What Is A CIC & Why It Matters

NHS Kingston's Board took the decision in July 2008 to create a social enterprise to deliver its frontline services, following an appraisal which identified this as the most effective way of delivering high quality services for local people. In July 2010, NHS London (Strategic Health Authority) signed out the social enterprise, Your Healthcare CIC (Community Interest Company), and it went live as a standalone organisation on the 1st August 2010.

NHS Kingston was the first PCT in London and second in the country to separate its provider arm from its commissioners to become a not for profit social enterprise. This followed the introduction of the Department of Health’s ‘right to request’ facility (November 2008) and the publication of the Transforming Community Services guidance (DH January 2009). Your Healthcare comprises a range of clinical and business support services aimed at the delivery of local ‘needs based’ health and learning disability services.

Why a social enterprise?

This was based on Kingston's rationale that:

• Changing to a social enterprise would cut bureaucracy and create a more flexible and responsive organisation delivering excellent quality local services at a competitive price
• Surpluses from efficiency savings could be reinvested in the local services
• It encouraged more involvement from the community – as staff, local patients and carers could be members of the social enterprise
• Comprehensive engagement with the social enterprise’s staff and patients would lead to more informed, better specified services for the local population

From 1 August 2010, all 187,000 people registered with GPs based in the London Borough of Kingston and some people in Richmond now receive community-based healthcare from Your Healthcare. The social enterprise delivers a full range of services to the General Practice (GP) population of the borough of Kingston and for people with Learning Disabilities in the borough of Richmond. In addition, it provides a broad range of infrastructure and business support services.

Broad range of services which includes:

• Healthcare services for adults with a primary focus on providing support for people with long term conditions and end of life care
• Specialist healthcare services for adults with learning disabilities. Integrated with RBK Care Managers (Kingston)
• Continuing Care assessments for people living in nursing homes (Kingston) and co-ordination of these assessments for people registered with Kingston GPs
• Enhanced services provided in Kingston and Richmond for people with learning disabilities who have complex and challenging needs 
• Specialist assessment and intervention services for people with learning disabilities both in the community and when appropriate at the Francis Centre
• Registered Care Home for eight people with learning disability and complex healthcare needs
• A 50 bedded intermediate care/rehabilitation nurse and therapy led unit for adults over 18 years. Includes six stroke rehabilitation beds 
• A multidisciplinary intermediate care team providing rehabilitation at home and facilitating discharge from acute settings and preventing unnecessary hospital admission
• A range of out-patient services provided at Cedars' Unit, Tolworth hospital, and in community clinics. These include:
  • x-ray 
  • ultrasound 
  • Podiatry 
  • Musculo-skeletal physiotherapy 
  • Speech and Language therapy 
  • Continence 
  • Leg Ulcer Care 
  • Specialist diabetes services 
  • Cardiac rehabilitation
    
    
• Nurses providing specialist advice and support to clinicians in all services. These include:
  
  • Infection control 
  • Tissue Viability 
  • Continence
    
    
• A health visiting service that is a universal service provided to all families in Kingston.
• School nurses providing care to school age children. 
• Advice on a range of health related issues including sexual health to young people under 19.
• Speech and language therapy assessment and treatment for children 0-19 years
• A tier 2 contraception service in a community clinic and outreach services.

How we work

The clinical services provided by Your Healthcare are highly integrated both within Your Healthcare, but also with other services e.g. Royal Borough of Kingston, Kingston Hospital Trust and voluntary organisations e.g. Age Concern Kingston.

Provider Services Managing Director Siobhan Clarke became MD of Your Healthcare and John Tate its Chair. At Board level there are two Leads for Clinical Services who are each responsible for a portfolio of services, long term care services, and short term care and universal services. These portfolios are interlinked on many levels and the Board Leads work closely to ensure the development of integrated care pathways that benefit all patients and service users.

Staff and Membership

A total of 587 NHS staff transferred to the new organisation but retained their terms and conditions including NHS pensions, which are also available to new joiners. it has been ‘business as usual’ for Your Healthcare’s patients and service users, who receive the same services as before with the same staff.

Patients and the local community, along with staff, are invited to become members of the new organisation, the aim being to give them greater involvement in their local health services, allowing them to influence how public money is spent, and provide better services for residents.

Reinvestment to enhance community services

As a not-for-profit body, any financial surpluses are re-invested back into services for the patients. The organisation’s history demonstrates its ability to achieve an annual surplus to its forecast target. Financial surpluses will be re-invested back into the organisation’s services to enhance existing service delivery and to pump prime new service development.

Your Healthcare has an operational budget of £24.7m. £20m of this is from NHS Kingston’s commissioners. This represents 9% of the total health budget for Kingston residents.

In creating this new business, the organisation has been subject to a range of local and national assurance processes that has enabled it to develop a business that is clinically, financially and managerially viable. Throughout 2008/09 and into 2009/10, 2010/11 and to the current day it has worked hard to reassure its staff, service users, NHS Kingston (its host NHS body) and NHS London that it is a viable, safe and effective business that guarantees the future delivery of community based healthcare services in Kingston and beyond. 

For more information please visit the relevant pages on other areas of the website.

Siobhan Clarke - Managing Director Your Healthcare 020 8339 8068
siobhan.clarke@yourhealthcare.org