It was excellent to be back in Birmingham for Social Enterprise UK's health and care conference, at the tucked-away gem that is the Priory Rooms, itself a social enterprise. I opened the conference by pointing out that the Priory Rooms was designed to be a place where people could take a quiet moment and reflect - and that hopefully the event would provide people the opportunity to do the same, given the sheer busy-ness and heads-down nature of grappling with the challenges of day-to-day operations. So I tried too to reflect a bit as we went along and capture some points of learning:

 
1) Healthcare isn't the white hospital on the hill - the opening session with Stephen Dorrell (former Secretary of State for Health and current NHS confederation chair) and Lord Victor Adebowale (CEO of Turning Point and our own new chair) made two things very clear. The first is that there is a cultural shift that needs to take place for everyone that 'health' is not something that happens (only) in a hospital - but something that is part of the general web of our lives: in our workplace, our leisure, our interactions and our homes. This was a theme throughout the day. The second was that social enterprise has a significant role to play in this broader health landscape - one only had to look at the sheer breadth of services provided by those present: from parenting to psychology and from mental health to musculo-skeletal therapy. We need to be ambitious about the role for social enterprise.
 
2) New structures are coming...but they need work - as ever with a health conference, the air was peppered with sets of initials. Once it was SHAs and PCTs, then CCGs and CSUs, but now all the rage is ACOs, MSCPs and STPs - or accountable care organisations, multi-specialty community providers and sustainability and transformation plans to you and I. Our session on the latter made clear how difficult it has been for even the largest social sector providers to get round the table (as Steve Waite of Livewell SW made clear), and there are still systemic issues - if STPs are to achieve their objectives in terms of patient outcomes, improved services and savings, then the wider social sector has a key role to play. But at the moment, in most STPs, the money and power resides with the acute hospital (CEO) - who has the least incentive to see money reallocated away from them and into preventative and integrated services. Of course that isn't true everywhere, but the myth that aggregation will lead to better join-up is, well, a myth. Without social sector engagement and involvement in leadership and flow/reallocation of resources, in most places, the necessary changes will struggle to take hold.
 
3) We shouldn't leave isolation alone - whether hearing from Steve Gilbert, the 'Lived Experience' consultant to the Mental Health Commission in the West Midlands, or his colleague Sean Russell on how low-level isolation and mental health issues can rapidly escalate into physical health...or viewing the evidence from Anita Charlesworth of the Health Foundation ("we don't need a chart to tell us loneliness is bad for us...but here it is"), isolation, connections, networks and the web of family and friendship relationships can't be underestimated in the wider policy context of health and care. Again, there is a huge role for social enterprises that are embedded in their communities to play.
 
4) The big and small can be more mutually supportive - one theme that emerged in an afternoon session I chaired on social enterprise in primary care (with the great Jayne Hiley from ACE), amongst much else of interest (recruitment, workforce challenges, a wave of retiring GPs, the importance of location), was the need for smaller and larger social enterprises to work better together. Either in gaining access to key conversations, getting broader support (back office, event space etc) or from more direct resourced relationships. One social enterprise there was talking about how they had mapped local social sector providers who were aligned to their mission and built relationships with them ahead of reinvesting their profits back into them and the community. More for us to do here to be that local as well as national broker.
 
5) Keep pushing on, keep going, keep inspired - the conference ended with an amazing talk from the inspiring Kibret who established and has grown the first Ethiopian social enterprise ambulance service (in the absence of any national / public provision). He uses a cross-subsidy model, and now has a fleet of 11 ambulances, 2 mopeds and has aspirations on an air ambulance soon. And all this in a country which has no recognised legal structure or infrastructure for social enterprise. A genuine privilege to have him at the event - and it helped place all of our own challenges in context and perspective.
 
I'm quite sure other attendees would come away with 5 different reflections: many thanks to all the speakers, to Bates Wells Braithwaite for their support, and for all those who made it such an inspiring and informative day. Now to translate some of what we have learned back into our work...
5 quick reflections from Social Enterprise UK's latest health conference from Nick Temple, Deputy CEO.