We need more social enterprises to deliver the long-term plan

The NHS long-term plan has been published and the targets have been set. Now we have to think about how we are going to deliver on it. One thing is certain, that we need to be more innovative if we want to deliver better outcomes for patients than we do currently.

This need to innovate and improve our culture is central to the social enterprise I lead, Community Dental Services CIC. CDS-CIC is a social enterprise delivering community dental care services in the Midlands and East of England. Our mission is to improve the oral health of as many communities as we can.

We are one of many social enterprises that play a crucial role in our health system but not one that is talked about enough. Social enterprises are independent organisations which are legally bound to follow their social mission and create social value.

There are around 100 social enterprises working within the NHS – alongside thousands of others working across our economy to improve health and wellbeing. Currently social enterprises deliver a third of all community health services as well as two-thirds of out of hours services and they employ over 100,000 staff – a significant portion of the NHS.

Many social enterprises, including mine, started their lives within the NHS but spun out to establish themselves as independent organisations. We did this because we wanted to focus on helping our patients, to be less bureaucratic, more innovative and to enable our people to provide the best possible care for communities.

We believe that by being part of the NHS family as a social enterprise, we can help generate better outcomes than traditional models of delivery.

Our instincts have been backed up by the latest government-commissioned research by Social Enterprise UK which surveyed public sector mutuals, employee-owned social enterprises which have been spun out of the public sector.

Research findings

This new research showed how they are in many ways outperforming traditional providers, arguably offering a blueprint of a better way of doing things. The majority of them work in health and social care, which is why this research makes for particularly important reading for our sector.

The research has shown that being set up as a social enterprise has resulted in a happier workforce, with more responsive and better services whilst being financially sustainable at a time when the rest of the NHS is in the midst of financial instability.

The headline figures for social enterprises are impressive. Eighty eight per cent of social enterprises have reported more responsive services and more than half say that they are delivering better services than before.

Nearly 70 per cent are innovating, developing new services or significantly improving existing ones. On top of this, 96 per cent of social enterprises generated a surplus – compared with the majority of NHS trusts which are running a deficit.

The research has shown that being set up as a social enterprise has resulted in a happier workforce, with more responsive and better services whilst being financially sustainable

Our own findings at CDS-CIC bear out this wider trend. Ninety eight per cent of our workforce feel proud of the service delivered to patients and customers.

Eighty six per cent of people feel they are able to contribute to the way the organisation operates, 88 per cent believe that we invest in their future and we have less than 3 per cent sickness absence.

Ninety eight per cent of our patients would recommend us and we are really delivering on our mission. In the last year, over 21,000 children have been given toothbrushing support and oral health education and 26 per cent of our patients have avoided hospital admission for General Anaesthetic in Suffolk following investment in sedation and behaviour management.

We have also hit all of our KPIs and targets. This is a model for delivering the aspirations of the long-term plan.

Our financial performance mirrors the findings of the research and we have achieved a financial surplus every year we’ve been operating as a public service mutual.

Productivity

The most impressive finding in the research was the level of productivity found in social enterprises. We need to boost productivity across the public sector, but particularly in the NHS, if we are going to both raise patient outcomes and be financially sustainable.

This government-commissioned research found that productivity in public service mutuals had risen by 3.7 per cent last year, compared to 0.3 per cent for the wider public sector. This compares to the 1.1 per cent increase in productivity that the NHS is seeking to achieve in each of the next five years.

For us, the reasons for this stark gap on productivity are clear. First, we have found that engaging our people and giving them more control has helped to boost their productivity – a key factor given the central role that people play in delivering our services.

We have also found that being independent within the NHS has helped to improve the speed of decision making, increasing innovation and enabling new approaches to be piloted. Finally, being a social enterprise has changed our way of thinking.

At a time when Lord Carter’s review has identified huge unwarranted variations in mental health and community care and the opportunity to save £1bn, you’d think that the NHS would be wanting to develop and grow the social enterprise sector

We are focused on delivering social value, that is increasing the positive social, economic and environmental impact of our work. This has encouraged fresh thinking and enabled us to think more strategically, with higher productivity as a result.

At a time when Lord Carter’s review has identified huge unwarranted variations in mental health and community care and the opportunity to save £1bn, you’d think that the NHS would be wanting to develop and grow the social enterprise sector.

Unfortunately, NHS England’s most recent legislative proposals threaten to undermine the role of social enterprise in the delivery of health and social care, reducing innovation from the system.

Hopefully, NHS England will look closely at responses from social enterprises to their consultation and the concerns raised to the House of Common’s health and social care committee. If we want to achieve the long-term plan, we need more social enterprises – not fewer.

Whatever happens, this research shows that social enterprise has huge potential to help the NHS, if we are allowed to do so. It is up to policymakers to decide what happens next.