Tag Archives: NHS

Profiteering from the sick and dying

Lucy’s latest blog explores profiteering from delivery of NHS contracts. This blog was first published on the 2degrees network, see https://www.2degreesnetwork.com/groups/2degrees-community/resources/profiteering-sick-and-dying/

At the beginning of the summer there was an announcement that Staffordshire Clinical Commissioning Group plan to contract out their cancer and end of life care to the tune of £1.2bn. By my estimation, given the profit margins of at least 10%, this is at least £120m profit taken out of care services, for shareholders (and could be as much as £240m). I suspect there will be a lot of interest from the private sector as an opportunity to get into this potentially lucrative market.

Almost in tandem with this announcement there was a Daily Mail article which reported survey results showing most people do not care who delivers NHS services as long as it’s free. On the face of this, it is discouraging news for social enterprises. However, if you were to turn this around, given the latest health and care scandals, I’m sure that trust would be the number one priority. Social enterprises with their local knowledge, approachability and transparency are very well placed to engender this. They are not some faceless corporate just after a fast buck, because their number one reason for being set up is to deliver that service to fit their social mission.

I am really encouraged that the Labour Party is now talking about ring-fencing a number of public sector contracts for social enterprise delivery, although this does miss the point that there is an inherent difference in the way that a social enterprise delivers – because of its primary social motivation. I am due to meet with Chi Onwurah and I will be making this point. At least there is recognition that social enterprises do offer a good alternative.

My prediction is that in years to come, we will all be questioning the values (or lack of them) that were used to make public spending decisions.

There must be wider recognition that social enterprises not only often take a lower profit margin, but they are also reinvesting and devising a service that is aimed at the people they serve – a win-win! Just looking at the price and not what’s going on behind the scenes is not good enough. We need commissioners and politicians to understand this fundamental point.


Our NHS: Social enterprise doing it better

I recently met with the team at South East Health – a recently certified social enterprise which is a conglomeration of doctors’ cooperatives, carrying out a variety of services including out of hours care, a roving GP, offender health and they run the NHS 111 service for the Great Yarmouth area (amongst many other things). My meeting was with the whole senior management team and I found the whole experience very inspirational. From my brief immersion, you could tell that there was a really collective effort shared in not only making services better and more joined-up for patients, but also how the reinvestment of profits and the social enterprise model can make a difference for the better.

We shared the frustrations and challenges of the NHS currently and how the bad stories often eclipse the good ones. The social enterprise model has so much to offer in the new contract environment – seeing ourselves as businesses but not at the expense of the care. We need to highlight this more effectively and ensure that good social enterprises like South East Health are on the same podiums as the private healthcare providers who are so effective at marketing their services across Government and the wider world.

They do have good stories too. In the face of so much bad publicity about the lack of performance of the new 111 service, their contract is getting extremely good feedback. But squeezes in budgets, which are facing everyone at the moment, are making life harder and harder as margins are cut. Commissioners need to not only understand the value of a social enterprise approach but also understand the dangers of contracting a substandard service from a purely cost-cutting basis.

It is only by working more collectively and effectively that we can bring pressure and influence to bear. South East Health represents some of the best practice in difficult times – part of a solution to a problem that many are grappling with. We just need more people to know about it. Particularly, as the Social Value Act puts the onus on clinical commissioners to deliver value to the local community.

Sentinel Healthcare CIC is another good example in the NHS, of spending money effectively, trying to ensure value for money and ensuring surpluses don’t go to private shareholders but back into the community, as a certified social enterprise.

This is what commissioners should be looking out for if they’re adhering to guidelines outlined in the Social Value Act. What better way than by looking for the Social Enterprise Mark?

Look for the Social Enterprise Mark