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Voluntary & Community Organisations: Not the Third but the First Sector of Integrated Care?

Year: 2025

Type: editorial

Abstract: When Mari, a person with diabetes and mental health challenges experiencing homelessness needed care, the hospital could treat their immediate health challenges but couldn't address why they kept returning.It was a small community organization, with deep neighbourhood knowledge, flexible funding, and trusted relationships-that provided the wraparound support that finally broke the cycle.This story, repeated countless times across health systems worldwide, raises a fundamental question: Why do we refer to the voluntary and community sector (VCS) as the "third sector" when it's often the first to respond, innovate, and reach those most in need?Over the past decade, integrated care has evolved beyond coordinating medical services to embrace truly holistic, person-centred approaches that address social determinants of health.This shift has highlighted the essential role of voluntary and community organizations, yet their contributions remain undervalued, underfunded, and poorly understood within health systems.This special issue challenges that positioning, presenting evidence that the VCS may be better positioned than traditional health services to deliver the values and outcomes that integrated care promises.The voluntary and community sector encompasses an extraordinary diversity of organizations, from volunteer-run food banks serving a single neighbourhood to global networks addressing systemic inequities.What unites these organizations across their varied forms is not structure but purpose: they prioritize mission over profit, community empowerment over institutional power, and social justice over efficiency metrics.Common values include social justice and equity, community empowerment and participation, inclusivity and diversity, as well as collaborative approaches to addressing societal challenges.This diversity enables VCS organizations to adapt rapidly to emerging needs, innovate beyond regulatory constraints, and develop culturally responsive approaches that larger institutions cannot match.Yet this same flexibility creates perception problems.To public sector professionals accustomed to standardized processes and clear hierarchies, the VCS can appear "fragile, volatile, messy and confusing," despite representing some of society's most enduring institutions (for further history and background to the VCS, please see Rees & Mullins [1] and Carmichael & Elson [2]).

Source: International Journal of Integrated Care

DOI: 10.5334/ijic.10183

Authors: Robin Miller, Michelle Nelson, Ivette Fullerton, Felix Gradinger, James Rees, Marianne Saragosa

Institutions: University of Birmingham, University of Toronto, University of Plymouth, University of Wolverhampton

Language: English

Topic: Nonprofit Sector and Volunteering

Subfield: Sociology and Political Science

Field: Social Sciences

Domain: Social Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $1,839