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

SLIDE 1

Hope Street Centre CIC www.hopestreetcentre.com

Alison Holbourn Grenville Page

Social Enterprise and Marketisation in Health and Care

Grenville Page

SLIDE 2

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!

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“Our ambition is to create the largest and most vibrant social enterprise sector in the world.”

Health White Paper 2010

DH launches vision of ‘largest social enterprise sector in the world’

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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.

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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
• rganisations, 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.

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...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.

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Examples...

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Guidance

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

SLIDE 9

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

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Commissioning cycle

Strategic planning Procuring

JSNA (needs assess) Provider mapping Gap analysis Prioritisation Investment planning

Monitoring & evaluation services

Market stimulation Service design Managing demand Contracting Offering choice Focus on outcomes Driving quality Experience feedback Managing perception Monitoring choice

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Policy Provider Commissioner

What does the market look like?

Regulator

• maker

maker

• enforcer

enforcer

Influencers

• arms

arms-length body length body

• think tank

think tank

• professional

professional body body

• pressure group

pressure group

• foundations

foundations

Provider Commissioner Regulator

• community

community

• acute NHS

acute NHS

• semi

semi-independent independent

• independent

independent

• third sector

third sector

• strategic planning

strategic planning

• care pathways

care pathways

• purchasing

purchasing

• performance

performance

• register & license

register & license

• assess & audit

assess & audit

• compliance

compliance

• recover & improve

recover & improve

• public disclosure

public disclosure

Stakeholders

• public

public

• suppliers

suppliers

• adjacent industry

adjacent industry

• users & carers

users & carers

• partners

partners

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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

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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

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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

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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

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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

SLIDE 17

Hope Street Centre CIC www.hopestreetcentre.com

Questions & Discussion Questions & Discussion