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Heallthy Commissioning: How the Social Value Act is being used by Clinical Commissioning Groups

Social Value refers to wider financial and non-financial impacts of programmes, organisations and interventions, including the wellbeing of individuals and communities, social capital and the environment. The Social Value Act requires those who commission public services to think about how they can also secure wider social, economic and environmental benefits. Before commissioners start the procurement process, the Social Value Act requires them to think about how the services they are going to buy, or the procurement process they are going to use to buy them, could secure the most valuable benefits for their area. Consideration of Social Value complements and contributes good commissioning.

Reviews of the Social Value Act have suggested that it is not widely used in the NHS. Social Enterprise UK and National Voices decided to test this assumption by using a Freedom of Information request to gather information on how the 2092 Clinical Commissioning Groups (and their commissioning support units) are using the Act.

The Five Year Forward View that set the direction for current NHS reforms seeks to safeguard the sustainability of health services in part by establishing new relationships with people and communities. A series of in-depth reviews have recommended much greater use of the Social Value Act as one tool to enable these relationships.

Our assessment of CCGs’ state of readiness with regard to the Social Value Act is, therefore, a significant measure of capability for achieving the system’s stated vision and goals.

As the key findings below show, we found that, compared to local authorities, CCGs’ use of the Social Value Act is limited, even though awareness of it is high. Only a small percentage of Clinical Commissioning Groups apply the Act actively and assertively. Good practice does not extend much beyond areas which have historically demonstrated partnership working, or those areas which have benefited from programmes designed to support social value commissioning.

It appears to be the case that the Act is used predominantly at the pre-commissioning stage, in service design. This is a perfectly legitimate use of the Act (indeed, some would say this is its most appropriate use); but it does mean that it is harder to demonstrate cause and effect between the Act and the outcome for the service.

Where there is social value weighting in a procurement, it is typically low. This suggests a certain apprehension about using the Act, or that social value has a low priority compared to other factors.

CCGs’ appreciation of what social value can be used to achieve focuses on the ‘social’ dimension. In common with much of the rest of the public sector, social value tends to be seen as a way that small, local, often BAME or voluntary sector providers can be supported. This is a relatively conservative approach. The Act could be used more fundamentally to shape the nature of local healthcare economies. The NHS could learn much from some of the progressive local authorities in this respect.