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The Darzi Report encourages primary care staff to set up social enterprises to deliver services. David Dawes offers advice on how to generate interest in entrepreneurship and prepare staff for the initial stages of the process
THE PUBLICATION last year of health minister Lord Darzi's NHS Next Stage Review has led to a renewed emphasis on the development of social enterprises by front line clinical staff (Department of Health (DH) 2008).
The report states: 4We will... encourage and enable staff to set up social enterprises by introducing a staff "right to request" to set up social enterprises to deliver services.'
Referring to primary care trusts (PCTs), it adds: 1PCTs will be obliged to consider such requests and, if the PCT board approves the business case, support the development of the social enterprise and award it a contract to provide services for an initial period of up to three years' (DH 2008).
Despite the enthusiasm of clinical staff and members of some PCT boards for this proposal, preparation for, and implementation of, social enterprises are complicated.
In the author's experience of supporting people to develop social enterprises, NHS staff tend to be at one of five stages (Table 1).
Taking people from the end of Stage 2 to Stage 5 requires straightforward coaching, specialist business and human resource support, and legal and financial advice, and there are many national and regional organisations that can help PCTs take staff through these stages.
But taking staff from Stage 1 to the end of Stage 2 is a different matter.
Before looking at how to help people move from Stage 1 to the end of Stage 2, it is worth examining some facts and figures about social entrepreneurs, particularly nurses, who comprise the largest NHS staff group.
The International Council of Nursing estimates that between 0.5 and 1.0 per cent of registered practising nurses are nurse entrepreneurs (Sanders 2003).
Two kinds of factors can lead nurses to embark on the entrepreneurial pathway: 'push' factors, such as unemployment or job dissatisfaction, or 'pull' factors, such as market opportunities (Harding 2004).
According to the unpublished findings of an RCN survey of members of its nurse entrepreneurs network (RCN 2006), there have been nurse entrepreneurs working in the UK for decades....