This report by the Public Policy Institute for Wales (PPIW) reviews the evidence on ways of increasing the role which Social Business Models (SBMs) can play in the provision of health and social care. We worked with experts from Birmingham University to review evidence from other parts of the UK and Europe.
Our report concludes that SBMs can offer benefits over other models of provision but any attempt to increase their role has to address a number of challenges including:
- Fears about job security among staff of existing providers.
- The need for leadership and new skills from frontline staff and commissioners.
- Difficulties combining the skills needed to meet the clinical demands of day-to-day delivery of care with those required to run a business.
- A perception among some commissioners that SBMs are not sufficiently business-like.
- The potential loss of public sector branding which could reduce confidence in SBMS.
- Difficulties demonstrating the benefits of using them and securing backing for SBMs from financial institutions.
Addressing these challenges requires cultural as well as organisational change. However, other countries have been able to overcome them. For example, the Social Cooperative movement in Italy provides an excellent example of the use of policy initiatives which enable SBMs to play a significant role in service delivery. Recent changes in EU legislation have also made tendering and procurement processes more favourable to the commissioning of SBMs which offers a considerable opportunity to move this agenda forward.
In light of evidence from a range of countries, our report identifies a number of actions that the Welsh Government and other agencies might consider taking to help increase the role of SBMs in the provision of health and social care in Wales. The full list of recommendations can be found in the report but key recommended actions include:
- Encouraging the development of consortia of social enterprises in health and social care which would enable providers to pool resources and share costs and risks when looking to take bank loans.
- Giving NHS and social care staff the right and necessary support to deliver services through SBMs.
- Encouraging micro and small social care providers by making government regulatory processes proportional to their needs and resources.
- Changing commissioning and tendering practices including the focus on price and an organisation’s track record which make it difficult for SBMs to secure contracts.
- Providing information and training to commissioners and other purchasers about SBMs and how to work positively with them.
- Providing clear guidance about new EU procurement rules and the potential flexibilities that they permit and new opportunities this provides.