Health and Social Care
Social Enterprise and the delivery of health and social care
The case for increasing the role of social enterprise in the delivery of health and social care is fundamentally about ways of delivering a better service for the public that is value for money. In particular, improving the experience of the service for the user and better meeting their needs. It is therefore important that the positive benefits of social enterprise models are communicated while at the same time maintaining a realistic understanding of potential risks:
- Innovation - too often the public sector does not encourage creativity. By combining a public service ethos with the entrepreneurial drive of a business approach, social enterprises are highly effective vehicles for innovation. For example, they are able to take a more holistic approach to meeting the health needs of users than traditional approaches within the NHS, making them ideally placed to help deliver the Wanless Report vision of a 'health not a sickness service'.
- Meeting community needs - many social enterprises have particular knowledge of, sensitivity to, and expertise about, the communities in which they work. As a result they may be better placed to engage with and meet the needs of communities they work with, including people from disadvantaged, excluded or vulnerable communities.
- Diverse models - social enterprise encompasses a wide range of models and there is no 'one size fits all' approach. They may be new enterprises responding to a gap in the market, staff-led externalisations from within the NHS, or established organisations diversifying into health and this will affect their values and governance structures, as will the services they deliver.
- Part of the NHS Family - there have always been independent providers within the NHS family, for example most people's first point of contact with the NHS is through their GP and almost all GP practices are privately owned. Social enterprises want to operate as part of the NHS, not as separate from it.
- Accepting Risk - everything carries a risk, and failures already exist within publicly delivered health and social care. There needs to be greater willingness within the NHS to take calculated risk related to innovation and new forms of delivery. This also means ensuring risk is shared between both parties and excessive risk is not transferred to social enterprises.
- Engaging stakeholders - where local authority services such as leisure and social care have been externalised it has been a result of recognition by councillors, customers, staff, unions etc. of the need for change. The stakeholders are different within the NHS but the issue is equally relevant, for example the expectations of nurses, GP's and patients will often be different. Geographical boundaries can also present an issue when working with the public sector.
- Partnership - more can be achieved by working in partnership than in isolation. Social enterprises have a strong track record of working in partnership with a wide range of organisations, from NHS trust, local authorities and other public sector bodies to Housing Associations and the voluntary and community sector.
- Managing expectations - social enterprise is not the easy option, it needs dedication and commitment. There needs to be recognition that culture change is a relatively slow process and that wholesale is not going to happen instantly. Rigid structures and established professional cultures will always slow the process of change and this is particularly the case within the NHS.