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Why NHS staff are going solo

The conditions are right for frontline staff to consider a move towards independence.

It never seems like a good time to take a risk, even a calculated and well mitigated one. However, for frontline staff groups in the NHS and those working in social care, now feels like an opportune moment to explore the option of going independent.

It’s no secret that the NHS is in a period of upheaval as PCTs close down and their functions are separated out. Numerous staff groups face an uncertain future. Maybe they will end up as part of their local authority’s public health teams, join one of the new commissioning support organisations, or perhaps their service will be openly tendered with staff facing transfer to whichever organisation emerges successful from that process.

It is not just teams from PCTs who are facing some doubt. Acute trust teams are also facing reorganisation as the NHS adjusts in readiness for dealing with the new CCG driven landscape. Any of these options could see existing teams being broken up.

For a number of years now through the Right to Request programme and its successor, Right to Provide, NHS and social care staff groups have had a tried and tested route to exploring the option of moving out of public employment into an independent social enterprise.

This policy was initiated under the Labour government and now the coalition has a firm commitment to give public sector workers new rights to provide services as staff-led enterprises. These can include staff-led mutuals, cooperatives, co-owned businesses and social enterprises, joint ventures and partnerships.

Taking control

A range of staff groups we are working with are not content to sit back and wait for their future to be determined for them. They are taking matters into their own hands in an effort to preserve a service and a team that they believe delivers a great service. Indeed, one of the key drivers behind the Right to Provide Programme is “to enable NHS and social care staff to take the initiative in developing services that better meet the needs of the patients and communities they serve and to secure additional benefits by providing this through a staff-led enterprise.”

Groups pursuing this opportunity have been able to apply to the Social Enterprise Investment Fund (SEIF) for assistance. This fund is designed to help staff groups at different stages of the process from business planning through to transition and set up of their new organisations. So far, since 2007, SEIF has supported over 600 social enterprise projects and has invested more than £100m.

After a period awaiting final confirmation, the Department of Health has now announced that SEIF will continue this financial year with £19m worth of new funding. This is very welcome news indeed and represents a great opportunity for staff groups to secure funding. It’s not my place to second guess what the Department of Health’s plans for SEIF are in the future - but as funding tightens across government, my instinct would be to take it while it’s there.

Satisfaction guaranteed

The benefits and challenges for staff and commissioners going down this route are well documented, but a report from the Mutuals Task Force makes a strong case for mutual and social enterprise delivery of public services. For service users, the report claims, this type of delivery raises the quality of the public services they receive. For commissioners, it increases both the value for money and the effectiveness of the services. For employees, it improves commitment and job satisfaction.

As a real example of staff commitment, the report highlights the independent Sandwell Community Caring Trust which saw its absenteeism rate fall from 22 per cent when within the public sector to less than 1 per cent 10 years after going independent.

We would strongly support these findings based on our own experience of supporting frontline staff groups. There is also a very strong argument for trying to achieve a balanced public service market where in-house public sector delivery, outsourced private sector delivery and, critically, social enterprise/mutual delivery are all substantial enough to keep each other in check. This macro-level benefit, which is a key stated aim of Right to Provide, is often overlooked when focusing on the merits of taking a particular service independent.

Take the plunge

So what should staff groups do if they feel the need to take control of their own destiny? The first step is to make an expression of interest to your NHS trust board or your council’s board. This involves clearly setting out your thinking, including: why you are interested in Right to Provide; what you would do differently; who will benefit from the new enterprise; how will the staff-led enterprise help to meet local priorities. Getting in early contact with the SEIF team at the Social Investment Business is also a must to get their invaluable advice and guidance and get your team on the path to making a funding application.

At this moment, the conditions are favourable for front line staff groups to consider a move to independence – but in a constantly changing public service environment, it’s impossible to say how long they will remain so.

Andrew Laird is a director of Mutual Ventures.

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