Health Plus Care conference, June 2015

24 June 2015

Our chief executive, Clare Pelham, spoke at the Health + Care conference on 24 June 2015. The text of the speech as delivered follows.

Why choose charities? Local action for local people

Missing person

I want to talk to you today about a missing person.

The missing person that I want to talk about is someone whose contribution is seldom recognised, rewarded or even mentioned when people talk about social care.

But they are absolutely crucial in ensuring that those who need support get it, that the right support, and the right services, are available in any local area. The missing person that I want to put centre stage today is commissioners.

And that missing person is the link between charities and local action for local people.

Because who is, quite literally, local action in person?

That person is the commissioner.

Not the enemy

There can be a tendency among providers to see commissioners as the enemy, as someone to battle with to get the settlement you want. In this world view, the commissioner is the archer selecting a provider from his quiver and firing it off at an unsuspecting disabled person.  

If you like it is a linear view of care which may be very inexpensive but I would contend is also very poor value for money.

And it is absolutely crystal clear to me that the people commissioning care are every bit as committed and passionate as the front-line care worker — trying, as we all are, to deliver the very best that they can with the resources available.

I have been a public servant and I know that every day up and down the country local government officials get out of bed to try and do a good job for their neighbours and friends.

Everyone wants to see the best possible service, the best possible outcomes. Everyone can see the massive challenges facing local authorities, the shortfall in funding and the increasing demand, and of course the impact on those who miss out.

Commissioners know that services need to be built around the individual and the outcomes that they want to achieve, but they face almost impossible pressures. This isn’t  just right for the person, it’s also right for the taxpayer. Better care means fewer hospital admissions and many other things besides.

And it doesn’t help commissioners, it doesn’t help providers and — most importantly of all — it doesn’t help the people we support if we don’t recognise these pressures, understand that commissioners are doing their best in very difficult circumstances and offer them our support.

Proud of our staff

So today I hope to do two key things:

  • I want to recognise and champion social care commissioners and the job that they do.
  • I want to set out how I believe that by working in partnership with charities, we can support them to be the local heroes we need them to be.

If you came in earlier, you might have seen a short film of Leonard Cheshire Disability saying why they are proud to work for the organisation.

Of course, as chief executive of Leonard Cheshire Disability, I am going to say that we have the best staff in the world. I say it because it’s true, but I know that the whole of social care is full of amazing people doing amazing things every day.

I think there are commissioners doing amazing things that they too should be celebrated. I hope that they are proud of what they do, because good commissioning is a totally integral part of successful care delivery.

I hope that they answer the question, ‘What did you do at work today?’ in just the same way that a dedicated care worker or nurse would. ‘Today I made a difference — I made sure that people who needed support today, got what they needed.’

Why a charity?

If you want to commission a service to be proud of, then the answer is obvious — commission people who are proud to deliver it.  Perhaps the next question is: why choose a charity?

As a charity we are guided in everything we do by our manifesto. We are literally here to change the world. We are working for a world in which every person is equally valued.

Where disabled people have the opportunity and support to live independently, to contribute economically and to participate fully in society.

That’s why our mental picture of a commissioner is not the enemy. Not the archer that we saw earlier. But this, a three-legged stool.

Together, the three legs are supporting the person. One of those legs is Leonard Cheshire (the provider), the other is the commissioner and the third leg is the local community.

So, this stool is a tangible symbol of all three of us putting the person at the heart of everything that we do. No-one has a monopoly on kindness. And we each have an important role to play.

As a charity, we have six very clear guidelines about when it is right for us to provide services. And there isn’t time today to explore all of them. But they all centre on doing the right thing for disabled people. And none of them are about generating income for the charity. In fact quite the reverse, one of our six guidelines is to achieve better outcomes for disabled people by generating charitable donations to enhance the services that commissioner pay for.


Eye-gaze technology at Symonds House

Mark using Eye-gazeThis is Mark.

