In the White Paper Equity and Excellence, the government announced its ambition to establish the ‘largest and most vibrant social enterprise sector in the world’. Social enterprise in health care explores the organisational and leadership changes that will be needed to support the development of social enterprises and makes recommendations that will be of particular interest to policy-makers and health care providers.
Based on the responses of a small group of directors of social enterprises and chief executives of acute and mental health foundation trusts, this paper explores the motivations for becoming a social enterprise and whether their ambitions have been realised in practice. In particular, the paper looks at the impact of social enterprises on the financial framework and on employees’ attitudes. One of the aims of the health reforms was to give greater autonomy to providers, but there is considerable uncertainty about how such organisations would develop and function. Interviews with the chief executives of foundation trusts showed they were receptive to the social enterprise model in principle but had concerns about the scale of change needed and about whether it would detract from the underlying intention – increasing staff engagement in decision-making.