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11 July 2018

Charities and social enterprises now key to public health provision in England

Will Richard, Communications & Engagement Officer

New research shows that third sector organisations are playing a growing part in public health provision in England.

colourful handprint on paper depicting art therapy
art therapy

A new study by researchers from the School of Population Health & Environmental Sciences and King’s Business School shows that third sector organisations are playing a growing part in public health provision in England.

In 2012 changes to legislation spread the responsibility for commissioning public health services across several bodies and required government contracts to ‘have regard to economic, social and environmental well-being in connection with public services’. Although this reorganisation was managed regionally, national constraints on local authority budgets meant that the third sector now plays an increasing role in providing solutions to challenges in public health.

Professor Judith Green, Professor of Sociology of Health at King’s and study author, said:

Social enterprises are playing an increasing role in providing public health. They can provide innovative services, and "reach the parts other providers cannot reach" by working with under-served communities. However, we found increasingly fragmented public health provision, which does raise questions about how to maintain comprehensive, equitable and evidence-based services for the future. Further research is needed to understand the benefits and risks of third sector providers in health economies.

Professor Judith Green

To better understand both the opportunities and risks of this commissioning model, the team at King’s conducted a qualitative study of four South London boroughs (Lambeth, Southwark, Lewisham and Greenwich). From this they identified 24 distinct ‘social enterprises’ that were commissioned to contribute to public health improvement: defining social enterprises as independent, mission-driven ventures that generate income through trading to pursue innovative solutions to existing social problems.

The 24 organisations ranged in size from small start-up campaigns to leisure centre chains with over 6,000 staff and offered a wide range of services including sexual health testing, peer support for homeless clients and therapeutic performance arts.

Commissioners highlighted their flexibility and responsiveness, operating within communities to provide more targeted services. The fragmentation of public health provision, however, makes longer term planning difficult and the sustainability of this model has yet to be assessed.