Clinicians launch community ENT to fend off independent giants

A group of 150 GPs, practice nurses and managers have set up a social enterprise venture in an attempt to protect NHS services from being 'picked off' by the independent sector.

City and Hackney ELIC (East London integrated care) has been set up as a community benefit society established under the Industrial and Provident Societies Act 1965.

It is due to start work within the next few months, initially offering community-based ear, nose and throat services for patients from across the City of London and Hackney. A GP with a special interest in ENT has been recruited to offer the service from a local health centre.

With some 20 per cent of all local GP consultations involving ENT problems, the move will allow a larger number of people to be treated where they live and reduce the numbers and cost of hospital referrals. The service will offer routine procedures such as ear syringing, but also arrange hospital referrals for tonsillectomy patients.

Project manager Paul Haigh said: 'GPs thought that it was very much better to be working together to provide locally driven and run services rather than having private sector companies like UnitedHealth or others picking off services.'

ELIC receives income under practice-based commissioning and under the terms of its charter may only plough profits back into improving the service locally.

It is also supporting schemes to allow all its members to get involved in the practice-based commissioning of other hospital services and is developing new clinical pathways to speed patient care. Local residents will also be invited to become members from next year.

The start-up costs totalled around£60,000, including legal fees which were paid for in part by a grant from City and Hackney teaching primary care trust and in part from GPs' own pockets. And as ELIC is not yet recognised as an NHS organisation, should it expand and wish to take on employees, these would not benefit from NHS terms and conditions.

The GPs providing the service would have to rely on their own personal medical indemnity insurance as such projects do not come under the NHS indemnity scheme.

While the NHS is encouraging clinicians and managers to band together in social interest organisations, Mr Haigh said that without specialist legal knowledge and a substantial start-up budget, this could prove daunting. 'It has taken us about 12 months to get to this stage and that has meant a lot of discussions with solicitors and that can prove expensive as we have to have our own legal advice.'

Mr Haigh said he hoped that the social enterprise unit at the Department of Health would be able to provide a comprehensive 'how-to guide' to set up a social enterprise venture. 'This sort of thing could seem very daunting for people in the NHS who have no experience of setting up companies,' he said. 'The private sector has its own in-house lawyers and is engaged in business ventures all the time.'