Establishing social enterprises in health: learning the lessons for DPULOs

I blogged recently on the King’s Fund’s recent interesting report on “Social Enterprise in Health Care”. (What can I say: I’m not the sort of person you want to get trapped in the kitchen with at a party.)

In that post, I highlighted that the King’s Fund wants to create conditions in which social enterprises can flourish and grow, and said that this would also have a beneficial impact for Disabled People’s User-Led Organisations (DPULOs).

I thought it would be useful, then, to highlight some of the other points that the report highlighted more widely, since many of these are relevant to DPULOs as well – either specifically within health or more generally across the various parts of the public sector DPULOs can work in.

External factors

The regulatory environment and access to finance act as barriers to the growth of social enterprises. The Social Enterprise Investment Fund (SEIF) partly addressed these barriers by providing £8.3 million to ‘Right to Request’ applicants. (The Strengthening DPULOs Programme, through its Facilitation Fund, acts in a similar way.). The support offered through the SEIF, though, was under pressure since there were more requests to it than it could meet. Other financial barriers that can be addressed can be indirect barriers: for example, removing taxation constraints.

Furthermore, understanding and addressing barriers can be and is being done in non-financial ways. For example, the Cabinet Office provides an information line and web service for social enterprises. Similarly, they have set up a mutuals taskforce to reduce some of the red tape social enteprises face, and have established “pathfinder mutuals” – organisations which are becoming mutuals and receive support, and via which learning about and solutions to problems they face will be highlighted.

Wanting to become a social enterprise is sometimes the “least worst” option, often motivated by being led by the ‘right’ sort of people instead of being taken over or merging with the ‘wrong’ sort. Other motivations for wanting to become a social enterprise include wanting to be more autonomous, to speed up decision making and to reduce bureaucracy.

Internal factors

Structural changes to organisations that happen from the top down – for example changing structures or governance documents – are not as effective as creating employee-led (and possibly by extension, user-led) initiatives. Engagement should be driven from the bottom up and be a permanent feature of the organisation’s culture and structure.

This said, supportive legal and financial frameworks were an essential ingredient in building the platform for engagement. Similarly, dedicated business support that offers advice and input specific to learning and development around social enterprises (and thus user-led organisations) is most beneficial.