Voluntary Health Scotland (VHS) has rallied behind third sector leaders’ calls to implement solutions that shift the sector from being seen as a ‘nice to have’, as its Chief Executive says a “perfect storm” of rising demand and financial pressure means it is harder than ever for organisations to stay afloat.

At the end of its annual conference, which emphasised the importance of amplifying voices of change, VHS gathered insights from its final roundtable session which asked: Is the third sector in crisis and what can we do?

While there was a resounding sense from those working in the voluntary health and care sector that ‘yes, it is in crisis’, suggestions for change were not in short supply.

These include shifting the perception around money and resources to support voluntary organisations to stay afloat and develop systems that reflect the vital role of the third sector, rather than viewing it as a ‘nice to have’.

This comes after the Scottish government revealed in its winter health and care plans that it will continue to explore how volunteers can support health and social care systems this winter.

VHS Chief Executive Tejesh Mistry told healthandcare.scot that having urged the government to demonstrate that third sector is not third in line for resources, he has since returned to Scotland’s health secretary with feedback from across the conference.

Solutions for a sector in crisis

Along with a shift in perception to better value the sector, the conference heard calls for local authorities and the government to work with third sector staff to embed person-centred care at the “heart of our health system”.

Following the conference, the VHS has not only returned to the Cabinet Secretary for Health and Social Care, but also Scotland’s ministers for public health, social care and mental wellbeing to share areas to act upon.

VHS has shared calls for a levy – or public health tax – on supermarkets to fund public health initiatives: target those making profit to utilise this to improve public health.

Another area people from across the sector echoed throughout the conference was the importance of public and community transport to address health inequalities and patient missingness.

Scotland’s Deep End GPs highlighted this during the conference session on patient missingness in primary care, outlining some early insights from a GP scheme to help find ‘lost’ patients.

Third sector staff reflected that free or subsidised travel for those who need it most would “transform access to health”.

A focus on ‘health creation’, ensuring communities are safe places for people to thrive, with quality transport and accessible, healthy retail choices and sectors that collaborate to support good health has also been shared with Scotland’s leaders.

Mr Mistry says that without this preventative work, the health of people across Scotland will suffer:

“Maintaining the vital role of the third sector in working in partnership alongside public sector organisations and in particular our health and social care services as a whole.

“Without preventative work, individuals and communities may not have safe spaces, sufficient support and trusted relationships to turn to.

“We are likely to see a decline in their health and wellbeing, they will need to access emergency care at a higher cost, or worse still, they might go ‘missing’ from view from a society that seeks to support and nurture happy and healthy lives.

“We should all feel that this position is unacceptable and many of our health professionals understand the third sector plays a vital role in wider support both before and after medical care.

“We need to shift to a world of health creation and not move backwards as progress has been made.”

However, Mr Mistry told healthandcare.scot that many organisations are at risk if closing amid recent funding cuts:

“There is a perfect storm of external factors that are exacerbating the operational environment for third sector organisations. The wider funding climate is extremely challenging, with trusts and foundations heavily oversubscribed, and public sector grants and contracts being cut or reduced in recent months and years.

“For leaders, this results in a lot of pressure as they seek to navigate organisational, staff and delivery expectations.

“They are required to maintain operations and quality of services whilst not having the stability to provide a fair level of support, sustainability, and resources to staff.”

He said this inevitably creates workforce challenges as workers in need of increased salaries amid the cost-of-living crisis are faced with a lack of job security and benefits.

Mr Mistry said as a result recruitment and retention are “severely impacted” which directly affects the delivery and quality of services, with people increasingly asked to deliver more with less staff and resources.

He added:

“Morale is low in some organisations, particularly those that have gone above and beyond through COVID years to serve their communities at a time when public services were closed or stretched.

“To face significant risk to their sustainability and to see and feel the impact of cutbacks is damaging for wellbeing. Doing more for less inevitably can take its toll in terms of workload and stress.”

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