Social Enterprises and the NHS - Unison

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Contents Foreword 2 Executive Summary 3 Acknowledgements 5 1 Introduction 6 2 Methods 8 3 Policy context 9 4 Varieties of social enterprise 14 5 Social enterprises: views from the field (1) national stakeholders 18 6 Social enterprises: views from the field (2) local stakeholders 31 7 Emerging issues and themes: implications for policy and practice 46 8 Conclusions 50 References 52 Social Enterprises and the NHS Appendix one Interview schedule for national stakeholders 54 Appendix two Interview schedule for local stakeholders Appendix three Examples of social enterprises in primary 56 and community care 58 CHANGING PATTERNS OF OWNERSHIP AND ACCOUNTABILITY 1
Foreword Recent years have seen great changes in the accountability of different parts of the NHS as alternative providers have become an increasingly visible part of the healthcare landscape. Social enterprise is the latest delivery model to be championed by the government (and opposition parties) as they look to extend diversity of provision and competition within the NHS in general and within primary care in particular. This latest report from Durham University is therefore very timely in its analysis of the wide variety of organisations characterised as social enterprises and their approaches to involving staff, public and patients. Although the report was commissioned by UNISON, it remains an independent study. It is striking therefore that so many of the report’s conclusions are consistent with the thinking of my union. For UNISON members, as social enterprises begin to deliver health services traditionally covered by the NHS, there are important issues to consider around pension entitlements, Agenda for Change and terms and conditions. As the report makes clear there are concerns that the traditional appeal of social enterprise – a focus on innovation, sustainability and community empowerment – may be undermined by a greater emphasis on a business ethos and creating a diversity of providers. Furthermore, it is possible that some social enterprises may smooth the way for the involvement of the private sector in primary care – whether intentionally or otherwise. There is little doubt that social enterprises are an issue of growing importance for the NHS and those who work in it, and this report signals the need to keep rapid developments under close and constant scrutiny. Dave Prentis UNISON General Secretary 2
Page 1: Social Enterprises and the NHS Chan
Page 5 and 6: the ability of social enterprises t
Page 7 and 8: 1 Introduction This government beli
Page 9 and 10: 2 Methods This study was carried ou
Page 11 and 12: Alternative Provider Medical Servic
Page 13 and 14: primary and social care and partner
Page 15 and 16: 4 Varieties of social enterprise 4.
Page 17 and 18: 4.4 Varieties of social enterprise
Page 19 and 20: 5 Social enterprises: views from th
Page 21 and 22: 5.2.3 Differences between mutuals a
Page 23 and 24: So the NHS, I don’t know why they
Page 25 and 26: their development in order to enter
Page 27 and 28: We need to move in the direction of
Page 29 and 30: organisations, because the non-exec
Page 31 and 32: and police the concept. But I think
Page 33 and 34: emphasised that ‘one of the main
Page 35 and 36: (iii) New approaches to commissioni
Page 37 and 38: that enjoyed within the NHS. There
Page 39 and 40: In the long term, that board of gov
Page 41 and 42: Example C This enterprise (C) had g
Page 43 and 44: The healthy living centre shared si
Page 45 and 46: One interviewee noted: And very ear
Page 47 and 48: 7 Emerging issues and themes: impli
Page 49 and 50: the DH that a ‘reprovision’ of
Page 51 and 52: 8 Conclusion The history of social
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References Allen P. (2006). New loc
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Appendix one Changing patterns of O
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Appendix two Changing patterns of O
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Appendix three Examples of social e
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Living Centre is developing a socia
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BOX 4 Private sector involvement in
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