Dr Richard Dune

27-06-2025

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Why VCSE organisations are critical to tackling health inequalities, empowering communities, and advancing NHS integration goals

The Voluntary, Community, and Social Enterprise (VCSE) sector plays a pivotal role in delivering more joined-up, equitable, and innovative care. Whether through grassroots support, social prescribing, or strategic partnerships, VCSE organisations are essential partners in Integrated Care Systems (ICSs) and Provider Collaboratives.

In this blog, Dr Richard Dune explores their role, value, integration, challenges, and potential in shaping the future of health and social care in England.

What is the VCSE sector, and why does it matter?

The VCSE sector encompasses a diverse range of organisations driven by purpose rather than profit. This includes everything from small grassroots charities and community groups to national faith-based organisations, social enterprises, and mutuals.

What unites VCSEs is their deep-rooted connection to the communities they serve, often those who are marginalised, underserved, or disproportionately affected by health inequalities. These organisations are trusted by local people, especially in places where statutory services struggle to engage.

VCSEs play vital roles in:

• Supporting mental health, housing, employment, and prevention
• Delivering services designed and led by the communities they serve
• Offering flexibility, creativity, and rapid response, especially demonstrated during the COVID-19 pandemic.

Economically, the sector contributes around £18.2 billion annually to health and care, employs over 1 million people, and mobilises nearly 14 million volunteers across the UK.

Their blend of innovation, local knowledge, and preventative impact makes VCSEs indispensable partners in delivering truly integrated care.

Why ICSs need VCSE strategic partners

Integrated Care Systems (ICSs) have a legal duty to design services that improve population health and reduce health inequalities. To fulfil these responsibilities, they must go beyond statutory and clinical providers. VCSE organisations offer unique, strategic value in system design and delivery. Their contributions are grounded in:

• Community insight - VCSEs often hold the deepest understanding of local needs through lived experience and grassroots engagement.
• Innovation - They deliver creative, preventative solutions in areas such as housing, mental health, food insecurity, and loneliness.
• Trust - VCSEs are embedded in communities, especially those least likely to engage with statutory services, making them vital conduits for inclusion and access.

Recognising this, NHS England required all Integrated Care Boards (ICBs) and Integrated Care Partnerships (ICPs) to have formal arrangements for VCSE engagement in place by April 2022. These are typically structured through VCSE Alliances that provide a unified voice, improve representation in governance, and ensure co-design of strategies and services across the ICS

VCSE in ICS architecture - System, place, neighbourhood

The VCSE sector plays a crucial role across all levels of the Integrated Care System (ICS) architecture, contributing to planning, delivery, and governance in a way that brings services closer to the communities they serve.

System level

At the top tier, VCSE organisations are formally represented on Integrated Care Boards (ICBs) and Integrated Care Partnerships (ICPs), often through VCSE Alliances or Leadership Groups. These partnerships reflect the diversity of the sector, from grassroots charities to national organisations. Their involvement ensures that community insights help shape strategy, influence investment decisions, and inform system-wide priorities around health, equity, and access.

Place level

At the local “Place” level, often aligned with council boundaries, VCSE infrastructure bodies such as Councils for Voluntary Service (CVS) coordinate sector engagement in Health and Wellbeing Boards and local planning forums. For example, in Wakefield, a housing-health VCSE partnership provides integrated discharge support, preventing hospital readmissions and delivering person-centred outcomes through coordinated community services.

Neighbourhood level

At the neighbourhood level, social prescribing link workers refer people to VCSE-led services such as befriending, mental health peer support, walking groups, or healthy cooking clubs. Local charities and faith groups often host these community-based interventions, which have deep roots in their respective communities.

Together, these three levels ensure the VCSE sector is not an afterthought but a strategic partner. When ICSs embed VCSE expertise into their architecture, they enhance their capacity to address health inequalities, deliver prevention at scale, and establish truly integrated care systems.

