NHS accused of pushing social enterprise out due to ‘integration’

The government is expected to put forward legislation this spring loosening competition and procurement rules, and encouraging integration among integrated care systems.

In a letter to the health and social care secretary, shared with HSJ, Social Enterprise UK, said services were already being brought in house to the NHS as a result, because officials believed this was the aim. 

SEUK chief executive Peter Holbrook wrote: “This is not just a theoretical concern. We have already seen contracts taken away from social enterprises, despite being rated good by the [Care Quality Commission].

“We are deeply concerned that without clarity from [government] and NHS England about the role of social enterprises within the future of health and care services that many ICSs will bring contracts in house, believing that to be the outcome wanted by policy makers.”

He said: “In London, we have heard reports that leaders within ICSs there believe that the government wants them to cut down the number of providers, including social enterprises, as part of the integration agenda. Integration is being defined by some as the merger of organisation and the reduction of diversity. A future where only statutory providers deliver services.”

SEUK did not cite examples, but last year North East Essex Clinical Commissioning Group pulled the plug on a large social enterprise community service contract, then moved to a 10-year  deal worth £440m with an alliance including two foundation trusts which are part of that area’s ICS, along with Virgin Care.

SEUK has calculated that around £97m worth of social enterprise healthcare contracts expire in the next 12 months and has called for all to be extended to April 2023, by when any legislation should be passed, and final rules clearer. 

The white paper makes no mention of social enterprises, which currently provide a wide range of services for the NHS, in particular in community health services. Social Enterprise UK estimates these organisations hold approximately £1bn worth of contracts with the NHS and employ 100,000 people. Mr Holbrook called on Mr Hancock to issue a statement of support so that commissioners continued to consider social enterprises.

An NHS England consultation on proposals for a “provider selection regime” — which would replace current procurement rules — finishes on Wednesday.

The DHSC has been approached for comment.