Is the risk of social enterprise to great for some?

For 15 months we have been exploring with our staff potential models for externalising our community health services including the possibility of a social enterprise.

The process has done much to highlight some of the issues that are of most concern to staff when they think about the future and their place in an ever changing NHS.

Just before Christmas nearly 1,000 staff in West Essex Community Health Services had the opportunity to vote on whether they were in favour of setting up and owning a not-for-profit company in the form of a social enterprise under the government's right to request scheme. The proposal was for a social enterprise to deliver all of our community health services.

When the votes were counted, it was clear that the majority of staff did not wish to go down this route.

We had a very high turnout with nearly 70 per cent of eligible staff voting. Of these, 498 (73.7 per cent) voted against and 178 (26.3 per cent) voted in favour.

The independent ballot, conducted by Electoral Reform Services, was the culmination of many months of staff engagement including three months of formal consultation.

I think it was absolutely right that we gave staff the opportunity to have their say on this particular model for delivering community health services because it was the only option they could choose for themselves.

We felt strongly that staff should have the opportunity to vote because the type of organisation we were talking to them about was one that would be owned and run by them.

The reason the PCT welcomed the possibility of a staff owned organisation was because a high degree of staff ownership was a mark of social enterprises that worked especially well. It would enable more integration with primary care with GPs as part owners of the enterprise.

In line with their national policy positions, some trade unions were very vocal in their opposition to a social enterprise model. We were at pains to work alongside the unions, meeting them regularly and attempting to agree a statement of common ground although in the end this did not prove to be possible.

Two key messages from staff during the consultation was a lack of assurance that a social enterprise would be seen as a preferred NHS provider or that new staff coming into a social enterprise would have access to the NHS pension.

There is no doubt that some staff were concerned that becoming a social enterprise would mean leaving the NHS although we explained they would remain part of the NHS family in the same way as GPs.

The pensions issue around new people joining a social enterprise made some of our staff fear for the sustainability of the new organisation if it couldn't attract high calibre staff.

Our engagement and consultation process generated a greater understanding among our staff about the need for change and this we will build on.

Over the next month or so we will be reviewing options for all our services and this may include social enterprise as a vehicle to deliver some services where staff have expressed a wish to go down this route.

We will remain on the Department of Health's list of first wave right to requesters and while staff overall have voted against pursuing social enterprise, this still remains an option for some discrete groups of staff.