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The Compact between government and the voluntary and community sector was launched in November 1998. The Compact provides a framework that sets out the principles and undertakings that should underpin the relationship between the voluntary and community sector and government. The Compact is integral to increasing the involvement of the public and patients in health. It is aimed at creating a new approach to partnership and a relationship of mutual advantage. It has undertakings on both sides, compliance mechanisms and codes of good practice to make the agreement work. Local Compacts aim to do this locally between the voluntary and community sector, local authorities and other local public bodies.

Part of the Compact's implementation is to move beyond a broad framework and concentrate on getting its application right nationally, regionally and locally. To assist in this, the Compact and Local Compacts are supported by five individual codes of good practice:

Community and voluntary groups play important health roles, including supporting service users, advocates or lobbyists, providers of a range of health and support services and as a conduit for information, particularly on the health promotion. Local community groups with an interest or role in health and/or social care are vital sources of expertise on their specialist areas e.g. sickle cell, Parkinson's, care for the elderly, HIV/AIDS, improving physical access, learning disabilities, mental health and testicular cancer to name but a few.

Sarah Mullally, Chief Nursing Officer, is the Department of Health's Compact Champion. The Department of Health is determined to see all NHS organisations in England signed up to a geographically relevant Local Compact by 31 March 2004. The new duty on NHS organisations to make arrangements to consult and involve patients and the public, Section 11 of the Health and Social Care Act 2001, provides a useful opportunity for NHS organisations, not already signed up to a Local Compact to do so. The Local Compact will be one mechanism that NHS organisations will be able to demonstrate their compliance to the new duty. NHS organisations signed up to a Local Strategic Partnership (LSP) will already be working within, or towards establishing, a Local Compact.

Experience shows that the process of producing a Local Compact is as important and influential as the final document itself. It involves local voluntary and community organisations, local authority councillors and officials, NHS boards and staff all working together to clarify roles and functions as well as expectations and ways of working. Through this, understanding and trust can develop, as can the recognition of shared objectives but also areas of difference, of complementary roles alongside independent ones.

A Local Compact, as a dynamic mechanism for an evolving relationship, should be a valuable tool for both the voluntary and community sectors and NHS bodies in the context of new policies and improving NHS local delivery. A Local Compact should be an integral part of the on-going consultation and involvement process of monitoring, reviewing and implementing service changes.