NHS vocational training: branching out

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A mental health and learning disability trust has helped one of its rehabilitation schemes become a social firm. Alison Moore reports

If you live in Exeter and want your garden maintained, there are plenty of gardeners to choose from. But what distinguishes one of them is that it is a social firm, employing former mental health service users and offering work experience to those recovering from mental health problems.

Hillcrest Branch (formerly part of Devon Partnership trust) has become the third not-for-profit social firm to grow out of an NHS organisation. A printing firm and a travel agency, both working with people with mental health needs, were spun off from Surrey and Borders Partnership trust in 2006.

The impetus to "externalise" Hillcrest Branch came partly from its own employees, who were former service users employed by the trust as "bank" workers as part of a vocational rehabilitation scheme offering supported but paid work.

The organisation was already providing gardening services to several health service premises as well as private homes and firms. Several employees had already used their experience of work with it as a stepping stone to full employment elsewhere.

Becoming a social firm would open the way to reinvesting profits in the business - especially for additional equipment and vehicles - and developing it further.

"We felt there was an opportunity for it to have a life of its own," explains Christine Wardle, vocations services manager at the trust and a director of the new firm. "There were five employees at the time and they were the driving force."

The trust approached Social Firms UK for advice in 2006 and its assessment was that there was the potential to become a social firm.

The first thing was to create a business plan which showed that, although the organisation had a reasonable income, it might need support to break even as a separate organisation. A contract was agreed with Devon county council under which the firm would be funded up to £40,000 over three years to provide therapeutic work experience for up to 10 people at a time.

This would be for a limited period of up to a year with four-monthly reviews. This would ensure that there was a flow of people through the organisation with regular vacancies for people to join.

Transferable skills

While at the firm, workers can master new skills and learn to deal with the routines of working life, including timekeeping and reliability. Although the work centres around gardening, many of the skills and attributes are transferable to other employment. The firm can then provide trainees with references when they decide to seek employment elsewhere.

The trainees identify issues they want to overcome or improve during the placement and progress is reviewed regularly.

During the placement they can also progress from working at the firm's base, where close support and supervision can be offered, to working as part of a mobile team in which they will be more in contact with customers and have to take more responsibility for their own work.

This additional funding, plus a projected income of £130,000 a year from contracts, made the firm look viable. As income grows, more people will be employed. Then there is the technical side of separation to be dealt with - a mass of detail, covering everything from insurance to payroll systems and pensions.

As Ms Wardle points out, within the health service, much of this is taken for granted, but everything has to be done from scratch for a small business.

Luckily, Hillcrest Branch was able to rent premises from New Leaf, an Exminster based vocational rehabilitation service, to provide a base at minimal cost. Vehicles - potentially a major expense - could also be leased. But formal agreements had to be drawn up covering ownership of assets. In the longer term, it is expected this sort of support will dwindle.

The organisation took on a dedicated manager, Grace Michaels, six months before it was separated, which eased many of these burdens.

"We needed someone with business knowledge and who had the right sort of attitude towards working with people with mental health problems," says Ms Wardle. "Until the manager was appointed, it wasn't anyone's full-time job. Having the manager in place was extremely helpful."

The firm had to be set up as a legal entity, a company limited by guarantee, with a board of directors. This includes Ms Wardle, as a link with the NHS trust, as well as a county council employee and someone from a voluntary organisation. Employees are reluctant to sit on the board, feeling it is a step too far for them.

A hurdle for health service bodies would be staff transfer - issues around this, especially pensions, have been a stumbling block for provider organisations looking at becoming social enterprises.

But because the staff were totally behind the development, this could be overcome. Unfortunately, they were unable to remain within the NHS pension scheme, which some of them had already joined, but stakeholder pensions have been identified as an alternative.

Furthermore, because the organisation was not providing mainstream NHS services, turning it into an independent firm was not controversial. But other spin-offs could be opposed if they were seen as privatisation.

In April the firm finally went live as an independent organisation. Social Firms UK chief executive Sally Reynolds identifies three factors that contributed to the success of the project: "The complete support that the initiative has had from senior management within the trust throughout the process; the level of income that Hillcrest Branch was already generating; and finally the staff who have taken on the prospect with quite considerable change with vigour and enthusiasm."

Ms Wardle says the main advantages are financial independence from the health service - although this could also be seen as a disadvantage. It no longer has to deal with all the requirements of NHS bureaucracy and reporting requirements, in addition to developing as a business. And finally it has proved a confidence booster for the staff whose idea it originally was. "It has been so exciting - and remains so," she says.

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Hillcrest Branch

Social Firms UK