Right to provide – what it means for NHS and social care staff

What is the right to provide?

Announced in March 2011, the right to provide builds on the government’s commitment to give public sector workers new rights to provide services through staff-led enterprises. NHS and social care staff can request the opportunity to manage the services or care pathways they currently deliver with the greater freedom and independence that comes from setting up their own organisation.

Why should staff consider the right to provide?

Real influence and control
The programme offers you the chance to have real influence and control over the way services are managed and run. Using your knowledge and experience, you will have freedom to re-design services, delivering care which is truly responsive to local community needs. Innovation is encouraged, and with less bureaucracy, you will be able to make quicker decisions according to the needs of your service users. By establishing a staff-led enterprise, you will decide how profits (or surpluses) will be used to continue to enhance the service, whilst still providing a service that is free at the point of need.

This approach has been pioneered in the NHS through the success of the Right to Request scheme. Introduced in June 2008, the scheme has enabled almost 25,000 NHS staff to move into social enterprises and directly manage services. Collectively, they will provide around 10 per cent of community services across the country.

No red tape
Jane Gray is a clinician at Leicester Homeless Healthcare Service (LHHS), which operates as a multi-agency one-stop-shop for homeless people. Under the right to request, the team officially launched as a social enterprise in September 2010. Jane says,

“The benefits for us are about being able to respond to patient needs in real time and to develop services without having to gain fresh approval. It’s about having the authority to act… We deliver on the front line and see the need and we don’t want to be stopped by red tape.”

Staff who have exercised their right to request see themselves as delivering a public service, but with additional freedoms, less bureaucracy and more accountability. Staff who are already a member of the NHS pension scheme, should be able to remain in the scheme whilst they will still deliver NHS-funded services.

Secure foundations
Increasingly, all healthcare providers – including NHS and independent organisations, charities and social enterprises – which meet the qualifying requirements – will be able to deliver a range of NHS services. The goal is to enable patients to choose from any qualified provider where this will result in better care.

In the long-run, this will bring opportunities for staff-led enterprises to expand and innovate. In the short term there will be a phased approach to extending patient choice with any qualified provider – starting with a small number of selected community and mental health services from April 2012.

In most cases, particularly for clinical services, where there is not an established market, you may be eligible for an initial uncontested contract to deliver. The length of the contract will be dependent on which service you are planning to deliver.

More information about the government’s plans to extend patient choice of provider

Scott Darraugh runs Social Adventures in Salford. Their right to request social enterprise went live earlier this year and already they have been able to expand the services they offer:

“During the last two years we have grown and developed our services. We have been able to increase the turnover of the organisation from £272,000 to almost 1 million through developing a range of income streams for the organisation. Only 63% of our income now comes via our NHS contract and we have been able maintain a surplus of £30K that we have reinvested into new innovative services to support local people.”

Who can apply?
The right to provide programme is open to all staff in health and social care. But the application process will differ according to where you currently work. Whether you are based within:
1. Acute, mental health or community NHS Trusts
2. Social care
3. Foundation Trusts
4. Primary Care Trusts
5. Arms Length Body or Special Health Authorities

More information on each application process

What do I do next?

  • Read ‘The Right to Run’ guide, published by the Social Enterprise Coalition. This is a simple resource to help you decide if social enterprise is right for you. It charts the journey from working in the public sector to starting a mutual or social enterprise, giving practical advice on everything from writing a business plan to bidding for the first contract. www.socialenterprise.org.uk
  • Read the Department of Health guide Making Quality Your Business – A guide to the right to provide’ which outlines the application process as well as giving you some helpful hints and tips.
  • Talk to your colleagues about the possibility of creating a staff led service. Are they supportive?
  • Speak to your manager or approach a member of your organisations’ board. Talk to them about your initial service idea.
  • Work with your director and team to submit an expression of interest (EOI) to the trust board. The Department of Health Right to Provide: Expression of Interest Guidance provides an EOI template and an overview of the information you will need to submit.
  • Your director will help you think through questions such as: does the proposal help your trust to meet their QIPP objectives, does it support service transformation? Expressions of interest must be submitted to your organisation’s board by 31 December 2011.

Andrew Burnell is the Chief Executive of Hull’s City Health Care Partnership (CHCP), which provides NHS services through a social enterprise model.

He says: “If anyone is thinking about setting up a social enterprise my advice would be: get a good strong team around you; enlist the help of people who have been through a similar process and learn from them; and stand your ground – if you know it makes sense to set up a social enterprise, do something about it!”

The Department of Health will support you throughout this process. If you need help or advice, you can contact: socialenterprise@dh.gsi.gov.uk. Support may involve matching you with a local mentor who has successfully been through this process already or reviewing your EOI or business case.

In addition, once your EOI has been approved, you will be able to approach the Social Enterprise Investment Fund for grant funding to help you develop your business case and buy in specialist financial and legal support.

Find out more

Making Quality Your Business

Right to Provide Expression of Interest Guidance

Social Enterprise Investment Fund

You can also send any queries you may have on the right to provide to socialenterprise@dh.gsi.gov.uk

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