’s been no drop of in demand for the services they fund, and we provide. This isn’t a simple problem, and it’s not one that we can solve overnight.

Putting it all into practice

These are big issues, and there’s plenty of talking going on about what good looks like, and how we as a sector and a society can ensure that the full potential of our health and care system is reached.

Part of my role as a leader is to do more than just talk. We need to quickly get beyond rhetoric, and start to put these ideas in to reality. It’s once we’ve done this that we’ll see the improvement in our health and care system that we really need.


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