The report authors warn that improved commitment to social value is vital to achieving the Five Year Forward View aim of creating a ‘new relationship with people and communities’ and NHS plans to move to more place-based ‘accountable care systems’. The report also highlights that adequate consideration of broader social value when making commissioning decisions is vital to ensuring that the public pound is used as effectively as possible.

The Public Services (Social Value Act) 2012 requires commissioners to consider broader social, economic and environmental benefits to their area when making commissioning decisions.

The Act was a response to the risk of competitive tendering focusing solely on cost at the expense of other forms of value. The legislation enables the public sector to commission providers who are smaller and community-based, and/or are engaged in social enterprise or not-for-profit activities.

Community-based approaches such as peer support and education for self-management deliver health and wellbeing benefits at low cost. The Act gives commissioners the flexibility to support the voluntary, community and social enterprise organisations that deliver these services.

The researchers found that:

• 43% of respondents either had no policy on the Act; were not aware of a policy; or had a policy in some stage of development.
• Just 25 CCGs (13%) demonstrated what the authors define as ‘highly committed, evidenced and active’ use of the Act.
• Weighting procurement for social value, even amongst the most highly committed CCGs, is limited and low. A pass/fail question or a weighting of 2% of the total evaluation was common.
• Analysis of Sustainability and Transformation Plans found that just 13% mention social value.

Freedom of Information Requests were submitted to all CCGs in England (209 at the time) and received responses from 91% (191).

Don Redding, Director of Policy at National Voices and joint author of the report, said, 'The Social Value Act enables commissioners creatively to shape local non-statutory provision, so as to support people and communities with prevention, managing their health and achieving wellbeing.

'This approach is inherent in the Five Year Forward View, the new care models and the general move towards more place-based and population-focused "accountable care systems".

'The NHS needs a serious review of how it supports commissioners to have the knowledge, confidence and skills to adopt social value these principles and approaches.'

Peter Holbrook, Chief Executive of Social Enterprise UK said, 'This is the first research that confirms what we knew anecdotally: that outside of a small number of encouraging examples, the healthcare system's uptake and application of the Act is currently very low. In this way, CCGs are lagging behind local authorities and housing associations in seizing the opportunity that the Act provides.

'The healthcare system needs to tap into the reach and knowledge of the social sector, to join up across services and agencies, and to maximise the value from each pound spent. The Social Value Act can help with each of these.

'It is now imperative that NHS England, Department of Health and Public Health England give clearer guidance to the system as a whole, and demonstrate social value principles in practice themselves.'

In the report, National Voices and Social Enterprise UK recommend that social value to be built into NHS England’s Right Care programme which assists CCGs with commissioning value-based patient pathways. They also call for NHS England, the Department of Health and Public Health England to issue joint guidance on implementation of the Social Value Act. The authors conclude that there must be closer working between the voluntary sector and NHS organisations to deliver greater social value.

Further reading

Social value in social care – new toolkit

Social Value Act – a vital tool for change

Measuring social value: new case studies