Mark is a retired GP living at Symonds House, a care home for adults with physical disabilities in Hertfordshire. He was diagnosed with MS in 1997. Since moving to Symonds House in 2012, Mark has, like many of us, used email to keep in regular touch with his children. As Mark began to lose dexterity this became increasingly difficult for him.

‘I was absolutely terrified of a future without email and the internet — it is how I connect with my family. Time with them is precious and I couldn’t contemplate not being able to stay in regular contact.’ — Mark

Staff at Symonds House discussed the potential benefits of Eye-gaze technology with Mark — specialist equipment that enables someone with limited body movement to use a computer using tiny movements in their eyes.

Purchasing this specialist equipment was only possible because we know the communities we support and those communities support us — in this case making it possible for us to build on links with the local community to fundraise the £18,000 needed to buy this equipment.

‘Eye gaze has been absolutely amazing. I used to have to rely on others to do things for me – now I can be much more independent.’ — Mark

This is just one of the things that we do to make a difference.

Broader role of charities

I said earlier that Leonard Cheshire is here to change the world. One way we do that is by providing care and support into employment in this country and round the world. And, of course, we also campaign to influence governments to do the right thing for disabled people. And the amazing thing about this global reach is that it gives us a worldwide knowledge-base that can inform everything that we do.

I wanted to pause for a short while and show you a film now that highlights just some of the outcomes that we at Leonard Cheshire achieve, and that underpins that working in partnership with charities can bring amazing results.


Some amazing people and some amazing campaigns there. I think it highlights just how crucial it is to have the person at the centre of everything, and how broad based charities can help to do that — how we can fill that ‘missing link’.


So, I said at the outset that I intended to do two things today:

  • To champion the commissioners who are doing all they can to get the support to those who need it;
  • And to show how charities can help in overcoming the problems that they face, how working together can fill the missing link in the care that people receive.

Eye-gaze is a perfect example of adding value beyond what a commissioner is able to do on their own. Where we can work together to deliver what matters to each individual.

There is no getting around the fact that today there is less money for care and support than five years ago, and we know there will be even less in future. This comes at a time when more people than ever before need support — people are living longer and more people are living with a disability. People’s needs are also becoming more complex.

Put together, this means we will all have to do more, for more people, with less. But it doesn’t mean that what we do has to be less good. It just means we have to think a little bit differently.

Maintaining quality and adding value is, and must remain, a non-negotiable priority for providers and commissioners. Poor quality care and support is not the right thing to do for people, neither is it the cost-effective thing to do.

This year’s survey of Adult Social Care Directors once again highlighted the chronic underfunding of social care – another £0.5bn from social care budgets this year. As budgets fail to keep pace with demand more and more disabled people are going without the care services they need. In reality this means that people are unable to maintain relationships with friends and family, remain in work or in many cases to live a life that extends beyond basic daily activities like eating, drinking and washing.


We know that the people commissioning services from us do an incredibly tough job and that they face the same pressures we do. And, more importantly, we know that they want the same things as we do — the best outcomes for people who need care and support and healthier, happier, more active communities.

That is why I’ve focused today on that ‘missing link’ in care provision.

It’s why I want to celebrate good commissioning, to celebrate when commissioner and provider and community link together in that three-legged stool to make sure that the service supports the individual.

At a time when the pressures on social care are so immense the only solution has to be to work ever more closely. It means re-doubling our efforts to ensure that services are built around the individual.

And I believe it means an ever more important role for charities who can help to provide that link direct to people whom we support. Who, crucially, can add value beyond what is possible for a commissioner alone.

We need to empower commissioners to take a long term view and trust in providers when they show why being the best value for money doesn’t always mean being the cheapest.

I hope that all of those who share the ambition to get the right support to the people who need it can work together to secure the settlement that we need for social care.

And I hope that by linking together we really can build the services that we want for ourselves, for our families, the services that all those we work with now want and need. Local action for local people — together.

If we can, then we really all can be proud of what we did at work today.