Engaging Third Sector Suppliers to the NHS Sue Baines, Mike Bull and Ryan Woolrych Manchester Metropolitan University

Objectives: Examine expectations that organisations from the Third Sector including social enterprises will compete for contracts to deliver public services. Look at the debates through a lens of entrepreneurship Report how these tensions are being played out in current policy and practice Introduce our 12 month ESRC funded Business Engagement Opportunities Scheme project to look at the issues in Manchester.

Mixed economy of health and social care World Class Commissioning - more providers and more kinds of provider, new opportunities for any sector to meet the needs of users (Department of Health, 2006; 2007) Opening the supply side to new providers to meet increasing demand for personalised services with limited resources (Audit Commission 2007). Partnership in Public Services: an action plan for third sector involvement, Cabinet Office a level playing field for providers, regardless of sector

Claims and counter claims Third Sector able to tackle the most entrenched social and health challenges, and raise the quality of services Opportunities to develop new and relatively reliable funding streams - escape dependency on donations and grants. ‘Trojan horse’ for privatisation of public services (Murdock 2007). Threats to the values of individual organisations, and to the distinctiveness of the sector > like the state and > like for profit business.

TSO perspectives on commissioners Averse to risk, overly prescriptive and didactic - in contrast to TSOs’ ability to respond quickly to unmet need Much positive work goes unrecognised - difficult to demonstrate value in ways commissioners understand. Processes are too bureaucratic Lack awareness of the Third Sector market, prefer to work with big players Lack trust especially of BME groups Don’t recognise difficulty of forming consortia to compete more effectively; consortia and prime contractor arrangements lead to tokenism

Commissioner perspectives on TSOs Still living in a grant culture, too much ‘whingeing’ Not business-like enough, limited experience with commercial business planning, lack sales skills Assert they do ‘good’ while reluctant to specify the value they bring to services Fail to meet governance standards and accountability eg lack mechanisms for handling complaints Write tenders based on what they want to deliver, rather than what the commissioner wants to buy Don’t sufficiently recognise the need for consortia to deliver contracts beyond the capacity of individual organisations Need to learn the commissioners’ language (but expect vice versa)

Becoming more entrepreneurial? Being adaptable and responsive recognising opportunities, creating value, innovative, energetic networking – or weakening of social and voluntary ethos Arguments and tensions eg moving on from ‘grant culture’, demonstrating value to funders, the problems of commissioning processes and size of contracts - suggest ‘service delivery’ outcomes Entrepreneurial themes - expanding frontiers and changing systems - captured in (respectively) consortia building, and response to unmet need.

Concluding points: This is the beginning, comments welcomed Many lenses, many world views Contracting might not be for all Knowledge transfer and critical understanding Some distance to go for all parties