In the previous volume, Local Authorities and Social Determinants of Health, there was an acknowledgement that local authorities are increasingly developing partnerships that allow them to act as ‘enablers’ of change, alongside the recognition of the role of the third sector in providing the soft structures which are essential for reinvigorating healthier communities and individuals (see Introduction to Part IV and Chapter 16 of Local Authorities and Social Determinants of Health, and Chapter 16 in this volume).

Third sector is a term used to describe the range of organisations that are neither public sector nor private sector. It includes voluntary and community organisations (both registered charities and other organisations such as associations, self-help groups and community groups), social enterprises, mutuals and co-operatives. As we will see in the chapters in this section, partnerships increasingly mean that the lines between public, private and the third sector become blurred.

The ‘levelling up’ agenda pursued by Prime Minister Boris Johnson resulted in a report by MP Danny Kruger, Levelling Up Our Communities: Proposals for a New Social Covenant, which was published in September 2020. Kruger notes that ‘Civil Society, as individuals and organisations, when they act with the primary purpose of creating social value, are independent of state control. By social value we mean enriched lives and a fairer society for all. The government believes that social value flows from thriving communities’ (Kruger, 2020).

The sector is often fragmented, with many small charities or groups focusing on a single issue or a particular community, and a number of larger charities that are well placed to respond to commissioning from local authorities or central government grants in a way that smaller charities are not. In 2017/2018 there were 166,592 voluntary organisations, with eight in ten of those having a turnover of less than £100,000. For the third sector as a whole, government income as a proportion of total income was at 29 per cent. Big funders such as the National Lottery and regional bodies such as the pan-London organisations (Greater London Authority, London Councils) are increasingly looking for charities to demonstrate added value through collaborative partnerships and will not fund individual organisations to deliver their big grants without these partnerships in place.