End of Year Review 2015: Health

2015 has been a year where the health and social care sector has made great strides towards opening up discussion about co-operative approaches to care. Health and social care co-operatives looked not only to expand, but to be more open and inclusive, with more opportunities for people to have their say on services.

A new book called The Co-operative Advantage, published in July, referenced The Circle as a model – although not a co-operative – where support is distributed and could ultimately replace residential care.

The Rochdale Circle was also cited as an innovative model for over-50s, based on the premise that people can be each other’s solution. Members enjoy hobbies together, offer lifts, and learn new things as part of a real social network.

Further attempts to expand on the co-operative model of care included the launch of Mapping Care through Co-operatives study by the International Labour Organization, and the establishing of the Forum for Co-operative Approaches in Care by various UK co-op care providers.

There are also plans, spearheaded by ChangeAGEents, to form a guild encouraging dialogue and to share best practice, in an environment where care work is increasingly being contracted out.

Finally, in October, three organisations in North East Lincolnshire entered into a co-operative agreement to cover mental health, community services and acute hospital services in the region. The pioneering agreement looks set to replicated elsewhere in the country.

Key events:

FEB: Simplyhealth named as the UK’s largest healthcare mutual. Read more here.

JUL: Red Cross voted as the Co-op Group’s charity partner. Read more here.

AUG: Mapping Care through Co-operatives study launched by ILO. Read more here.

DEC: Plans made for Co-operative Guild of Social and Community Workers, led by ChangeAGEnts. Read more here.

Highs and Lows:

Cheryl Barrott, Co-founder of Change AGEnts. Chair of Co-ops Yorkshire and the Humber (CYH) Co-founder of Fair Care

Highlights:

“Social co-operation being recognised as an emerging sector within the co-op movement and Change AGEnts having a voice and some influence. The opportunity to work with friends and colleagues to blend the best of the public sector with the best of co-operation and the growing synergy between younger and older people within the movement.

“Also, the Fair Care campaign gaining traction, with opportunities for exciting new social and health care co-op. The buzz around the Co-operative Guild of Social and Community Workers, is creating a space for deliberation, mutual support and potentially a powerful voice for workers and practitioners.

Low points:

The pernicious ageism within the movement. The John Lewis/AGE UK advert, reinforcing ageist tropes to rattle the tin which makes it so much harder to get the empowering messages about ageing across to the more inexperienced members of the movement. The sadness of co-operators focusing on the economic, to the detriment of the social and cultural needs. How some in the movement confuse philanthropy with mutualism and therefore believe failed 19th century charity models can deliver 21st century care co-operatives. Scary!

What would you like to see next year (and how do we get there)?

I hope to see the Guild launched, strengthening the working conditions together with the values and principles of co-operative social and community workers. Also for Fair Care to become the gold standard with a recognised mark established, to enable care co-ops, to meet our economic, social and cultural needs and aspirations, in accordance with the spirit of the co-op values and principles. To see young and older members valued in a movement of all ages and the Forum (social care co-ops) to champion co-operation and co-op solutions to care provision. Another hope is for Co-ops UK to recognise social and community co-operation, engage with and champion social and community workers and our collective approach to delivery.”

Kelly Crowe

CEO of NASHCO

Highlights:

“In 2015 health insurance CO-OPs enrolled a million members, in just their second year of operation. There are countless examples across all CO-OPs that demonstrate the value these insurers provided: from being (in some cases) the only alternative choice to a large, traditional insurer, enriched benefit design, exceptional customer service, and lower premium rates in many markets. In all cases, they offered their members the chance of member governance that has been long lacking in the health insurance industry in the United States.

Low points:

“The devastating outcome of both the risk adjustment and risk corridor programs were more than most CO-OPs, who were already financially fragile, could overcome. Twelve CO-OPs will not be enrolling new members in 2016 and eventually will wind-down operations.

What would you like to see next year (and how do we get there)?

“We would like to see the Center for Medicare and Medicaid Services (which oversees the CO-OPs and much of the implementation of the Affordable Care Act) make appropriate modifications to the risk adjustment formula to prevent further damage to existing CO-OPs; consider ways to enhance the CO-OPs’ access to outside investment; push out the payback period of the initial start-up loans, which were used to help CO-OPs begin operations.  

These would give the CO-OPs enough additional runway to be successful. 

Marc Bell 

CEO of Benenden

Highlights:

“Benenden helping more people with their health challenges than at any point in our 110 year history. We have been very successful at growing our revenues and balance sheet. Over the last year, Benenden has also diversified its product range with the launch of a new home insurance product, which hit the market back in July.  

“It was also a big year for us in terms of our new relationship with Bupa, who we signed a £200m deal with. 

“One particular highlight has been winning the Moneywise award for the UK’s most trusted private healthcare provider for an unprecedented fifth year.   

Low points:

“It’s been another difficult year for the NHS generally and these problems are not going away overnight. The NHS is being crippled by the current epidemic of lifestyle diseases and non-essential procedures, which place it under enormous financial burden.  As an organisation which is complementary to the NHS, at Benenden we very much want to ensure that the NHS has a sustainable future and to have conversations around how mutuals can help in the support of this, for example looking at alternative ways of funding the service.

What would you like to see next year (and how do we get there)?

“More progress being made in the use of the mutual model for the provision of healthcare. If we look to the success of our mutual colleagues in Europe, where the mutual model is well developed, we see mutuality in healthcare is a sustainable option. To achieve this, we need to continue to explore new ways of delivering elective healthcare and to engage with policy makers to educate them about the benefits of working with not-for-profit organisations like Benenden.

“At Benenden, we’ll also be looking to improve our service offering to members next year. One of the main things we’ll be focusing on is capitalising on the £45m investment we’ve made to create a leading independent hospital and a flagship facility for members in Kent.”