Moving from working in the NHS to work in social enterprise, Karen Jackson, chief executive of Locala CIC, reflects on what she has learnt from working in a community interest company, and the opportunities to deliver better quality out-of-hospital care through stronger partnership working.
Having worked in the NHS, namely hospital services, for over 25 years I took the positive career decision to move outside the NHS family last year to join Locala CIC.
The time seemed right for me to learn more about ‘out-of-hospital’ services delivered in our communities rather than expressing opinions from afar, which, on reflection, were often misguided.
It was a bold step – but I’m delighted to say I have been welcomed wholeheartedly by my peers in Kirklees and the ‘Locala family’ and any nervousness I had about a slight change in direction have been diminished.
It’s fair to say I have learned a lot about the power of inclusion and the complexity of out-of-hospital care and most importantly the need to meet people’s needs in the communities and neighbourhoods where they live and in their homes.
What is a CIC?
Locala CIC delivers adult and children community services across Kirklees and also some in Calderdale and Bradford. As a community interest company (CIC), we are listed at Companies House and are a social enterprise. This means our members (staff, partners and community leads) are required to use any surplus funding and assets for public good.
We have a council of members drawn from colleagues, partners and the local community. This group sets the direction of the organisation as well has having a number of statutory duties such as appointing the chair or non-executive directors (NEDs). Our board is made up of NEDs and executives. It also includes colleague representation to demonstrate our commitment to our values and that of all staff. We reinvest our surpluses in our services and the local community which we serve. These investments have been wide ranging from the development of Tea and Tech cafes in Dearne Valley aimed at reducing isolation to contributions to local schools, Brownies and various community groups to support communities and young people. All our investment is aimed at ensuring we meet our overarching vision.
How do we work?
Our vision is: Making a positive difference to the wellbeing of the people and communities we serve.
Being outside the NHS while delivering NHS and council-commissioned services brings a unique perspective – it brings an added benefit in that we are able to have conversations between the NHS, council and community organisations in a way that is unusual as we have a foot in all camps (if you can have three feet!). We take our local relationships with our partners and our communities very seriously and I truly believe we all have something to bring to our health and care system – which is all about delivering high quality care to over 450,000 people.
Using this interesting new dimension has allowed us to challenge some of the current ways of working. In Kirklees we now have an integrated provider board which is really driving relationship building, development of trust and importantly ensuring that the Kirklees health and wellbeing plan is being turned into reality with clear, deliverable outcomes.
We have also had the opportunity to build good relationships with many special and inspiring social enterprises around the country and, on talking to them about integrated care systems like the West Yorkshire and Harrogate Partnership, I can confirm that good relationships like ours are not always the case and in many situations they are positively excluded from these important conversations.
Clearing up any misunderstanding
I often find that the role of social enterprises in the health and social care economy are misunderstood, with many confusing our offer with that of a profit-making organisation driven by shareholder needs.
We are also often disadvantaged when tendering for services. For example, social enterprises are not statutory bodies, so unlike our colleagues in the NHS, we must pay VAT on any of the contracts we deliver. This can sometimes make it difficult to deliver good quality services within tight financial constraints. Unlike other NHS organisations, we cannot access additional sustainability funding, and we must balance the books at the end of the year. This environment means we must work in a much more agile and innovative way.
The latest guidance on integrated care provider contracts indicates that the contracts can only be held by statutory bodies. Social enterprises are effectively excluded from leading services across systems and pathways for the patients that we serve. In West Yorkshire and Harrogate, Locala is working as part of the WY&H partnership to further develop relationships with a wide range of partners in the community.
Despite these challenges, the social enterprise sector is creative, inspiring and developmental in a way that sometimes statutory organisations are not able to be. We can often be more flexible in how we use our funding and deliver our services, and our staff often describe how good it feels to work in leaner, more agile organisations.
Locala is a learning organisation and we are very keen to share good practice and learning much wider than within our own organisation.
Karen Jackson is chief executive of Locala CIC. Follow them on Twitter @locala