Health Policy and Social Enterprise in the UK

George Leahy

Director of Research & Policy

PURPOSE

The purpose of this presentation is to discuss with you:– UK health policy– Social enterprise in the UK– Social enterprise in the health sector– The Coalition as a model

UK HEALTH POLICY

• 4 ‘natural’ experiments• Devolution has created 4 different

health systems– England, Northern Ireland, Scotland, Wales

• But all still ‘free at the point of use’• England has a programme of (health)

‘system reform’

HEALTH POLICY & SYSTEM REFORM

• Focus on commissioning and contracting– World Class Commissioning

• Care closer to home – moving as much activity out of hospital as possible

• Community-based organisations to deliver health & social care– NHS and non-NHS

• Hospitals ‘independent’ and compete for ‘activity’

‘THE MARKET’

• Policy is aimed at creating diversity and plurality of providers in the care market

• Case for this: it will make the NHS more efficient– Public finance for healthcare is more effective

• And deliver improved outcomes– Improve Public Health – and reduce inequalities – as well as better patient experience

SOCIAL ENTERPRISE

• Businesses with a social and/or environmental purpose

• Operate in many industrial sectors– Energy production– Waste & recycling– Coffee/chocolate– Telecommunications– Transport

1. Trading goods and services

2. Primary purpose beyond commercial outcomes

3. The activity that generates the financial profit, is also the primary means of achieving the social outcomes or mission

EXAMPLES

• Co-Operatives• Social Firms• Community Interest

Companies• Companies Limited

by Guarantee• Employee-owned

• Estimated 55,000 enterprises in UK– Coalition: 8-10,000

members

• Café Direct• Divine Chocolate• ONE Water• Phone Co-op

SOCIAL ENTERPRISE: HEALTH & SOCIAL CARE

• Department of Health Social Enterprise Unit

• Encourage social enterprises to start-up

• £73m Investment Fund (capital)

• NHS providers becoming social enterprises– Delivering community nursing

& Physiotherapy

• Non-NHS SEs operate in:– Prison health– Drug and alcohol treatment– But also public health/health

promoting activities• Exercise

• Healthy eating etc

EXAMPLES

Secure Health• Delivering prison

health services– Inc prisoners in

decision-making

Central Surrey Health• Ex NHS• Owned by employees• Company limited by shares• Deliver community health

services – Health visiting– District nursing– physiotherapy

EXAMPLES

Turning Point• Drug and alcohol

treatment• Connecting Care

– Assessing needs

• Successful transition– From voluntary sector– To enterprise model

Sandwell Community Caring Trust

• Home care services• Employee-owned• Top 100 best employer

in UK

WHY SOCIAL ENTERPRISE?

• Changing landscape of public service funding– Less grant, more contracts for services

• Financial sustainability and diversification• Innovation (freedom to)• Internal efficiencies (lower absenteeism)• BUT, traditional VCS needs time to adjust

PROMOTING SOCIAL ENTERPRISE

The Coalition was established in 2002 as the UK voice of social enterprise– A Coalition of organisations that promoted interests of social

enterprise that wanted a national influence

The Coalition:– showcases the benefits of social enterprise– shares good practice– influences policy – Is made up of over 46 networks and reaching

10,500 social enterprises– Less than 1/3rd funding from government grant

INFLUENCING POLICY• Campaigns to promote social enterprise as a

business model and in public service delivery• Lobby govt on business support, tax etc• Support the development and implementation

of govt SE action plans• Work through our networks to develop values

and a common language• Political activity with our members and the

APPG on social enterprise– (All Party Parliamentary Group)

SUMMARY

• Health policy in England is promoting a market based approach to delivering services

• Social enterprises are seen as an important element of creating a ‘plurality’ of providers

• Social enterprise is seen as a sustainable funding model• And as an innovator of service delivery• The Coalition has been key to keeping social enterprise high

on the political agenda as an alternative business model– To the private sector– To traditional voluntary sector– To existing public service providers