Alison Holbourn Grenville Page Grenville Page Discussion Whats - PowerPoint PPT Presentation

Hope Street Centre CIC www.hopestreetcentre.com Social Enterprise and Marketisation in Health and Care Alison Holbourn Grenville Page Grenville Page

Discussion • What’s happening? • What’s the policy framework? • Spin outs and open market testing • Risks and opportunities? • Risks and opportunities? • Financials Interactive – please ask questions!

DH launches vision of ‘largest social enterprise sector in the world ’ “Our ambition is to create the largest and most vibrant social enterprise sector in the world.” Health White Paper 2010

Advantages (what the DH says...) ...for patients and service users • Social enterprises involve patients, staff and service users in designing the services they provide. This means that services are better tailored to meet patients' and service users' needs and are based on expert knowledge of a particular area. particular area. • Social enterprises re-invest any surplus profits into the community or into service developments. This means that social enterprises very often benefit the whole community as well as the people who use their services. • Involving patients, staff and service users in designing services.

For health & social care organisations.... • Social enterprise offers health and social care organisations the opportunity to deliver high quality services in ways that are flexible, non-bureaucratic and have the potential to deliver good value for money. It also allows health and social care organisations to deliver services that are tailored to their local population, and make a difference to the local community. Because staff have a stake in social enterprise community. Because staff have a stake in social enterprise organisations, experience has shown that they are very committed to the aims of the service, and that this delivers benefits for the organisation, for example, improved staff retention. • High quality services: flexible, non-bureaucratic, good value.

...for the third sector • Third sector organisations have expertise in specific areas, and great understanding of the groups they represent. They understand how services should be delivered to best meet peoples' needs. Social enterprise models offer the opportunity for a sound commercial relationship between public sector relationship between public sector commissioners of health and social care services and third sector providers of those services. • Expertise and understanding of the groups they represent.

Examples...

Guidance Open Right to Public Provide Services Localism Personal Bill Budgets Right to AQP Challenge

Legal Forms • SEs not a ‘legal form’ as such • Spin out guidance requires an ‘allowed’ form e.g. Mutuals, CICs, Charities • All NHS services are provided by private • All NHS services are provided by private companies, SE’s and FTs (Community Benefit Societies) • Constitutional engagement of staff, public and stakeholders feature in many SE’s

Commissioning cycle JSNA (needs assess) Provider mapping Strategic Gap analysis Prioritisation planning Investment planning Procuring services Monitoring & Focus on outcomes Driving quality evaluation Market stimulation Experience feedback Service design Managing perception Managing demand Monitoring choice Contracting Offering choice

What does the market look like? Policy Influencers  arms arms-length body length body  think tank think tank  maker maker  professional professional  enforcer enforcer body body  pressure group pressure group  foundations foundations Commissioner Commissioner Provider Provider Regulator Regulator  community  register & license community register & license  strategic planning strategic planning  acute NHS  assess & audit acute NHS assess & audit  care pathways care pathways  semi  compliance semi-independent independent compliance  purchasing purchasing  independent  recover & improve independent recover & improve  performance performance  third sector  public disclosure third sector public disclosure  partners partners  public Stakeholders public  users & carers users & carers  adjacent industry adjacent industry  suppliers suppliers

Is the enterprise financially sustainable? • Understanding the current financials • Transition and running a free standing enterprise • Building the 5 year financial plan and market • Building the 5 year financial plan and market assessment • Financial Considerations and Risks

Understanding the current financials • Baselining the current operations and assets • Corporate Services and overheads • Hidden costs • Contract income or value of current service • Contract income or value of current service activity • Current pressures

Transition and running a free standing enterprise • Employees - TUPE • Governance arrangements - Board, non- executives and development • Strategic and corporate capability and associated services services • IT systems and support • Premises and equipment • Contracts with suppliers • External reporting and Audit • Legal support

Building the 5 year financial plan and market assessment • Taking forward the baseline and running a free standing enterprise • Financial interpretation of market assessment • Pay and price increases • Pay and price increases • Efficiencies • Operating returns • Contingency, asset replacement, future investment • New business

Financial Considerations and Risks • Corporation Tax and VAT • Cash flow and sources of external finance • New business and Contract terms • Transfer of assets and liabilities - depreciation • Transfer of assets and liabilities - depreciation and replacement • Corporate capability and capacity • Set-up costs and transition planning • Stakeholders

Hope Street Centre CIC www.hopestreetcentre.com Questions & Discussion Questions & Discussion