The importance of the VCFSE sector in health and devolution: A call for sustained national recognition

Warren Escadale, VSNW’s CEO

The voluntary, community, faith, and social enterprise (VCFSE) sector plays a crucial role in driving community-based innovation and addressing social challenges, yet it remains under-recognised at the national level. In this blog, our CEO, Warren Escadale, tells us how to achieve meaningful integration and systemic change, we must push for stronger acknowledgment and partnership across all levels of governance.

Lately, I've been reflecting on the national recognition of the VCFSE sector. While the sector’s influence has grown over the years, the lack of a prominent national profile concerns me.  

This was highlighted to me recently when reading one of Michael Wood’s recent reports on prevention. Wood, who has long been a strong advocate for our sector, explored the impact on prevention of selecting interventions with the highest returns on investment. However, despite the top 20 interventions with the strongest returns being all community-based, mention of the role of the VCFSE was disappointingly thin.

A recent report on priorities for the new Government to strengthen Integrated Care Systems from the Health Devolution Commission also makes marginal references to the role of the sector. Despite the initial draft of the report including strong messages about the sector following feedback and involvement from myself, it feels like these messages have been somewhat diluted.

Indeed, in recent national reports such as the Get Britain Working white paper and the Darzi review on the state of the NHS, references to the VCFSE sector are vague, if there at all.

It’s as though our sector becomes a silent component of the "Local" conversation—visible only when convenient. This oversight worries me, as it risks outcomes that sideline the sector's integral contributions, clashing with the past decade of progress in regions like the North West, where the VCFSE sector has been redefining its role—moving beyond waiting passively on the sidelines to actively shaping the agenda.

Progress in the North West

Despite national gaps in recognition, there are signs of progress at regional levels. For example, in Cheshire and Merseyside, the VCFSE sector’s value has been acknowledged through its inclusion as a full partner member of the Integrated Care Board (ICB). This step forward exemplifies a shift toward integrating the sector more formally into health system leadership, with the North West being the first region to have full VCFSE partner membership on our ICBs.

Partnership work in delivering the Greater Manchester Accord, involving the VCFSE sector, NHS, and Combined Authority, reflects a mature model of distributed leadership. Our Q2 update, available here, underscores this model and the tangible outcomes it delivers.

The recent single settlement agreements for the West Midlands and Greater Manchester also marks a pivotal development. These deals hold promise for a more integrated approach that links health and economic strategies, addressing social determinants and reducing inequalities. This is an opportunity where the VCFSE sector’s role must be clear and pronounced.

Looking forward

As we move ahead, several policy milestones will shape the landscape:

• “Get Britain Working” White Paper: Published at the end of November with £240m investment to reform employment support and tackle economic inactivity. This includes £125m for eight “Trailblazers” to develop joined-up health and skills support (the only area in the North West being Greater Manchester which will include additional funding for the ICS) alongside eight Youth Guarantee trailblazers with £45m funding led by Mayoral authorities to support young people who are not in education, training or employment (again only one area identified for the North West (Liverpool City Region)). How these pilots integrate VCFSE expertise will be pivotal for sustainable, community-centred outcomes.

• Devolution White Paper: This will extend to almost all of England, with significant implications for the North West, including Cumbria, Lancashire, and Cheshire & Warrington. Ensuring that VCFSE input is embedded in these developments is paramount.

• Spring Local Government settlement: This will further influence resource distribution and partnership models across sectors.

• UK-Shared Prosperity Fund “extension”: This is vital to avoid a VCFSE sector cliff-edge, however inevitably all these pieces of work will likely converge as devolution deepens.

The challenge—and opportunity—lies in how the NHS engages in these dialogues and partnerships. The VCFSE sector must be seen as a key player, not a peripheral actor.

The path to cultural and systemic change

While regional recognition is a strength of our sector in the North West, broader cultural and systemic change requires national commitment. Currently, our progress in the North West offers a blueprint of what true devolution can achieve. This model shows that when local authorities, health services, and VCFSE entities collaborate as equal partners, communities thrive.

Still, this momentum needs national support to avoid “battling the tide” alone. The VCFSE sector—and alliances that represent it—should continue demonstrating leadership, not wait for others to dictate our relevance.

Conclusion

The VCFSE sector has the expertise, innovation, and resilience needed to shape meaningful change. Progress is being made, but it must be recognised and supported at the highest levels. For genuine integration and devolution to work effectively for communities, we need to push for systemic acknowledgment. We’ve proven we can lead—now, it’s time to ensure that recognition extends beyond local patches to a national stage. Waiting for others to act won’t do; we must be the drivers of this change.