SEQOL is a successful public service mutual spin-out providing integrated health and social care and supported employment. It launched in October 2011 as one of the first employee mutual public service spin-outs. The 800 employees (750 FTE) transferred from NHS Swindon and Swindon Borough Council. Early on in its development, we recognised that becoming a public service mutual was more than just a structural change; the heart of any success would be through changing and engaging people.
At SEQOL, we have found that real improvement – in the way services are run and the outcomes for local people – comes from developing an environment in which employees can work more efficiently, apply their insight and skills to shape and deliver more effective services; to be creative and innovative, where their energy and commitment is valued and harnessed. After all, an organisation is not a separate entity – what it achieves, and how it does so, is a reflection of the people who work within it.
From my experience working in health and social care since 1995, initially as a social worker and then as a manager of community health and social care teams, the environment within public services to enable real improvement has generally been inconsistent or lacking. This has meant efficiency and creativity from managers and frontline staff has often been stifled by unnecessary bureaucracy, restrictive operating models and a culture of silo working.
Public service mutuals, with the emphasis on employee ownership, offer a genuine opportunity for employees to develop an organisational environment which enables real improvement in public services to be achieved.
Colleagues in SEQOL have taken this opportunity – and through hard work, commitment and energy are already achieving success in service improvements and new service developments, alongside significant increases in efficiency and productivity.
Importantly, SEQOL is a social enterprise and a community interest company. The combination of a clear social and community focus and the fact employees have a right to buy a £1 share in the company have been important factors in engaging colleagues to develop their new ways of working.
The social enterprise ethos and community interest focus fits with colleagues' professional values and public service commitment. Initially, some employees feared losing their professional value base, and therefore their sense of purpose. For example, some nurses felt unhappy about leaving the NHS. Reinforcing the point to colleagues that they continue to provide public services has been crucial to the development of SEQOL. Colleagues are now expressing a renewed sense and clarity of purpose; they can see the links between their actions, the way services are delivered and the outcomes for local people.
Employee shareholding in the company has reinforced the role each individual can play in influencing and improving services. Not only does this make for a more rewarding work place, but due to a marked difference in how colleagues engage in the business development agenda, employee ownership is having a positive impact on service improvements.
Colleagues know that if their idea stacks up and makes good business sense then it will be given full consideration; ideas and insight from the frontline are recognised as essential for the continued success and development of the company.
Entrepreneurially spirited SEQOL employees initiated the launch of a SEQOL online shop, improving access for individuals and their families to mobility aids and equipment for daily living. This idea was developed by drawing from existing services and a private sector partner.
With a similar patient-care focus and business head, an occupational therapist in our integrated discharge team challenged the fact that the service only ran on weekdays. A pilot of the proposed weekend working proved so successful that commissioners have now agreed to fund it and it is being expanded to include social work as well – giving patients access to the same integrated care model, irrespective of the day of the week.
There are many more examples within SEQOL and other public service mutuals of employees across all roles, actively driving service developments – much more than they did previously. They are the same dedicated, professional colleagues they were prior to spin-out, so why the change in behaviour?
What seems to have happened post spin-out is that, in developing a different organisational environment, colleagues have become re-energised by the possibility of making real improvements to transform service delivery and improve outcomes for local people.
This doesn't just happen. It isn't easy, and it takes determined and adaptive leadership. Fostering a collaborative spirit, framed around employee involvement and influence within decision making, alongside a positive focus on performance, accountability and individual responsibility.
"Transformation" has become an overused word within change management and the public sector. But in the context of public service mutuals it might just redeem its integrity.
Transformation can be achieved by making lots of little changes or by making one big change – but whichever way, to be a true transformation, the difference between what came before and what is happening now has to be palpable. It has to be a change you can see, a change you can hear, and a change you can feel. This is true of SEQOL. And it is true for the other public service mutuals with which I have contact.
The success of public service mutuals is much more dynamic than organisational structural change, because it has at its core people change and engagement; a reconnection of purpose, community focus and a real sense of employee influence and ownership.
Ultimately effective and efficient public services come from putting people at their heart – not just those who use services, but also those whose skills, commitment and energy deliver these services every day.
Katie Taylor-Neale is engagement manager at SEQOL and a Mutuals ambassador.
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