VCSE in provider collaboratives

Voluntary, Community and Social Enterprise (VCSE) organisations are no longer seen solely as subcontractors in Integrated Care Systems; they are becoming integral strategic partners within provider collaboratives. These collaboratives unite NHS trusts, local authorities, and VCSEs to co-design, govern, and deliver system-level transformation.

A prime example is the East Midlands ‘IMPACT’ collaborative, which brings together nine providers across the NHS, charity, and independent sectors to lead mental health service reform jointly. VCSEs contribute not only frontline services but also valuable insights into inequality, lived experiences, and community resilience.

Their inclusion helps address unwarranted variation, promotes service co-production, and builds capacity across multiple care settings. By embedding VCSEs as co-equals, Provider Collaboratives are advancing a truly integrated, equitable, and preventative health and care system.

Tangible benefits delivered by VCSEs

The Voluntary, Community and Social Enterprise (VCSE) sector delivers measurable value across Integrated Care Systems (ICSs), enhancing both population health and system performance.

• Population health & service access

In Somerset, VCSEs co-deliver mental health support via helplines, peer networks, and integrated pathways. In West Yorkshire, local charities have helped redesign eye care pathways, improving early detection, community outreach, and post-diagnostic support.

• Tackling inequalities

VCSEs act as trusted anchors in underserved communities, bringing lived experience, cultural competence, and co-designed interventions that address the root causes of exclusion.

• System resilience & efficiency

Their agility enables ICSs to respond rapidly in emergencies, as demonstrated during the COVID-19 pandemic. VCSEs also innovate in areas such as prevention, crisis response, and end-of-life care.

• Service improvement & specialisation

From hospital discharge to rehabilitation and wellbeing courses, VCSE-run services often fill critical gaps and enrich personalised care pathways.

• Social value & local economy

Initiatives like the Wigan Deal demonstrate how investing in VCSEs yields a fiscal return of up to 2:1, while also enhancing social capital, fostering civic pride, and promoting local employment.

Key challenges and barriers

Despite growing recognition, meaningful VCSE integration into ICSs faces persistent challenges:

1. Scale and diversity

ICS footprints may span thousands of VCSE organisations, from hyperlocal groups to large charities, making coordinated engagement and representation complex.

2. Funding sustainability

Many VCSEs rely on short-term, project-based grants or unstable contracts, undermining their capacity for long-term strategic collaboration.

3. Procurement models

Rigid, competitive procurement processes often exclude smaller VCSEs, stifling co-production and innovation.

4. Data sharing and governance

Limited access to real-time, interoperable data, coupled with compliance concerns, restricts joint working and continuity of care.

5. Power asymmetry

Without deliberate effort, VCSE partners can be marginalised in decision-making forums, risking tokenism rather than equitable collaboration.

Practical steps ICSs and VCSEs can take

To build meaningful, long-term partnerships, NHS England and leading VCSE advocates recommend several actionable steps:

A. Form a VCSE alliance

Establish a system-wide alliance that brings together large and small VCSE organisations. Define clear terms of engagement, governance arrangements, and strategic advisory roles. This ensures diverse voices shape priorities.

B. Invest in capacity

Establish a system-wide alliance that brings together large and small VCSE organisations. Define clear terms of engagement, governance arrangements, and strategic advisory roles. This ensures diverse voices shape priorities.

C. Adapt commissioning models

Shift from short-term, transactional contracts to longer-term partnership funding. In Derbyshire, for instance, ICSs are piloting single-flex contracts that reduce bureaucracy and promote shared outcomes.

D. Embed across all levels

Ensure VCSEs are actively involved in ICBs, place-based boards, Primary Care Networks, and neighbourhood partnerships.

E. Improve data sharing

Develop shared dashboards, resolve information governance concerns, and integrate social prescribing outcomes into population health systems.

