Social enterprise going ‘over the heads' of NHS mavericks

The ‘right to request' social enterprise initiative is failing to attract the interest of frontline health staff dedicated to driving change in the NHS, according to a leading civil servant at the Department of Health (DH).

Right to request was introduced as part of Lord Darzi's Next Stage Review Final Report last year giving all NHS staff the right to ask their primary care trust board if they can set up a social enterprise to provide NHS-contracted services.

However, Bob Ricketts, director of system management and new enterprise at the DH, told members of the NHS Network yesterday that social enterprise was going ‘over the heads' of the health staff who had the potential to make a difference.

‘We hoped the right to request would attract the mavericks who are frustrated with the NHS, but I'm not sure we have managed to do that,' he told delegates.

‘We may be going over the heads of the mavericks and using too traditional ways to get to them.'

‘Our aspiration is to see a substantial increase in social enterprises in the NHS and to use social enterprise to create a social movement to transform health services. It's to help us drive a cultural change in the NHS.'

Ricketts said that since the Darzi report's launch there had been between 12 and 15 right to request applications and that around two-thirds were being pursued.

But he said the message of how frontline employees could change service delivery was ‘not getting to the right groups of staff'.

‘They are thinking about how they can help patients and get out of the NHS rather than actually wanting to make a difference,' Ricketts said.

Ricketts highlighted that intervention and prevention services could be provided by social enterprises. For example, he said that around half of patients with type two diabetes received no lifestyle guidance. This could be picked up by social enterprises, he said.

He added there could be many opportunities with the government's personalised health budget initiative, which gives patients more control over their treatment, and predicted that there would be more joint ventures between the NHS and third sector organisations over the next three to four years.

However, he predicted that the biggest challenge would be the fact that commissioners would be squeezing NHS budgets for the next five years.

‘Commissioners are going to need to look at how to invest to save,' Ricketts said.

‘It will probably be five years of restraint on public services. But they are also going to be more interested in sustainable services. Social enterprises can do that.'

Delegates also heard from Catriona Patterson, DH's social enterprise unit's head of NHS pensions, who said DH was still attempting to solve pension problems raised if NHS staff moved into social enterprises.

Further announcements were due in June, she said.

• NHS Networks was set up to allow those working in or interested in the NHS to share ideas and already has around 900 members. To find out more about how to join the network, visit www.networks.nhs.uk