Recommendations following Fit for Purpose Conference September 2007
· Support for Thematic Health and Social Enterprise Network. The role of the Network should be to support the sector’s capacity to respond adequately to opportunities for growth.
· Multidisciplinary Partnership Working: Maximise opportunities for partnership working e.g. health professionals, statutory agencies and Housing, via the Network.
· Health Impact Toolkit: SFPH should produce an interactive toolkit that will allow social enterprises to articulate benefits at the individual, social and environmental level in their dialogue with the statutory sector. The toolkit should be adopted as best practice for social enterprises in this sector and rolled out via the Network.
· Case Studies: To benchmark the success and activity of existing social enterprises involved in the health arena, case studies should be produced to demonstrate to public health officials (policy makers, politicians, and to the wider sector as examples of good practice) the ability of social enterprises to deliver services effectively and efficiently. It would also serve the purpose of building confidence amongst existing social enterprises. An important element of this work will be to explore and highlight the added value provided by social enterprises carrying out public service delivery.
· Dissemination: Information gathered via the thematic Network, focus groups and case studies will be disseminated to promote good practice to health professionals, procurement officials and third sector organisations The dissemination process will culminate in the 3rd Social Enterprise and Health Improvement Conference in September 2008, to report on the developments over the last 12 months and take forward learning opportunities over the subsequent 12-24 months.
· Access to Tendering Process: To ensure access to all tender processes (large and small contracts) for social enterprise in a consistent manner across the public sector. This will enable social enterprises to bid to deliver services on a contractual basis to public sector commissioners. This would help provide a ‘level playing field’. As a starting point, social enterprises should where appropriate be routinely included in preferred bidder lists for contracts under £15,000. In addition, joint bids by social enterprises should be encouraged, particularly where larger companies partner up with smaller local social enterprise who would otherwise not be capable of delivery (e.g. Forth Sector’s Laundrette subcontracting with CESEL Deliveries to win the Borders Social Work laundry contract). The Scottish Government should ensure that the Community-led Task Group on Health Improvement works to achieve this level playing field for social enterprises.
· Promotion of Service Delivery by Social Enterprise: The Health & Wellbeing Directorate of the Scottish Government should give specific strategic direction to local Community Health Partnerships to promote service delivery by social enterprises, particularly in the areas of heath improvement and social care,
· Health Specific Invest to Save Fund:, Access to some form of public funding/finance is important for start-up enterprises, particularly those setting up in areas where market failure exists The Scottish Government should set up a ring-fenced fund for the Health & Care sector to match resources from a Futurebuilders fund, which might mimic the INCREASE Fund made available to the Community Recycling sector
· Public Social Partnerships: The public social partnership pilots in North Lanarkshire and Renfrewshire has demonstrated value which could be transferred into the health sector and more partnerships should be encouraged.
· Social Added Value: The added value provided by social enterprises should be taken into account by public health commissioners as part of Best Value. Specifications for contracts should include social enterprises where appropriate. Specifications should also be outcome focussed giving bidding organisations the opportunity to demonstrate innovative solutions. The opportunity for using Social Clauses in public contracts should not be overlooked.
Conclusion from Case Studies Report April 2008
The challenge for social enterprises is to demonstrate clearly the value they can bring in delivering effective and efficient public health services. This report seeks to showcase the activity of a range of social enterprises through 14 examples from Scotland and 5 from England. This work stems from recommendations that emanated from the ‘Fit for Purpose – Social Enterprise and Health’ Conference held in Glasgow in September 2007.