F. Evidence value

Utilise social value tools to capture the contributions of VCSEs to prevention, wellbeing, and health equity.

Practical steps ICSs and VCSEs can take

“VCSE are thought leaders…person‑centred…the sector seeks out resources to build resilience and solve problems.”
                                                                                                                                                                                                  - Chris Wheway, St Barnabas Hospice

“VCSE are thought leaders…person‑centred…the sector seeks out resources to build resilience and solve problems.”                                                                      - Chris Wheway, St Barnabas Hospice

“VCSE are thought leaders…person‑centred…the sector seeks out resources to build resilience and solve problems.”
                                                                                                    - Chris Wheway, St Barnabas Hospice

“VCSE are thought leaders…person‑centred…the sector seeks out resources to build resilience and solve problems.”
                                                                                                                                                                                                  - Chris Wheway, St Barnabas Hospice

“We need to make sure more of the investment is getting out to the communities…not just the infrastructure organisations.”
                                                                                                                                                                   - Gary Sainty, Humber & North Yorkshire VCSE Alliance

“We need to make sure more of the investment is getting out to the communities…not just the infrastructure organisations.”
                                - Gary Sainty, Humber & North Yorkshire VCSE Alliance

“We need to make sure more of the investment is getting out to the communities…not just the infrastructure organisations.”
                                                                      - Gary Sainty, Humber & North Yorkshire VCSE Alliance

“We need to make sure more of the investment is getting out to the communities…not just the infrastructure organisations.”
                                                                                                                                                                   - Gary Sainty, Humber & North Yorkshire VCSE Alliance

“Doing this helped the HPOC team understand ICS priorities…and helped others understand what the VCSE sector can offer.”
                                                                                                                                                                                                                                    - King’s Fund guide

“Doing this helped the HPOC team understand ICS priorities…and helped others understand what the VCSE sector can offer.”
                                                    - King’s Fund guide

“Doing this helped the HPOC team understand ICS priorities…and helped others understand what the VCSE sector can offer.”
                                                                                                                                       - King’s Fund guide

“Doing this helped the HPOC team understand ICS priorities…and helped others understand what the VCSE sector can offer.”
                                                                                                                                                                                                                                    - King’s Fund guide

Looking ahead - VCSE priorities for 2025

As ICSs mature, the Voluntary, Community and Social Enterprise (VCSE) sector has a pivotal role in shaping equitable, preventative, and community-driven care. Key priorities include:

• Embedding VCSE-led innovation

Scaling co-designed initiatives in prevention, mental health, social prescribing, and digital inclusion, with a focus on addressing social determinants of health.

• Strengthening alliances and infrastructure

Formalising VCSE alliances, securing representation on ICBs and place-based boards, and integrating VCSE leadership into system workforce development.

• Enhancing sustainability

Developing longer-term funding models, adopting social value in procurement, and reducing reliance on short-term grants.

• Improving data integration

Advancing shared intelligence, linking worker data systems, and outcomes-based reporting to support population health management.

• Advancing collaborative commissioning

Embedding VCSE voices in commissioning decisions and developing blended finance models.

• Driving system equity

Partnering to lead targeted interventions for marginalised and high-need populations.

Final thoughts

The VCSE sector isn’t just an add-on; it’s a cornerstone of modern, integrated, community-centred care. When ICSs fully listen, invest in, and empower VCSEs:

• Systems become more resilient, responsive, and equitable
• Health outcomes improve faster
• Local economies and social fabric thrive.

But this doesn’t happen by accident. It requires:

• Commitment - Strategic funding, leadership access, and co-design mandates
• Governance - Real representation across system structures
• Cultural change - Shifting from transactional to relational models.

The early successes, including co-designing mental health pathways, innovative social prescribing, and housing-health partnerships, demonstrate the power of this integration. Extending and scaling this progress will determine whether ICSs truly deliver on their promise: better health, reduced inequality, and communities at the heart of our health system.

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