Community-based organisations risk being left behind in the race to enter the primary care market, unless the government does more to support them.
That was the message today in a new King's Fund report Social Enterprise and Community-based Care which suggests that the government could do more to support those seeking to set up social enterprise* organisations.
The government's recent White Paper on health care outside hospitals signalled a drive to open up the primary care market to a range of providers, including those from the independent sector and those forming social enterprises - which are business with primarily social objectives that reinvest financial surpluses to pursue those objectives.
The report welcomes the government's vision of a range of different providers including those from the private sector, but says more needs to be done now to help new social enterprises to start-up. Otherwise it suggests that contracts in the market may be awarded to for-profit companies, leaving little for social enterprises when they finally enter the sector. The report argues that social enterprises that are co-owned by staff and patients may be particularly well suited to the provision of primary and community care and the commissioning of NHS services by groups of general practices.
The main recommendations in the report include:
- creating guidance at a national level to aid the development of social enterprises in primary and community care
- bringing forward the date (currently April 2007) for the government's proposed Social Enterprise Unit which will provide advice, access to finance and developmental help to social enterprises
- ensuring that primary care trusts are accountable in providing support to the development of social enterprises
- providing support networks to potential leaders of social enterprises, allowing them to share ideas and problem solve jointly; and
- providing guarantees that NHS pension rights will continue to exist for staff transferring from the NHS to new social enterprise organisations.
Report author and The King's Fund senior policy fellow Dr Richard Lewis said:
'We welcome the fact that the government recently outlined proposals to help social enterprise develop and enter the market for community services. However these will take time to develop and there is a concern that for-profit companies will sweep into primary care unchallenged. This would undermine the attempt to develop a truly diverse market in primary care.
'If too much time passes before staff and patient led-organisations take shape, there may be little in the market left for social enterprises. Only by reducing barriers to entry in to the primary care market will the new vision of public ownership be made a reality.'
Commenting on the report, The King's Fund chief executive Niall Dickson, said:
'In the end what matters is the quality of care that is delivered in the new arrangements. Encouraging a variety of different types of organisation into healthcare must be the future. That should mean a key role for various forms of not for profit organisation - with the right support and encouragement social enterprise could flourish in this environment.'
The report concludes by saying that social enterprise offers the prospect of a new degree of partnership working between health care professionals and the public.
Read the report: Social enterprise and community-based care
Notes to editors:
* There are an estimated 15,000 social enterprise businesses operating in England with an estimated annual turnover of £18 billion. Source: Small Business Service Review of the Social Enterprise Strategy
Social enterprises already operate in all sectors of the economy (for example, building societies, community based co-operatives and NHS foundation trusts). Social enterprises are also beginning to be established in primary care. In East London, East London Integrated Care (ELIC) has been set up comprising 220 GPs, practice nurses and general practice managers. Overseen by a members council with professional and patient representatives, the organisation helps GPs carry out new responsibilities as practice based commissioners as well as providing care directly - starting with ear nose and throat services.
- For further information or interviews, please contact the King's Fund media and public relations office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185.
- Richard Lewis is a Senior Fellow in health policy at the King’s Fund. David Carson is Chairman of The Healthcare Foundation and Peter Hunt established Mutuo (Communicate Mutuality Ltd) in 2001.
- The King's Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health and social care, offering leadership development programmes; seminars and workshops; publications; information and library services; and conference and meeting facilities.