VCS Role in Population Health Management - Local Strategies


As part of their role to support the local voluntary and community sector, Medway Voluntary Action continues to liaise with social and health care stakeholders in relation to strategic changes evolving from the NHS and its Long Term Plan - and here is their most recent update and invitation for the sector to get involved.

Jane Howard, CEO of Medway Voluntary Action, provides a short update on the local position:

"You may be aware that changes are occurring in the NHS. In short, what was Clinical Commissioning Group areas have changed into Integrated Care Systems (ICSs) within which Integrated Care Partnerships (ICPs) operate on a ‘local’ level with the aim of delivering services tailored to the needs of communities that fall within their smaller geographical areas. In Kent and Medway we now have one Kent and Medway ICS which is an amalgamation of 8 CCGs. Within this there are 4 ICPs. Servicing Medway is the Medway and Swale ICP.

The Medway and Swale ICP are utilising a model called Population Health Management. This model takes a holistic view of health and recognises that the wider determinants of health have an impact on whether someone lives a long and healthy life or not. For this reason this model works at tackling these wider determinants of health.

The Medway and Swale ICP are keen re-define the relationship with the VCS and work in partnership with them to successfully deliver the Population Health Management model locally - and are asking for your help."

Nikki Teesdale, Director of Integrated Care Partnership (ICP) Delivery - Medway and Swale ICP, explains further:

"Population Health Management is a partnership approach across the NHS, other public sector services including the voluntary sector and the public, all of which have a role to play in addressing the interdependent issues that affect people’s health and wellbeing. It is an approach that aims to improve physical and mental health outcomes, promote wellbeing and reduce health inequalities across an entire population by working together as a system.

Our health is shaped by a range of factors and whilst it is hard to be precise about how much each of these factors contributes to our health, the overwhelming evidence is that the wider determinants of health have the most impact. These include factors such as lifestyle and health behaviours smoking / alcohol and recreational drug use, income and wealth, education, housing, our local community network, transport and leisure and the health and care system. There is also now greater recognition of the importance of the communities we live and work in, and the social networks we belong to.

The population health management programme enables systems and local teams to understand and look for the best solutions to people’s needs – not just medically but also socially – focusing on the wider determinants of people’s health.

This approach will help to prevent or delay the onset of long-term conditions, their functional consequences and the progression of frailty. Population health management will therefore enable more people to benefit from early identification and treatment, personalised care planning, self-management support, medicine management and secondary prevention services.

A key part of the programme is to identify ways to share ideas, data and resident experience in order that we can build communities that will support our residents, and that as a system we can work collaboratively to address the root causes of inequalities that present themselves."

Over the coming months Medway Voluntary Action and Medway & Swale ICP will be reaching out to engage further with the VCS on this model - and their first initiative is to invite Medway's VCS to participate in their Data Asset Register workstream. 

The purpose of the Data Asset Register is to help the ICP better understand the information that they need to begin to work towards effective Population Health Management. The have created a spreadsheet and are inviting all local stakeholders, including local VCS groups and organisations, to share what data they currently collect in relation to health outcomes. You can access the spreadsheet by clicking here - and you will see that you are only being asked what sort of data you can provide, not the data itself. The ICP is aware that the data collected in the sector varies and will be very much determined by the feedback required by funders. However, what will be common across the board is the rich qualitative data in terms of case studies etc that will be very valuable as part of the collection of this evidence.

Medway Voluntary Action recognise that this initiative marks a distinct change in the way we have worked in the health arena to date.  Initial VCS feedback is that the pro-active stance taken by the ICP in working with us is very much welcomed and encouraged. This initial request for VCS participation comes as one of a range of initiatives currently being progressed to work more effectively with the sector; very much due to the recognition that we have a great deal to ‘bring to the table’ in terms of knowledge, skills and experience.

To participate in this Data Asset Register activity, simply download the spreadsheet and add details of the type of data that your group or organisation collect - then please save and send your completed spreadsheet to the MVA team: by 15th June 2021.

MVA will then collate everyone's responses and forward them onto the ICP - MVA will also keep you updated on progress once this initial exercise has been completed.

If you have any questions, or would like to discuss Population Health Management further, please contact the MVA team on 01634 812850 or


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