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

The Department of Heath wants to create the ‘largest social enterprise sector in the world’ by liberating foundation trusts and handing over services to NHS staff.

In today’s launch of the Department of Health’s (DH) white paper Equity and Excellence: Liberating the NHS, health secretary Andrew Lansley said power would be devolved from Whitehall to patients and professionals.

The paper spells out the department’s plans to make the NHS more competitive, with providers being more accountable and transparent. There will also be a new role for local authorities to break down the silos of health and social care. Giving GPs the responsibility for commissioning care in their local community and giving patients more choice and control of their care are also part of DH’s vision of service reform, along with cutting red tape by phasing out primary care trusts and strategic health authorities.

The paper states that DH’s ambition is to ‘create the largest and most vibrant social enterprise sector in the world’.

‘The government’s intention is to free foundation trusts from constraints they are under, in line with their original conception, so they can innovate to improve care for patients. In future, they will be regulated in the same way as any other providers, whether from the private or voluntary sector’ it says.

‘As all NHS trusts become foundation trusts, staff will have an opportunity to transform their organisations into employee-led social enterprises that they themselves control, freeing them to use their frontline experience to structure services around what works best for patients.’

However, the paper adds that DH recognises the employee-led model may not be suitable for all providers, such as small, community organisations.

Launching the paper, Lansley said: 'The government’s ambition is for health outcomes – and quality services – that are among the best in the world.  We have in our sights a unique combination of equity and excellence.

'With patients empowered to share in decisions about their care, with professionals free to tailor services around their patients and with a relentless focus on continuously improving results, I am confident that together we can deliver the efficiency and the improvement in quality that is required to make the NHS a truly world class service.'

The white paper has been welcomed by the Social Enterprise Coalition (SEC), but CEO Peter Holbrook said there was some confusion over the role foundation trusts and social enterprises will play.

‘SEC welcomes the high level commitment outlined in the white paper. However, there does seem to be some confusion as to the differences between Foundation Trusts and social enterprises,’ he said.

‘There needs to be greater understanding of the differences between these two organisational forms and the different roles they can play as part of the landscape for healthcare in England.’

He added that GP commissioning could create further opportunity for social enterprise, but warned that there needed to be a ‘considerable shift’ in GP capacity to give smaller social enterprises a chance.
‘Without this there is a considerable danger that the market will be dominated by large providers that will stifle innovation, limit choice and squeeze out smaller, local providers who may be best placed to deliver the improved health outcomes the government wishes to see,’ he said.

Dr Peter Kyle, deputy CEO of chief executives’ body Acevo, said Lansley’s reference to the government’s vision of creating the largest social enterprise sector in the world is ‘precisely the kind of commitment Acevo has been calling for’. However, he reiterated Holbrook’s concern that more information was needed about how GP commissioning would work.

A DH consultation on the white paper is now due to take place.

Equity and Excellence: Liberating the NHS can be downloaded below.