Marcus Van Hagen Business Manager, Secure Healthcare

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Social Enterprise A Risky Business? A Case
Study On Managing Risk 15 November 2007
Marcus Van Hagen - Business Manager, Secure
Healthcare Mark Johnson - Director, TPPlaw
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• A social enterprise is a business that trades
• with a social purpose.

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• Often the difference between success and failure
  is not that one has better abilities or ideas but
  the courage that one has to bet on ones ideas,
  to take a calculated risk and to act.
• Andre Malraux French Statesman

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• Take calculated risks. That is quite different
  from being rash.
• Gen. George S Patton

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The Scenario

• Barchester PCT is looking to commission
  healthcare services for HMP Casterbridge
• Services currently performed in-house by a staff
  group of around 30 nurses, doctors,
  pharmacists, admin staff some employed by PCT
  some by HM Prison Service
• Healthcare Unit currently turns over 5million,
  occupies facilities within prison. Ageing
  equipment, existing drug stocks, relationships
  with several external suppliers
• Prison Health CIC is interested in bidding for a
  3 year contract

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What is the Commissioner looking for?

• exit strategy from current unsatisfactory
  provision
• high quality service within defined budget
• value for money
• compliance with statutory obligations
• change in service culture
• improved health outcomes

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What is the Provider looking for?

• activities which contribute to our social mission
• an attractive business proposition which will
  generate an income stream and return for
  community and social benefit
• opportunity to innovate and deliver better
  outcomes healthcare and reduce re-offending
• ways to shift the culture by engaging with
  stakeholders staff, service users, other
  agencies
• risks within defined and manageable levels

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What are the Key Risks?

• Strategic
• Financial
• Operational

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Strategic Risks
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Financial Risks
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Operational Risks
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Conclusions

• Failing to Plan .. Is Planning to Fail
• Proper due diligence on the existing and future
  service environment is essential
• Continual joint brainstorming of the risks and
  management approach fosters better partnership
• Social enterprise combines business disciplines
  with a social purpose

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Social Enterprise Can Make A Difference

• From An Inmate
• To Primary Care Trust Managers
• I am writing to praise the professionalism and
  care I have had from the doctors here and the
  detox team. I have been addicted to painkillers
  for 4½ years and never once in all that time in
  prison have I had the level of care shown to me
  that the nurses and doctors have shown. It isnt
  often we got anything good to say about the
  system but when something is working well I am a
  strong believer in credit when credit is due. And
  the detox doctors and nurses, have not messed me
  around or let in any way. In fact the opposite is
  true they have been excellent. And I would
  appreciate some sort of recognition for what I
  see as the excellent services I have had and the
  high duty of care.

14
CEOs Are On Hot Seat Over Subprime Crisis By
Reuters 31 Oct 2007 People can make devastating
mistakes," said Jeffrey Sonnenfeld, co-author of
"Firing Back How Great Leaders Rebound After
Career Disasters". "The critical question for a
board is whether the mistakes were the product of
a fair effort at good business judgment, or the
result of stupidity, corruption or cronyism."
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Darzi calls for greater private sector
involvement in NHS The private sector's role in
the NHS has been affirmed by Lord Darzi, the
minister responsible for the health service's
'Next Stage Review'. Darzi recommended in his
interim report that patient choice should be
extended to the "full spectrum of NHS funded
care, going beyond elective surgery into new
areas such as primary care and long term
conditions".
Private sector health scheme role to be cut By
Nicholas Timmins, Public Policy Editor November
12 2007 A pioneering 700m-a-year government
scheme to buy surgical treatment centres and
diagnostic services from the private sector is
set to be more than halved by ministers. A senior
executive said the companies were now very wary.
There is a trust issue here, he said. We have
been led up the garden path. We are not sure we
want to go up it again.
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A senior executive at Sports Direct, has quit
over her concerns about poor corporate governance
at the sportswear company, writes the Telegraph.
Chris Bulmer, a non-executive director at Sports
Direct said "Independent directors need to
insist on the corporate governance rules being
applied correctly. Otherwise what's the
point?" Share Cast 13 November 2007
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From The Times October 11, 2007 The madness of
feeding this ravenous NHS Camilla Cavendish The
hungry maw of the NHS is swallowing more and more
resources, at the expense of virtually everything
else the health service marches relentlessly on,
having hoovered up two thirds of the increase in
public spending in the past five years.
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Average pay for GPs up by almost 10 to 110,000
a year Ministers argue need for more flexible
working Figures show 1,200 earn more than
200,000 John Carvel, social affairs editor The
Guardian Thursday November 1 2007
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San Francisco Chronicle Prescription drug
spending booms Study finds demand for brand names
driving up costs for all
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Thank you for ListeningQuestions?
Mark Johnson Tel [phone] Email
mark_at_tpplaw.co.uk
Marcus Van Hagen Tel [phone] Email
marcus.vanhagen_at_securecare.org.uk
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Ward bug errors cause 90 deaths
A "litany" of errors in an NHS Trust's poor
handling of the infection clostridium difficile
resulted in 90 deaths, a watchdog's report has
found. The Healthcare Commission called the
deaths at Kent's Maidstone and Tunbridge Wells
NHS Trust "a tragedy". It said nurses at the
trust were too rushed to wash hands and left
patients to lie in their own excrement.
The commission found countless examples of dirt
MRSA ROW SHAMED HOSPITAL TRUST KEEPS BOSS'S
PAY-OFF A SECRET