Trailblazing pathfinders are using new funding to create choice and breathe new life into communities. Louise Hunt reports
When the Department of Health announced£1.4m of funding for social enterprise pathfinder schemes in April, it signalled its commitment to developing new types of healthcare providers to work alongside the NHS.
The move can be viewed as part of the government's agenda to split primary care trusts' commissioning and provider roles by offering more choice of alternative service delivery.
The start-up funds are being used by social enterprises around England hoping to address shortfalls in provision. The chosen 26 projects are seen as trailblazers that could inspire the health and social care sectors to follow suit.
SCA Healthcare in Southampton is planning to use its funding to redevelop a community hospital. The hospital had already lost its inpatient beds and was one of several hospitals set to be closed by Hampshire PCT.
It is expected to be the first community hospital-based pathfinder to provide NHS services for older people and those with long-term conditions while making an income from providing private health services such as physiotherapy and complementary therapy on site.
SCA Healthcare was launched as a social enterprise group, providing dental services for PCTs and thus making up for a shortage of NHS dentists in Hampshire.
'When the social enterprise pathfinder project came up, we saw it as an opportunity to expand our projects into the health service,' says SCA Healthcare chief executive Brian Strevens.
'This will be one of the first pathfinder projects in the country to bring in a range of services at one community health service,' says Mr Strevens.
SCA Healthcare got£11,000 from the 2007 fund and is expecting to receive a further£48,000 for the financial year 2007-08 to get it to market. In addition, it has applied for a PCT grant worth£900,000 to refurbish the site and the PCT is giving the first five years' rent free, while the hospital builds up its income streams.
The organisation will provide part NHS care, including a long-term conditions centre for diabetes, cardiac and pulmonary check-ups that would otherwise be delivered at an outpatient clinic. NHS nurses and consultants will also be employed to monitor patients remotely, via computers at home and a central control. And it is working with the local mental health trust to provide a respite service that will offer around 15 places a day for older people with mental health problems.
It hopes to generate income by offering private clinics, such as sports medicine, counselling and complementary therapy services. It is expected to be running by April 2008.
While many pathfinder projects provide new or additional services, Forest of Dean Health Enterprise Trust is hoping to take over a large chunk of West Gloucestershire PCT's community services.
'The idea of a spin-out social enterprise is that it can provide the same service but more flexibly,' says project director Ian Carmichael. 'For example, PCTs deliver services to the GP-registered population, but if we have spare capacity, we can offer services to other PCTs and health boards.'
A further advantage of being a social enterprise, says Mr Carmichael, is that it can attract investment from organisations outside the health service. One such possible route is through a local council coal regeneration fund that is being used to revive coal mining areas through housing development, for which the enterprise trust hopes to develop health services.
If its plans come to fruition, Forest of Dean Health Enterprise Trust will be in charge of two 30-40 bed community hospitals with minor injuries units, district nursing and allied health professionals.
The organisation was given£30,000 for 2007 to set up its organisation. Mr Carmichael says the project is still in the very early stages of negotiations with the PCT on contract arrangements and staff terms and conditions.
The Dementia Care Partnership has been pioneering independent living since the early 1990s, when it was a pilot health and social care project testing the feasibility of supporting people with dementia and older people with functional mental illness in their homes and communities.
Becoming a social enterprise pathfinder is now enabling the carer-led charity, with three-day services in Newcastle and Northumberland, to take its philosophy of citizenship and empowerment even further by giving clients the chance to be actively involved in running the centres.
One project will transform its day services into social enterprises where, for example, clients will make produce from food they have grown in a 'productive garden', which might be sold in its restaurants - where clients also work with volunteer buddies.
Working with a local school will enable the partnership to extend this work by offering use of a much larger garden, as well as woodwork and computer room facilities.
'The exciting thing about getting pathfinder status is that it enables us to venture into areas we haven't been able to before. It's about breaking down barriers and exercising the clients' rights as citizens,' says chief executive Rani Svanberg.
Another development is the creation of a volunteering and employment agency to specialise in recruiting and training local people as carers to work with clients.
Clients will also be involved in developing a specialist training programme in dementia and mental healthcare in partnership with Northumberland University. Ms Svanberg hopes the project will become an accredited training agency, offering national vocational qualifications to social care and nursing home sectors.
The Dementia Care Partnership received£52,000 from the pathfinder start-up fund this spring. 'We are commissioned by the PCT and social services, but the fund is now enabling us to move towards a social enterprise model where we can make additional income rather than relying on statutory contracts,' says Ms Svanberg.