Back in March 2016 we published this post in which we detailed our own findings regarding the poor utilisation of the social value Act in health commissioning. We found social value similarly absent in STPs (Sustainability & Transformation Plans).
It is encouraging therefore to find that new national research — conducted at a scale that local networks like our own could simply not achieve — mirrors these findings exactly.
SEUK has just published Healthy Commissioning: How the Social Value Act is being used by Clinical Commissioning Groups. This finds that of the 209 CCGs in England:
» 57% say they have a social value policy or reference social value in one or more of their procurement policies.
» 43% either have no policy, were not aware of a policy, or had a policy in some stage of development.
» Just 25 CCGs (13%) demonstrated what the researchers described as ‘highly committed, evidenced and active’ use of the Act.
We also found that at precisely the time when we are seeing the NHS put ever greater emphasis on early intervention, preventative services and community-based provision — all areas in which third sector and social enterprise providers are heavily represented — commissioning opportunities for new services are few and the social value Act, which could offer an excellent framework to underpin such procurement, is almost entirely neglected. There are isolated examples of outstanding practice, however. The work being done with third sector partnerships by Dudley CCG — which we documented in its earlier stages here — is certainly worthy of mention.
SEUK’s report says:
“…for the first time in its history the NHS has a vision and goals for bringing the contributions of community groups and organisations into the mainstream…as an essential component of sustainable healthcare – and yet the responsibility for enabling this has never been more obscure and confused.”
The causes of this failure to grasp the potential of the social value Act in health are numerous, of course. Successive waves of reorganisation, financial crisis, and continuing political uncertainty all play a part. But so too, it must be said, does the complex and impenetrable culture of CCGs. While we have spoken to some in CCGs who say they want to better understand the application of social value, we have never been able to find a structured, accessible route to effect such a working partnership.
In addition, as SEUK’s report points out, robust guidance on the use of the legislation has been woefully lacking. Public Health England has published one guidance paper, and the Sustainable Development Unit has also published one. But amongst health sector staff we have spoken to we found that even these limited sources of guidance were little known.
The SEUk report recommends that:
» NHS England and the Department of Health should mandate every CCG to have a social value policy.
» Every STP should have a social value strategy, outlining its plans in relation to the Act.
» The Department of Health, NHS England, NHS Improvement, and Public Health England should disseminate and promote good practice on social value.
» The Department of Health, NHS England, NHS Improvement, and Public Health England should work with the Inclusive Economy Unit to draft stronger and clearer guidance for the healthcare system in relation to social value.
» CCGs should enact the principles of the Social Value Act to goods and works that they buy, as well as services being commissioned, and that the Social Value Act is strengthened to that effect.
Anyone who is trying to stay abreast of the social value debate and any organisation struggling to try and embed social value outcomes in its niche in the delivery environment will find this report useful.