In his new job heading a group of not-for-profit organisations, former Rethink chief executive Cliff Prior will have a key role in reshaping community services. But first he has to explain what it is all about

In his new job heading a group of not-for-profit organisations, former Rethink chief executive Cliff Prior will have a key role in reshaping community services. But first he has to explain what it is all about

'Everyone I speak to says: "That's a fantastic sounding job - what is it?"'

And in part, Cliff Prior's new job is all about answering that question. The new chief executive of UnLtd has a goal of promoting social enterprise - to potential entrepreneurs, the organisations that will buy their services and the public at large.

The man whose time running Rethink helped raise the profile of mental health, now has an endowment fund of£120m to identify, seed-fund, train and develop social entrepreneurs. UnLtd, set up in 2000 by a group of non-profit organisations, will be a key player in deciding whether social enterprises - defined as business-like organisations whose main product is a social good - change the landscape of community services.

Mr Prior believes there is a momentum in society, shifting away from traditional forms of organisation. As he puts it, this is not traditional public sector, or the 'me me me of profit-driven business', or 'the often burdensome end of charity work'.

'This generation of people has never had a job for life. It seems natural to create your own thing. In the past if you liked music you went to a big commercial outlet and bought music by a well-known artist - now you are more likely to make your own music and put it on MySpace.'

Mr Prior's vision extends beyond spending the endowment. Are there people who would rather invest their£1 in someone who will make it into£2 worth of social good (even when making a profit) rather than some organisation that will turn it into 20p?

'At the moment a lot of people give money to a charity. In the future it may be that some of those people will be saying: "I like this person and their idea. I like their style and approach and believe in their ability to make change happen" and give money direct to that, whether that is from a foundation or the general public. Or maybe you give time or expertise. It becomes a much more personal relationship that you join up to.'

What is the opportunity for the NHS? Some would claim GPs are essentially social enterprises - Mr Prior demurs in the main but says 'you come across some who are developing their practice beyond the day job'. The Bromley-by-Bow practice in east London is the favourite example, although some point out that its fame is helped by the fact it is still so rare. 'Bow's problem is they do so many things that they are reliant on very complex multiple funding streams,' he says. 'That's difficult to manage in terms of commissioning relationships. It survives by being famous and by nature you can't have too many of those.'

Social enterprise is generating most new interest among nurses, GPs and allied health professionals who want to strike out from what they see as an unappreciative employer. Mr Prior has concerns. 'Very often it's people who have got a passion for a model of healthcare delivery. They are very strong on the clinical side, very strong on staff engagement, and understand the need of users. But they don't necessarily know how to run a business, don't always know even what they would need to learn.'

Those skills can be learned - Mr Prior's issue is what motivates people. 'Are people who invent things the same people who want the grind of watching the bank balance and employing people? Take a stocktake of your motivation - do you really want to run a business? If not, team up with someone who does.'

How do you find that partner? One popular model seems to be primary care nurses teaming up with GPs for their small business experience. However, Mr Prior also says that NHS staff should look to their service users as well - many successful social enterprises have been set up by business people energised to change the way a service is provided because of treatment they or a loved one has received.

But he has a word of warning. 'Many of the most successful business entrepreneurs started by going bankrupt several times. You learn from experience. That's a tough message for people who may still feel they have a job for life and a very nice pension scheme at the end of it. It's a very different world. They've got to think about failure.'

He also has concerns about NHS commissioners, whom he says do not have the experience that their opposite numbers in local government gained during the development of community care. The emphasis on efficiency worries him, too. Indeed it should when too many organisations fail to realise that what savings can be made operationally are more than swallowed up by the cost of regular tendering.

'My hunch is that although there are some gains to be made, it's not enormous and it would be missing the real trick, which is creative.' It should be, he says, about replacing services with something completely new rather than just a me-too service which costs a bit less.

He says they are not helped by the system, particularly a 'very rigid' tariff system that pays for set interventions and discourages innovation. This is made worse by a tendering process 'where the commissioner specifies the service and gets tenderers to compete on price'.

He gives the example of Addiction UK, set up in response to service user experiences, as an example. It provides telephone and web-based support for those unable or unwilling to attend a clinic in person. 'It's a completely different sort of service and if you had put out a standard tender it wouldn't have fitted.

'The DoH has some work to do to enable approaches which are more favourable in creative enterprise. The tariff will need to be revisited.' On tendering, although local government's best-value rules which replaced compulsory competitive tendering 'haven't been 100 per cent implemented as intended, it does at least put value and price on the same footing'.

Meanwhile, he says, 'far-sighted primary care trusts will be encouraging their commissioning managers to spend some time with social enterprises to see what dynamic they have and what the potential is. And it's not just an intellectual case but getting them emotionally.'

Of course, a number of primary care trusts are exploring the possibility of setting up community foundation trusts, and pilots are likely to be announced by Monitor in the new year. Mr Prior is far from certain that there is any advantage. 'To become a foundation trust means going through a very intensive diagnostic process which most people say they hated at the time but found very useful in understanding their organisation as a business,' he explains.

But actually becoming a foundation trust after that process means 'taking on very intensive continuing regulation and some pretty tight limits on what you can do. What is the payback? An acute trust is very capital intensive and unlikely to be allowed to take out those assets without being a foundation trust. But if you are a community service which is a people operation, do you need to go down that road?'

Time will tell whether or not social enterprise delivers on its promise. Access to the national IT programme and resolving the issue transfer of pension rights will both be important. He believes long-term conditions is a real opportunity, whereas acute care, which resists slicing off small services, will be much more difficult.

Intermediate care services are another matter, however. 'It can only be a matter of time before professionals working in a [threatened] community hospital pal up with some of the agitators trying to keep it open and form a new social enterprise - if they can find a way to transfer the asset.'

And Mr Prior believes uncertainty is a defining feature of social enterprise. 'The only thing you can't predict is where it will go. In every sector that made space for social entrepreneurs, completely different things have happened that no-one expected. So watch this space.