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Time to sharpen your act for a new NHS commissioning world
The significant changes in healthcare commissioning have been well documented and debated. But as new GP commissioning groups and structures take the reins, it is important for new and established social enterprises to change their approach – says Mo Girach of the NHS Alliance.
Social enterprises face huge challenges over the coming months and years, including delivering more innovative services, providing greater value for money, demonstrating clearly public engagement and involvement, and utilising collaborative partnership arrangements to amplify their viability and flexibility in responding to commissioning and tender opportunities – including their financial portfolio.
Of course, usual business rules apply if social enterprises are to thrive in the new environment. Demonstration of quality, safe, effective and efficient services is a must, but, perhaps even more significantly, the relationship between commissioner and social enterprise is integral to building, maintaining and developing trust, understanding and respect.
Excellent service provision is not always enough to guarantee future business; social enterprises have to sell themselves as well as their business model.
In relation to social enterprises, the NHS Alliance – which represents GP’s and is taking a national lead on new Clinical Commissioning Groups (CCGs) – believes the revolution and innovation required in healthcare services critically depends on how social enterprises interact and work with GPs.
We have entered a very different world to the previous structures operated through Strategic Health Authorities and Primary Care Trusts. To cultivate the new relationship with GP commissioners, social enterprises should demonstrate an awareness of the wider healthcare economy – and an understanding of the interactions between public health, primary, secondary and tertiary care arenas, in addition to other influences on health status, such as education and benefit systems. This is about providing integrated commissioning options.
Social enterprises would also do well to clearly articulate their organisational benefits compared to other legal structures, where social return on investment and community involvement act as key influencers around the increased governmental emphasis on commissioning from the third sector.
Commercial naivety around commissioning and the commissioner relationship can restrict the success of social enterprises and must be addressed. The importance of a clear strategy for working with CCGs must not be underplayed and CCGs will be looking for organisational strength in certain key areas, including (but not limited to) the following:
- Commitment to greater choice and innovation, through new business relationships and partnerships
- A shift towards services that are personal, sensitive to individual need and maintain independence and dignity
- A strategic reorientation towards promoting health and wellbeing, investing now to reduce future ill health costs
- A stronger focus on commissioning services and interventions which achieve better health across communities to promote inclusion and tackle health inequalities
The commissioning changes have been introduced to bring about change, modernisation and service development at a time where demand is increasing against a backdrop of potentially reducing resources. In order to meet this challenge social enterprises must appeal to a commissioning agenda led by GPs. This is about going beyond the traditional spectrum of health and social care services, and it encompasses a broader range of support to enable people to:
- Live independently;
- Stay healthy and recover quickly from illness;
- Have as much control over their own lives as possible;
- Live with, and/or look after, their family;
- Participate as active and equal citizens;
- Have the best possible quality of life.
There is a recognition that Clinical Commissioning Groups that engage with social enterprises in an effective way can lead to better outcomes for people with long-term conditions. It is also acknowledged that social enterprises can offer more cost effective use of NHS resources and can widen the diversity of a local provider base, ensuring patient choice.
Social enterprises must capitalise on this increased awareness and develop not only service options for commissioning groups, but pathway options for commissioning consideration and be creative and innovative. By this, I mean that they must provide the solutions for the CCGs, be proactive and look for solutions rather then problems (or indeed assume the sole right to be awarded contracts!).
A range of exciting social enterprise structures, such as community interest companies, mutuals and co-operatives have varying advantages in delivering change flexibly and across traditional provider boundaries, where those social enterprises who work closely with GPs, understanding their intentions and needs for their local population in a mutually respectful relationship, will flourish.
Mo Girach is an independent consultant, an advisor on social enterprise to the NHS Alliance
A Clinical Commissioner’s Guide to the Voluntary Sector, co-written for the NHS Alliance and Acevo by Mo Girach, Holly Hardisty and Alex Massey, was published last month. It can be downloaded below.