From Civil Servant to Entrepreneur

Posted on 20th February 2012

A new path for service delivery
The train trip from London’s St. Pancras station to Leicester takes about an hour, a pleasant ride through green rolling countryside past towns with marvellously British names like Wigston, Wellingborough and Luton. Then it’s a two minute walk to Dawn Centre and Inclusion Healthcare, a Pathfinder social enterprise project under the Big Society initiative that aims to “improve the health and wellbeing of the homeless and other marginalized groups of people through the delivery of responsive and high quality healthcare services.” Jane Grey is a former nurse with the National Health Service(NHS) who is one of Inclusion Healthcare’s two executive directors. As a nurse, she still spends some of her time delivering services to the centre’shomeless people and learning disability clients. In 2009, she and a GP colleague were running a homeless health care general practice service in Leicester.  Reading government tea leaves, they worried that their service would be dissolved or put onto the open market to tender.  Even worse, as she tells it, they feared that “a private provider would come in and take the service over and maybe not run it to our vision and values.”  Although none of the team saw themselves as business people, they were from civil servant to entrepreneur. A new path for service delivery.  The train trip from London’s St. Pancras station to Leicester takes about an hour, a pleasant ride through green rolling countryside past towns with marvellously British names like Wigston, Wellingborough and Luton.  Then it’s a two minute walk to Dawn Centre and Inclusion Healthcare, a Pathfinder social enterprise project under the Big Society initiative that aims to “improve the health and wellbeing of the homeless and other marginalized groups of people through the delivery of responsive and high quality healthcare services.”  Confident that they knew what the needs were and roughly what it would cost to run the service.  Under the Big Society and related NHS reforms, employees now have the right to ask to run services themselves.  After much soul searching and discussion, there was a team vote and a hundred percent agreement to proactively take the opportunity to become a social enterprise under the Big Society umbrella.  They have been trading for 13 months.  As a result of their initiative, Leicester’s Inclusion Healthcare now has a five-year contract to deliver general practice services to homeless people.  Gray notes that, “Already, we’re in renegotiation to try to extend that period as indeed one should, assuming that we meet our quality agenda and we are delivering all of the contractual requirements.”  Inclusion Healthcare is a Cabinet Office Pathfinder.  As a result of this status, it is getting support and mentorship in areas where the team is relatively inexperienced – such as business management – from KPMG.  Gray notes that being a Pathfinder is “advantageous both for the Cabinet Office, because they get to know what’s happening on the ground, and for us because we’re able to inform policy, raise our profile and have a voice to put the needs of vulnerable and hard to reach client groups on the agenda.”  Inclusion Healthcare hasn’t just been turned loose by the National Health Service.  Many of their key performance indicators were monitored monthly, though that has moved to a three-month assessment that reflects, Gray argues, an increased confidence in the facility’s management.  The organization is target-driven to a degree, though she makes the point that because of the specialized and complex needs of her target community, “there does need to be a certain level of flexibility … to recognize the ‘differentness’ of the client group.”  Legally, Inclusion Healthcare is a registered company.  As a not-for-profit social enterprise any surplus goes back into developing patient services, training and development, and the wider community.  As Gray says, “We manage our books really well and we try to generate some surplus; we don’t call it profit.  It’s not about generating income to increase salaries and get sports cars; it’s about putting it back.”  The organization is starting to think like a business, looking for gaps and opportunities to fill them.  Inclusion Healthcare already has two other contracts, one with the Leicester Partnership Trust to deliver GP services to learning disability clients and another that provides GP services to a twenty-bed facility for people with moderate to severe learning disabilities.  Gray says Inclusion Healthcare will look for more opportunities that allow it to play to its strengths in delivering primary healthcare to hard to reach groups and people who have substance abuse problems. She believes this is a growth area because there is “an over-representation in that client group of people who have substance abuse problems.”  When asked what it was like to go from being a civil servant to a social enterprise entrepreneur, Gray laughed. “(It was) quite scary.  Actually, if I’m brutally honest, it was terrifying and exhilarating at the same time, which I suppose is a complete contradiction in terms.  But the overriding emotion was that it was absolutely the right thing to do.”

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