NHS Social Enterprise Spin-outs - the real story

NHS Joke

I've posed the question elsewhere of whether the NHS Right to Request process actually led to ANY increase in the number of spin-outs to social enterprise – and not received a satisfactory answer.

Of course I know of a few cases claimed by the Right to Request process – my question is whether these, and possibly others, would have gone ahead, and maybe even been EASIER, without this 'support' intervention.  I certainly managed to keep one NHS externalisation last year out of the official process – which was completed very smoothly in just a few months thankyou very much.

Now I've just read the latest Third Sector Research Centre Working Paper on Social enterprise spin-outs from the English health service: a Right to Request but was anyone listening? by Robin Miller and Dr Ross Millar.   This should make uncomfortable reading for the NHS, and all those responsible for promoting the Right to Request.

The researchers studied the uptake of Right to Request in the West Midlands. They found that by July 2010, 2/3 of the PCTs in the West Midlands were still not aware of any Right to Requests being developed.  From the other 6 PCTs 13 staff groups were known to be exploring Right to Requests - 6 of these had had Expressions of Interest approved by their PCT Board, 2 were about to have their Expressions considered, and the other 5 were still at the ideas stage.

Just 3 months later the picture had changed entirely - by October 2010 all of the whole provider arms had abandoned the process, and there were only 2 Right to Requests still live – one clinical team and one service cluster – both still at an early stage.

Although the Right to Request initiative has now finished. the paper's authors also note that the ideas behind it are still live in the NHS and elsewhere, and indeed that aspects of the Localism Bill and the so-called 'Open Public Services' Bill such as the Rights to Buy/Challenge/Provide might extend similar processes to local authorities.

I am of course very much in favour of introducing social enterprise into public services, and very often an independent sector organisation is indeed the best way to do this.

But please lets stop hyping solutions without putting in place the basic conditions to enable them:

  • really expert social enterprise developers
  • flexible enough pension arrangements and other staff transfer conditions
  • contracts that focus on results not processes
  • honest responses to trade union reservations
  • time release to develop inspirational leadership

 – and I could go on!