The intention is to help demonstrate the case for social enterprise to be acknowledged as an accepted vehicle for delivering good quality services to the health and social care sector in Scotland. The social enterprises in question were selected on the strength of their perceived success after carrying out desk-based research, together with tacit knowledge gained via the Local Social Enterprise Networks. They represent a broad mix in terms of turnover, staff size, lifespan and development capacity. From this research, a number of common threads emerged:
a) Almost all the social enterprises involved have been dependent on the drive and commitment of a key individual or individuals. This element has proved vital in setting up and establishing the respective enterprises. The role of the ‘keyman’ is well documented in business circles. It also appears to be the case in social business circles.
b) Their motivation has often stemmed from a sense of injustice arising from seeing services delivered poorly for a particular client group, and feeling that they could do things better. There has been a strong sense that alternative methods will produce better outcomes for people using the services. This is backed up by a conviction that a personal investment in such a style or method or client group brings about tangible benefits. Also evident is a political rationale that ‘not for profit’ enterprises are able to encourage better employee retention and, therefore, quality and consistency of service.
c) A perception that local authorities are often unwilling to commission social enterprises, and ‘play safe’ by invoking the ‘best value = cheapest option’ approach.
d) Social enterprises are concerned that commissioners of services do not always take into account the merits of the wider social impact of their business. One example is the perception that by employing clients or service users, a service is often deemed less ‘professional’.
e) Approximately 30% of the case studies are actively involved in the contract and tendering processes with Public Sector commissioning bodies. Another 30% are significant ‘sellers of services/products’. The remaining percentage continue to rely on Service Level Agreements, frustrated that they cannot move beyond this to elicit contracts or are still needing to ‘prove their worth/value’.
It is clear that social enterprises are impacting amongst vulnerable, hard to reach, disenfranchised and under-served groups. Whether their worth and value is being fully recognised is difficult to gauge. There still appears to be a lack of understanding on both sides – in terms of what social enterprises can deliver, and what commissioners are looking for.
The contrast between the social enterprises in England and Scotland was evident in the level of contracts secured and the scale of the operations and, most importantly, in terms of measuring and articulating the benefits they bring. While all found it difficult to explicitly detail outcomes, often relying instead on ‘woollier’ language of self worth, confidence, combating loneliness, widening circle of friends, the English examples were, in the main, clearly more attuned to the notion of demonstrating their ‘added value’. This is, perhaps, not surprising in light of the investment and support available through the NHS in England.
Regardless of their location, all the enterprises were able to demonstrate the positive impact that they had on the communities they serve, be that of interest or place. They are vital to the people who are using the service; there is no doubt that without them there would be a greater ‘draw’ on the public purse and on local communities. The challenge will be to help social enterprises to demonstrate their worth and value within the policy context of NHS Scotland’s health outcomes. Commissioners of services do not appear to be ‘in tune‘ with social enterprises and vice versa. This is the barrier that has to be overcome.
Within the last couple of months, two reports – one in England and the other in Scotland – have reinforced the fact that the gap (between commissioners and social enterprises) still exists, but it is also clear that benefits can be derived and evidenced from a new approach.
The Cabinet Office and the Improvement and Development Agency (IDeA) published a report last month (February 2008) that suggested that while commissioners are beginning to recognise that social enterprises can offer added value in terms of innovation, local knowledge and engagement with service users – particularly in hard to reach communities – commissioning policies are still not reflecting this.
Their evidence found that 83% of commissioners acknowledged that the sector brings something unique to public sector delivery but, crucially, there was still a lack of trust about its ability to deliver. Their belief was that the sector still lacked the capacity and resources to manage service contracts.
Social enterprises themselves felt that they continued to be stereotyped as ‘amateurish’, and that the procurement process was cumbersome, over-bureaucratic and stacked against them.
In Scotland, however, the ‘Community Benefits in Procurement’ Report (Scottish Government, January 2008) highlighted the fact that social inclusion clauses in the letting of regeneration and housing contracts had delivered clear and measurable social benefits.
If it is accepted that social enterprises are good value in terms of innovation, local knowledge and engagement with service users, particularly in hard to reach communities, social benefit clauses – as referred to in the ‘Community Benefits’ Report – can put social enterprises at a distinct advantage not only in providing social benefits for commissioners of public sector contracts, but also in providing a credible local partner for other contractors.