THE VIEW FROM HERE—A SOCIAL ENTERPRISE PERSPECTIVE

THE BASICS

Your Healthcare CIC is the registered name of our business and is the successor organisation to NHS Kingston’s Provider Services

We deliver services in partnership to a Kingston registered GP community of 187,000 people and to people in Richmond with a learning disability

It is a £25m business employing c550 staff Successful TUPE transfer, A4C and NHS Pensions We are a 1st wave Department of Health ‘Right

to Request’ Social Enterprise organisation committed to the founding principles of the NHS

We will be governed by elected members of staff and the community we serve

January 2008 – August 2010

TU’S

Internal separation

✔

Assessment of viability and

capability

Joint ‘case for change’ road

shows

Independent Options

appraisal

PCT Board confirm their

decision for SE

To the market (or not)!

Business Plan written

TCS – ‘Right to Request’ invoked

(1st)

5 year contract awarded – Mar

2009

Shadow form – April 2009 – July

2010

Tech. Guidance pub. Sept 2009

IBP rewritten Nov 09. Due

diligence tests ✔✔✔

B2B’s at NHS L and SHA Board

July 2010

YHC established Aug 2010

CONSULTATION AND ENGAGEMENT

Working with the representatives of our staff / Trade Unions was a fundamental plank of our process, and our success

Managers and staff identify service specifications

Briefings and Road shows - HR Surgeries

Choosing a name for OUR organisation

Workshop with Leadership and Staffside to develop our form (mutual organisation) and constitution

‘Potential’

SIX MONTHS ON ? Sound and robust governance frameworks, systems

and processes - independently validated (RSM Tenon)

Registered with the CIC Regulator who approved our Constitution to enable us to trade on 1st April 2010

Attained CQC registration

Awarded Social Enterprise Mark

NHS Litigation Authority plus insurance cover in place

Ipsos MORI undertaking a full suite of service surveys – early results are very favourable – above the London comparative average scores (all areas)

MEASURES OF SUCCESS Seamless transition to SE – no impact on

business continuity

Month on month delivery of the financial plan & continued financial viability

We have a history of successful strategic financial management delivering to our forecast, and realising year on year savings. Last year (2009/2010) we forecast a surplus of £873k and delivered £876k

Track record of reinvesting these savings in service improvements for the local community e.g. safeguarding team capacity

We have a legally binding contract not an SLA

MORE SMUGNESSES

Incremental planned business expansion Successful record of partnership

development and delivery Demonstrating improved performance

through effective service quality improvements and productivity benefits as a result of information systems.

Ever improving staff retention and recruitment indicators BUT – brings it’s own problems!

Memorandum of Agreement – Joint statement with Trade Unions

ACHEIVEMENTS

Above 90% of patients referred to rapid response team are seen within 4 hrs.(6 partners in this scheme)

Ability to demonstrate performance by activity and quality by improved data quality (% of appointments without an outcome is below 1%).

Childhood Obesity: Above 95% of children in year 6 and reception are measured and only 6% and 16% in reception and year 6 were recorded as obese in year 2009-10.

Breast feeding coverage for Apr 10 to Feb 11 is 95% with the prevalence target of 75%.

MORE ACHEIVEMENTS Leg ulcer healing rate within 12 weeks is above

65%.

Increased District Nursing productivity by 15%

We win awards for our services – e.g. KU19 and now we’ve started to be asked to judge awards (Young Enterprise Finals & Kingston Business Awards)

Partnership development for Hawkes, with GP’s and Age Concern

REFLECTIONS

Form must follow function

Independent support – people are willing to join you because they think it is a good idea

Remember that the people that ‘sign you out’ don’t know half as much as you do – help them with examples

Be prepared to be met by doubters

Communication, constant, transparent, using different media

FURTHER REFLECTIONS

Make this transformational not transactional where you can

Work with your staff side and full time officers – it’s fundamental - Be Honourable in all your dealings with staff and partners

Get used to the tests (and the criticism and doubt)

Raising your head above the parapet and becoming noticed is scary

But It makes a real difference to the

wellbeing of your patients and people - then it is undoubtedly worth it.

IS IT WORTH IT?WITHOUT A DOUBT

The organisation exists to mutually benefit the owners -Where you have ‘ownership’ you have productivity gains.

We retain our surpluses and these have to be

used to innovate and invest to benefit the members

We can be wholly congruent with the Transforming Community Service (TCS) initiatives without the fear of being sidetracked.

Still experiencing “Policy disconnect”- where other organisations don’t grasp the concepts of Right to Request/Run and providing NHS Healthcare services from outside the NHS

WHAT’S NEXT?

Consolidation and Growth Supporting others of a like mind,

partnerships with other providers/hosting .

Talking to Local Authorities about possibilities

Enabling Potential to find its way Releasing time to care – the “productive

Ward” in both the hospital and the community

Developing the membership base Electing the Governors

With apologies to the Labour Party, Conservatives, Gene Hunt, and Life on Mars

The questions that we get asked most frequently and the answers….

Q: How are you going to transform your services? A: This question assumes that your services weren’t

very good in the first place but it is fairer to say that this vehicle gives us the opportunity to tailor services to suit service users’ needs, to transform our partnerships and business approaches – in other words ‘freedom to act’.

Q: What if a large American conglomerate approaches the commissioner to buy your organisation?

A: The organisation isn’t for sale! It can’t be sold. It belongs to the tax payer.

Q &A’S Q: What are your plans for business growth? A: Strangely no one asks you this in the NHS! YHC has

a target to grow by 2% per year. Our productivity target is much more of a stretch….

Q: Are you too small? A: NO!

Q: Is this the thin end of the wedge to privatisation of the NHS?

A: NO!

Q: What you describe is just like a Foundation Trust; what’s the difference?

A: The overhead costs and the regulatory application.

Q: Why were you prepared to take what many commentators call a bold step without the model being trialled more rigorously?

A: ‘You don’t learn to swim by exercising on the

beach.’(Ronald Cohen 2007)

Thank you