| Social enterprise can play a key role in unleashing the potential of
staff to transform health and social care services. So said Patricia
Hewitt, Secretary of State for Health, with the launch of her pamphlet “Social
enterprise in primary and community care” (PDF 700K),
published by the Social Enterprise Coalition last month. But what is
social enterprise
and how
is it connected to health care?
Social enterprise
Social enterprises are types of businesses that fall under the umbrella
of the “third sector” — a broad term used to describe
organisations not run by the Government or in the private sector. The
Social Enterprise
Coalition, which promotes and demonstrates the benefits
of these organisations nationally, defines social enterprises as dynamic
businesses with a purpose working to deliver lasting social and environmental
change.
Matthew Walsham, senior policy officer at the SEC, explains: “By
combining the entrepreneurial drive of a business approach with a public
service ethos, social enterprises can offer innovative solutions, engaging
and empowering patients, staff and other stakeholders in new models of
delivery.”
In her pamphlet, Mrs Hewitt discusses how social enterprise is well placed
to provide health and social care services and looks at what the Government
and the NHS need to do to optimise the potential of the third sector
(see Panel).
Inside the pamphlet
The pamphlet says: “Social enterprises,
with their capacity for developing innovative and flexible solutions,
and their ability
to create wealth and employment, could play an even greater role
in future, particularly in the delivery of public services.”
The document says that there are many third sector organisations
providing different aspects of community-based mental health services
and sexual health support. It points out that a change in the mindset
of commissioners is needed if the NHS and social care is to make
the best use of the third sector to improve the health and wellbeing
of the public.
However it goes on to say that third sector organisations will
also need to adapt. “To realise its full potential with an increasingly
diverse and challenging market, third sector organisations will need
to more effectively communicate their unique selling points to commissioners,
develop strategies for ensuring the services they deliver are of
the highest possible quality and effectiveness, and secure robust
and transparent systems of governance,” the document says.
The pamphlet can be accessed as a PDF file (700K) |
Mrs Hewitt’s interest in the third sector is established:
she set up a Social Enterprise Unit in October 2001 when she was Secretary
of
State for Trade and Industry. Commenting on the pamphlet, she said: “As
the NHS continues to develop services to meet the needs of patients in
diverse communities, I believe we will see a growth in the involvement
of social enterprise and the voluntary sector.”
Mr Walsham says that many social enterprises, particularly those already
delivering social care services, are exploring opportunities in the primary
and community care markets.
“There is also increasing interest in the potential for social enterprises
to emerge from the NHS — something which has happened within local
authority provision of social housing, leisure and social care,” he
adds.
Community interest companies
The Government’s commitment to the involvement of social enterprise
in health care delivery is tangible: a national community interest company
(CIC) has been established to take over the running of the Department
of Health’s Expert
Patients Programme in England and the Government
recently announced the appointment of three board members for the company.
Since July 2005, social enterprises have been able to register as a community
interest company, which operates under a new type of legal framework.
According to the Office of the Regulator of Community
Interest Companies,
a CIC is a company that operates for a social purpose and uses its assets
and profits to promote these aims.
A crucial aspect of a CIC is “asset locking” — where
assets remain within the company and in the event of its dissolution
can only go to another asset-locked body.
Before the legal framework for CICs came into effect, there was no simple
way for a company’s assets to be locked for public benefit other
than to apply for charitable status. Whereas a charity can exist only
for charitable purposes, a CIC may be established for any objective so
long as its activities are carried out for the social good, and it can
operate using strong businesses principles and goals, provided there
is no financial benefit for stakeholders.
Over a year later, some 450 companies are now registered with the CIC
regulator. Expert Patients Programme
Since its inception, the Expert Patients Programme has existed as an
NHS-run training scheme, providing people with long-term medical conditions
the opportunity to develop new skills for better managing their condition
day to day.
Alison Blenkinsopp, from the department of medicines management, Keele
University, was involved in writing a document about community pharmacy’s
contributions to the management
of long-term conditions, published by
the Royal Pharmaceutical Society and launched at the British Pharmaceutical
Conference last month (PJ, 9 September, p299). Professor Blenkinsopp
explains: “The idea for the EPP is to have a CIC that oversees
the organisation, provision and development of self management training
for patients. This is to strengthen the infrastructure and co-ordination
to enable a big expansion of EPP courses.”
According to the DoH, the expert patients CIC will be a not-for-profit
organisation that will reinvest any surpluses in the company. This approach
allows the organisation to retain the values of the current programme
but with the ability to build social capital.
A spokesman for the DoH says that community interest companies, unlike
arm’s length bodies and special health authorities, can trade.
He explains: “This will mean that the EPP can be commissioned by
a range of organisations, not just PCTs, making the EPP more widely available
to people in their communities.”
The DoH spokesman points out that, to date, the EPP has been funded centrally,
which is inconsistent with the drive for local decision making on the
use of resources.
“The majority of health service funding is provided directly to PCTs
to allow them to decide how this resource is spent to meet the needs of
their communities,” the DoH spokesman explains. “PCTs are
currently the main providers of the EPP. [They] are being encouraged
to commission more services rather than provide them directly. Due to
this, the EPP is less likely to be provided by PCTs in the future, so
the EPP social enterprise will provide courses for PCTs and practices
to commission.”
He says: “The White Paper ‘Our health, our care, our say’ made
a commitment to treble the investment in the EPP. This investment will
be used to support the transfer to the CIC and to extend its services
to support increasing numbers of people with long-term health conditions.” |
The
Pharmaceutical Journal