Calum Irving argues that Scotland will have to invest in third sector support bodies if it is to protect front-line health and care services

In the same week as trying to shape some thoughts for TFN on health and social integration a whole series of announcements and launches have appeared. And, as we all know everything is linked to everything else.

There’s the Civil Exchange audit of the Big Society. Then there’s the thought-provoking English Independent Commission on the future of local infrastructure’s report. There’s the legislative proposals emerging from the Smith Commission and the announcement of a £100m to tackle delayed discharge. And behind all of that at the local level our network, the third sector interfaces (TSIs) are at a sensitive stage in negotiating a strong role of the third sector in the Integrated Care Fund (ICF). This £100m fund aims to support health and social care partnerships to focus on prevention, early intervention and care and support for people with complex and multiple conditions.

A bit of support for gathering the evidence, brokering the relationships and building the collaborations can tackle big issues

Calum Irving

So how are they all linked? Well, two bits of rhetoric are jamming up against each other now. Money is tight and getting worse so there's a focus on protecting the frontline, however, at the same time, everybody wants to empower communities or support social action, and develop preventative, assets-based approaches and so on (whichever set of jargon you prefer).

The commission on third sector infrastructure report highlights the paradox that many third sector bodies want more support to engage in change, but they also think that frontline services should be protected first.

The report also shows just how transformative infrastructure can be. A bit of support for gathering the evidence, brokering the relationships and building the collaborations can tackle big issues. We’ve seen it in mitigating welfare reform and TSIs have shown how, when supported, they can do it on any subject.

In Scotland, the ICF should be one of those subjects. Under the Reshaping Care for Older People (RCOP) Change Fund a great deal of innovative third sector services were developed; these were collaborative, preventative and community based. But our network tells us the ICF is a mixed picture so far. Some excellent initiatives in the third sector will continue, some may not and new ones will emerge. Different areas will be more enabling than others.

And while that’s all going on, £100m to tackle delayed discharge has just been announced. The Scottish Government press release talks about prevention but then talks about the NHS and local authorities only. Undoubtedly both face extraordinary pressures now and deserve our support but what about those famous asset-based approaches, the third sector and community empowerment. So much that could prevent bed blocking exists in the third sector and could be developed further: community transport solutions, support upon leaving hospital, befriending services, help with tasks at home and activities to tackle isolation.

This is how all of these are issues are linked. It is because we need to relieve the pressure on the frontline that we need more than the frontline. But, are we as a country going to be brave enough to admit that?

Caulm Irving is chief executive of Voluntary Action Scotland.