Right to provide – what it means for host organisations

What is the right to provide?

Announced in March 2011, the right to provide (R2P) 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 ‘spinning out’ of the NHS and setting up their own organisation.

Specific programme objectives include:

• Enabling increased diversity of care provision
• Delivering increased efficiency and improved quality
• Enabling patient choice; and
• Supporting QIPP objectives and delivery of the Foundation Trust pipeline.
This policy builds on the success of the Right to Request scheme. From 2008-2011 almost 25,000 NHS staff will have moved into social enterprises and have consequently taken over the community services they provide, delivering tangible benefits to patients, staff and their supporting host organisations.

Health and social care staff interested in exercising the Right to Provide are invited to submit expressions of interest (EOI) to be considered by their organisation’s board by 31 December 2011. Applications can be made by an individual or a team. They may cover a single service, a number of services or be built around a specific care pathway.

What are the benefits?
Staff-led enterprises not only improve staff commitment and engagement, but can deliver real long-term value to your trust. With the freedom to develop more innovative and flexible services, patient outcomes are likely to improve. Supporting an individual or team with their application, can help you meet QIPP objectives; improving quality as well as reducing your overall service costs.

What does this mean for you?
As an NHS Trust, your trust board should review and consider any EOIs received. The final decision will be subject to assurance from your strategic health authority (SHA).

• We would encourage you to work in partnership with the trust communications team, to explain the right to provide programme to your staff, and the process for submitting an expression of interest, including any supporting board documentation that may be required.
• Directors are encouraged to act as sponsors for EOIs. Encourage teams who are considering submitting an EOI to discuss their proposal with you at an early stage. Help them to think through questions such as: does the proposal help the trust to meet QIPP objectives? Does it support service transformation? Will it help us meet our local priorities? How will they measure quality outcomes? Does it support the Trust’s plans to move towards being a Foundation Trust?

Reviewing expressions of interest
• The board can ask the Right to Provide lead and service team to resubmit their expression of interest if you feel that there are gaps which need to be addressed. It is important to remember that an EOI will only contain outline proposals rather than full detailed plans.
• If the board decides to support an EOI, the next stage will be to ask the Right to Provide lead (and service team) to develop a draft integrated business plan. It is important to note that approving an EOI does not mean that you have agreed to the establishment of a staff-led enterprise., but you are responsible for ensuring that the relevant guidance and support is made available to staff. The plan will help determine whether the proposal is viable, including full details of costs and governance arrangements
• If the board rejects a proposal, you are asked to give detailed feedback to the staff concerned to explain the board’s decision.
• Once an expression of interest has been discussed by the trust board, the EOI should be shared with your SHA. The SHA will then assure the board’s decision.

Whilst it is important that once an EOI is approved your staff are supported locally to develop a business plan, they are also able to apply to the Social Enterprise Investment Fund for a grant to enable them to develop their proposal and to buy in, for example, financial and legal expertise.

Find out more
The Department of Health offers comprehensive guidance on the Right to Provide policy and links to other resources in ‘Making Quality Your Business – A guide to the right to provide’

The Department of Health will also be happy to discuss any queries you might have. If you need help or advice, you can contact socialenterprise@dh.gsi.gov.uk

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