UPDATE 04/04/16: Further to the post below, we now have a survey online aimed specifically at health commissioners and practitioners. It only takes a few minutes to complete. If you are able to pass this link on to health colleagues that you know this would be much appreciated. Many thanks. (Documents summarising key findings of our research and which inform this survey can be downloaded here in a zip file.)
Recently, as part of continuing work funded by The Barrow Cadbury Trust, we have been looking specifically at how social value is being used in health — including surveying almost 50 social enterprises involved in tendering for health-related contracts.
Read on for more about what we found out.
1. Social value in health – the current state of play
The health sector generally is lagging behind in its implementation of the social value legislation. Social value is not widely understood in health and some practitioners do not realise that the legislation applies to health bodies. Lord Young’s review of how the Public Services (Social Value) Act 2012 is being implemented reached a similar conclusion.
Health bodies that are making progress are starting to follow guidance from Public Health England which frames social value in the context of the Marmot Review and recommends specific social value ‘activities’ in health commissioning that can help address health inequalities and the social determinants of health.
It is disappointing that this guidance is not being more widely used and that the health watchdog bodies, including Healthwatch, are not doing more to advocate its use.
And even where health bodies are making good progress on social value — and here are some examples — they seem more likely to do so if they have been able to access additional ‘project’ resources to help make this happen.
2. What social enterprises and voluntary organisations involved in health commissioning are saying
We surveyed almost 50 social enterprises, over half of which had tendered for a health contract in the past twelve months. They reported that information about new tender opportunities and about what is to be commissioned is hard to find.
They also reported that commissioning specifications are frequently unclear about the additional social value commissioners want to achieve. In fact, only 4% said that in their experience contract specifications were “consistently clear” about social value. 50% said they were “sometimes clear”, and 27% said they were “rarely clear”. This makes it extremely hard for those organisations who really can deliver on social value to do so in a meaningful way.
In addition, few invitations to tender specify how social value should be demonstrated or reported, and even where new methods for capturing social value are emerging — such as the PSIAMS personal outcomes software, now in use in Dudley, Wolverhampton and Birmingham — commissioners are not always aware of these and do not necessarily recognise the information they can furnish.
The financial pressures facing the health sector are so great, and the new landscape of health so complex (as this brilliant King’s Fund animation shows), that social value is struggling to gain any traction at all.
There are huge opportunities for the health sector to work collaboratively to develop meaningful approaches to social value, but this is only happening in isolated instances — and even then, social value is likely to be treated as a “special project” rather than a core responsibility, as the legislation requires.
While social value cannot solve the current health crisis it does offer commissioners a means of extracting greater value from procurement — while simultaneously helping to address some of the other strategic aims that are right at the top of the policy agenda. The under-utilisation of social value in health represents a very real missed opportunity.
UPDATE 19/04/16: Today we gave a presentation based on this work at the City Drive marketplace event at the Muath Trust, Sparkbrook. If you missed it but want to view the presentation click here.
There is interesting discussion about the role of social value in health — picking up on our work — over on the Inside Outcomes website.