Health Q&A
Right to Request
Q: What is the Right to Request? How successful was it?
A: The first policy of its kind in the world, the Right to Request (R2R) includes over 40 diverse projects from single service lines of 4 staff and a turnover of £400,000, to provider arms with over 2,000 staff with projected turnovers of close to £100 million.
Forty of these social enterprises are already live with the remaining going live over the next few months. Many of the R2R social enterprises have already won new contracts and are expanding their services in exciting and innovative ways.
Q: If social enterprise is such a big part of the Big Society concept, why did the Right to Request scheme close in September 2010?
A: The Right to Request policy was developed as a mechanism for front line PCT staff to put forward proposals to create social enterprises, in line with the
Transforming Community Services: Enabling New Patterns of Provision, issued in January 2009, which set out the requirement for Primary Care Trusts (PCTs) to agree the future form of their community services.
The revised Operating Framework restated that splitting Primary Care Trust commissioning from the provision of services by April 2011 remains a priority and that PCTs should continue their work to develop and review proposals for the divestment of their community services.
Direct provision is no longer an option in a future NHS of autonomous providers, freed from PCT control.
Right to Provide
Q: What is the Right to Provide?
A: The Right to Provide (R2P) builds on the success of Right to Request programme, extending the right to wider NHS and social care. Secretary of State for Health, Andrew Lansley, announced the Department of Health’s Right to Provide policy on
The Government is committed to the Big Society approach, making public services answerable to the people that use them. R2P devolves power to front line staff at a local level who know how things can be done better and gives them the opportunity to put their ideas into practice.
Q: Who is eligible to apply?
A: The Right to Provide in health, public health and adult social care applies to most services, excluding those where it would not be possible to mutualise because of security or operational reasons. Options of different organisational models include cooperatives, staff-led mutuals, partnerships and joint ventures.
Staff delivering health and social care services for Local Authorities and Foundation Trusts (FTs) may be interested in the policy and the opportunity to develop services with partners. FTs may be interested in using the policy to encourage innovation and the development of clinical leadership.
Staff who work for NHS Trusts currently in the Foundation Trust pipeline however, are not eligible to use the Right to Provide mechanism for mutualisation.
Q: When’s the closing date?
A: NHS Trust staff had until
Q: Will you be publishing the names of those services pursuing the right to provide?
A: A list with the current selection of the projects progressing under the scheme will be published on the Cabinet Office Mutuals Information Service website and updated as and when appropriate. NHS Trust staff had until the
Q: Isn’t this just more privatisation?
A: No. Social enterprises share the same public sector ethos as the NHS. They re-invest surpluses into services and the community; they do not use surpluses to pay shareholders.
In addition to improving services, social enterprises can contribute to the wider regeneration of communities. Public money spent commissioning social enterprise contractors often achieves social benefits beyond the service directly procured.
Q: What support will be available to services that want to go down this route?
A: The Department of Health produced a technical guidance document ‘Making Quality Your Business: A guide to the right to provide’ as well as an Expression of Interest template, for health and social care staff wishing to pursue the Right to Provide. These can be found on the DH and CO websites.
Q: What happens to my pension under the scheme?
A: Assuming that you continue to provide NHS-funded services and you set up an appropriate legal form, such as a social enterprise, you should maintain your eligibility to continue to be in the NHS pension scheme if you are at present a member of it. More information is in the pensions annex of ‘Making Quality Your Business: A guide to the right to provide’. However, this and the preservation of your terms and conditions may be important factors in your decision to exercise your right to provide.
Q: Does it matter what size organisation I am looking to set up? Will I be rejected if it is too small?
A: In short, no. The key to any expression of interest is the business model / business case, not the size of the proposed organisation. There are a wide variety of different sized organisations set up as a result of the right to request scheme, ranging from organisations with just four members of staff, up to larger organisations employing over 2,000 people.
Q: Why does the Government intend to encourage the development of social enterprises?
A: Social enterprises offer many benefits, including empowering staff to enhance the quality of local services, enabling decisios to take place at a local level, contributing to the wider regeneration of communities, boosting social includsion and tackling unmet needs by delivering services to communities that often receive litter or no support.
Our ambition is to create the largest and most vibrant social enterprise sector in the world. The government supports the creation and expansion of mutuals, co-operatives, charities and social enterprises. We want to enable these groups to have much greater involvement in the running of public services.
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